Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.
Pan Afr Med J. 2020 Dec 2;37:293. doi: 10.11604/pamj.2020.37.293.26017. eCollection 2020.
continuous assessment of healthcare resources during the COVID-19 pandemic will help in proper planning and to prevent an overwhelming of the Nigerian healthcare system. In this study, we aim to predict the effect of COVID-19 on hospital resources in Nigeria.
we adopted a previously published discrete-time, individual-level, health-state transition model of symptomatic COVID-19 patients to the Nigerian healthcare system and COVID-19 epidemiology in Nigeria by September 2020. We simulated different combined scenarios of epidemic trajectories and acute care capacity. Primary outcomes included the expected cumulative number of cases, days until depletion resources and the number of deaths associated with resource constraints. Outcomes were predicted over a 60-day time horizon.
in our best-case epidemic trajectory, which implies successful implementation of public health measures to control COVID-19 spread, assuming all three resource scenarios, hospital resources would not be expended within the 60-days time horizon. In our worst-case epidemic trajectory, assuming conservative resource scenario, only ventilated ICU beds would be depleted after 39 days and 16 patients were projected to die while waiting for ventilated ICU bed. Acute care resources were only sufficient in the three epidemic trajectory scenarios when combined with a substantial increase in healthcare resources.
substantial increase in hospital resources is required to manage the COVID-19 pandemic in Nigeria, even as the infection growth rate declines. Given Nigeria's limited health resources, it is imperative to focus on maintaining aggressive public health measures as well as increasing hospital resources to reduce COVID-19 transmission further.
在 COVID-19 大流行期间持续评估医疗资源有助于进行适当的规划,并防止尼日利亚医疗系统不堪重负。在本研究中,我们旨在预测 COVID-19 对尼日利亚医院资源的影响。
我们采用了先前发表的基于离散时间、个体水平、症状性 COVID-19 患者向尼日利亚医疗保健系统和 2020 年 9 月尼日利亚 COVID-19 流行病学转移的健康状态转移模型。我们模拟了不同的流行轨迹和急性护理能力综合情景。主要结果包括预期的累积病例数、资源耗尽前的天数以及与资源限制相关的死亡人数。结果在 60 天的时间范围内进行预测。
在我们的最佳流行轨迹中,这意味着成功实施了控制 COVID-19 传播的公共卫生措施,假设所有三种资源情景,医院资源在 60 天的时间范围内不会耗尽。在我们的最坏流行轨迹中,假设保守的资源情景,仅在 39 天后就会耗尽通风 ICU 床位,预计有 16 名患者在等待通风 ICU 床位时会死亡。只有在急性护理资源与大量增加医疗资源相结合的情况下,三种流行轨迹情景中才会有足够的急性护理资源。
即使感染增长率下降,尼日利亚仍需要大量增加医院资源来管理 COVID-19 大流行。鉴于尼日利亚有限的卫生资源,必须专注于保持积极的公共卫生措施,以及增加医院资源,以进一步减少 COVID-19 的传播。