Social distancing policies might need extended past April to ensure hospital bed supply

If North Carolina’s social distancing policies end this month as scheduled, there is a 50% chance that hospitals statewide could not handle the number of patients infected with COVID-19.

That is the conclusion of statistical modeling conducted by university and government researchers and released today.

“To save lives we need to make sure we flatten the curve,” said Dr. Pia D.M. MacDonald, senior director and senior epidemiologist with RTI International, based in Research Triangle Park. “The more social distancing, the more lives can be saved.”

Nearly 3,000 people have tested positive for COVID-19 in North Carolina, although because of testing limitations  that is most certainly a vast undercount. About 270 people are hospitalized; 33 others have died from the virus.

Gov. Roy Cooper’s stay-at-home order expires April 29. That order prohibits gatherings of more than 10 people and has closed all businesses except those considered essential, such as pharmacies and groceries.

The researchers emphasized that they aren’t recommending a specific policy; nor are they suggesting the stay-at-home order remain in effect indefinitely. Yet they did underscore that  social distancing, as it’s currently implemented, would help ensure the state’s hospital system isn’t overwhelmed over the next three months as a result of the pandemic.

The conclusions are based on a composite of several models that are specific to North Carolina. These models considered two scenarios: one that assumed social distancing remains in effect — and that people comply with the order — after April 29; and the second that all restrictions would be lifted after that time.

If social distancing remains in effect, the probability of a bed shortage, for both acute cases and the most severe requiring intensive care, is just 22% through June, said Dr. Aaron McKethan, an adjunct professor at the Duke University School of Medicine. If social distancing is lifted, the probability rises to 50%.

“We all want to get this pandemic behind us and get back to work,” McKethan said. “We want to keep policy officials informed as much as possible,” when weighing the costs to the economy and public health.

The models don’t examine local hotspots or regional differences in the number of available hospital beds and ventilators. Researchers said they plan to delve into that data soon.

The three models disagree on the timing of peak in demand for hospital beds if social distance policies are relaxed. Some models predict the peak would occur in May, others in June or July. “All models agree that we have a shortage,” said Dr. Mark Holmes, professor at the Gillings School of Global Public Health at UNC Chapel Hill. “The question is when.”

A University of Washington model released this morning was more optimistic. Those researchers now predict 500 people in North Carolina would die from COVID-19, down from 2,400 originally forecast.

North Carolina researchers had received that report shortly before the media call and said they hadn’t yet analyzed it. However, McDonald said North Carolina’s models accounted for the state’s ” unique attributes and are more granular than what you see out of the University of Washington.”

State officials have not announced how today’s findings could influence the governor’s stay-at-home order or state and local social distancing policies. The NC Department of Health and Humans Services and other state agencies have scheduled another briefing today at 4 p.m.