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COVID-19 health care demand and mortality in Sweden in response to non-pharmaceutical (NPIs) mitigation and suppression scenarios
Joacim Rocklov
Novel Coronavirus
Acceso Abierto
Atribución-NoComercial
10.1101/2020.03.20.20039594
Background: While the COVID-19 outbreak in China now appears contained, Europe has become the epicenter, with both Italy and Spain reporting more deaths than China. Here we analyse the potential consequences of different response strategies to COVID-19 within Sweden, the resulting demand for care, critical care, deaths and their associated direct health care related costs. Methods: We use an age stratified health-care demand extended SEIR compartmental model fitted to the municipality level for all municipalities in Sweden, and a radiation model describing inter-municipality mobility. Results: Our models fit well with the observed deaths in Sweden up to 25th of March. The critical care demand is estimated to peak just above 16,000 patients per day by early May in the unmitigated scenario, while isolation of elderly and intermediate social distancing can reduce it to around 5000-9000 per day peaking in June. These peaks exceed the normal critical care capacity in Sweden at 526 beds by an order of magnitude. We find, however, that by employing strong social distancing and isolation of families with confirmed cases, as guided by testing, the outbreak can be suppressed to levels below the normal critical care capacity. We estimate death rates in COVID-19 are closely related to the different response strategies. Conclusion: The impact of different combinations of non-pharmaceutical interventions, especially the extent of social distancing and isolation, reduce deaths and lower health care costs in Sweden. In most mitigation scenarios, demand on ICU beds would rapidly exceed total ICU capacity, thus calling for immediate expansion of ICU beds. These findings have relevance for Swedish policy and response to the COVID-19 pandemic. ### Competing Interest Statement None ### Funding Statement None ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The data can be accessed in correspondence with the authors.
Cold Spring Harbor Laboratory Press
2020
Preimpreso
https://www.medrxiv.org/content/10.1101/2020.03.20.20039594v2
Inglés
VIRUS RESPIRATORIOS
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