BC compares coronavirus case rates to hardest-hit regions in the world

BC Health Officers have released new modelling surrounding the COVID-19 pandemic, stacking British Columbia’s growth rates of the virus against other countries around the world.

Dr. Bonnie Henry, BC’s health officer, told reporters during a press conference that the information compares what’s going on in the province and “pulls it together with what is happening around the world.”

The data released on Friday compares BC’s growth rates against South Korea, Hubei, and Northern Italy. Health officials then apply each jurisdiction’s respective scenarios to BC’s population and assess the different hospitalization requirements for critical and non-critical care.

“Our rate of growth is being impacted in a positive way by the measures we’ve adapted in the past few weeks,” said Henry. “We’re not out of the woods by any means yet and we’ll have to track carefully over the coming weeks.”

She stresses, however, that this is modelling is strictly for comparison and not a prediction.

BC’s trajectory, at this point, is actually lower compared to the rest of Canada, despite being exposed to coronavirus at an earlier point in time. Henry said that measures such as physical distancing and prohibiting large social gatherings have helped to reduce the number of cases.

The province reached two cases per million people on March 4. Restrictive measures around travel, movement, gatherings, and schools were implemented between March 12 and 16.

“It took a bit of time for them to sink in and for people to understand what we’re asking of them,” says Henry.

The incubation period for coronavirus is 14 days, so it’s expected to take several more days before health officials see the full effect of the restrictive measures.

Despite not having complete results, Henry says that the province’s trajectory has reduced. At this point, BC has 130 cases per million people and a 12% daily increase — almost half of what the trajectory would have been (215 cases per million or a 24% daily increase) had these measures not been put into place.

Canada, despite being exposed to the virus later than British Columbia, sees a steeper climb and a 39% daily increase. This could be because Quebec has started to report probable cases as well.

When comparing BC’s cases to the epidemics seen in South Korea, Hubei, and Nothern Italy, they were compared to a 61-day outbreak.

Henry says that at this point, the province is tracking similar to South Korea and says that testing measures have been comparable to theirs. The province is up to approximately 3,000 tests per day, which are mainly focused on clusters of outbreaks and health care systems.

“That’s where we need to make sure we’ve tested everywhere so we can protect our health care setting,” says Henry. “There are many things that could make this shoot up again — even an outbreak that we missed or one in a remote or rural community or a care home.”

British Columbia’s ability to meet hospitalization demand

Health officials say that there are two main focuses when looking at BC’s ability to meet hospitalization demand in the coming weeks.

The first is looking at the capacity for any patients that would require treatment in ICU or acute care units, along with the number of ventilators available for patients.

The second is focusing on the number of beds available for patients that don’t require intensive treatment but still need hospitalization.

Health Authorities have identified the 17 largest hospitals in the province, which are being designated as primary care sites for coronavirus.

The province says that deferring elective surgeries earlier this month was a key move in opening up hospital capacity, gaining access to 3,900 beds in acute capacity and upwards of 371 beds in intensive care units.

If needed, the province also has the capacity to move less acute patients off-site and away from the hospital.

“If we have a surge in a particular hospital, we want to be able to move less acute surgical or medical patents to open up capacity for more COVID patients,” says Stephen Brown, BC’s Deputy Minister of Health. “We don’t think we need it but we’re doing it out of an abundance of caution.”

In terms of equipment, BC says that they have 914 beds that are vent-capable and more than 1,200 ventilators.

The ventilators, however, include ones that are used for transport or neonatal purposes, as well as some that are available at smaller local hospitals and may not be used immediately. There are also ventilators at the BC Children’s hospital that could be repurposed for adults but, for planning purposes, are being held for children and youth.

The total number of hospital beds available, excluding maternity, pediatric, mental health, rehabilitation, and palliative care is 5,610. This includes 1,320 in the Vancouver Coastal Health region and 1,447 available in the Fraser Health region.

Health authorities also say that they’ve created a number of assumptions to create some of these models, which includes assuming that 4.7% of the province will need critical care and 13.8% will need basic hospitalization.

The Interior Health region and Island Health region may have a higher number of critical care patients due to an older demographic.

Brown says that of all the cases in critical care, 80% of them will be ventilated. This is an aggressive number because data from Germany and France suggest that earlier ventilation can have a stronger impact on fighting the virus and infections.

Applying British Columbia’s capacity and ventilator demand to different scenarios

So how would British Columbia fare in terms of hospital capacity and ventilator demand when put in different scenarios? Specifically, if BC’s epidemic were to behave similarly to South Korea, Hubei, and Northern Italy.

If the province saw a scenario that was equal or less of Hubei’s epidemic level, British Columbia looks “reasonably equipped” to take care of patients that need intensive care or ventilators without needing to expand out of the 17 main hospitals.

Should the epidemic escalate to that of Northern Italy, BC would have to use all of its sites to meet bed demand, it would be able to meet vent demand, however, there would be a challenge in transporting patients between sites. The province would also be forced to use beds that are off-site from hospitals to open up capacity for COVID-19 patients.

This planning is based on a “worst-case scenario.”

Health authorities are now focusing on preparing a four to six-week staffing schedule for health care workers which would allow for them to have rest, to be well-paced, and to not burn out.

On Thursday, health officials announced 66 more cases of coronavirus, bringing the province’s total number of known cases to 725.

More information to follow…