Abstract
[tplist user=”1″ entries_per_page=”100″ type=”article” image=”left” image_size=”121″ image_link=”self” template=”tp_template_2016″ ]Europe is now considered as the epicenter of the SARS-CoV-2 pandemic, France being among the most impacted country. In France, there is an increasing concern regarding the capacity of the healthcare system to sustain the outbreak, especially regarding intensive care units (ICU). This study aimed to estimate the dynamics of the epidemic in France and to assess its impact on healthcare resources for each French metropolitan Region. We developed a deterministic, age-structured, Susceptible-Exposed-Infectious-Removed (SEIR) model based on catchment areas of each COVID-19 referral hospital. We performed one month ahead predictions (up to April 14, 2020) for three different scenarios (R0=1.5, R0=2.25, R0=3), where we estimated the daily number of COVID-19 cases, hospitalizations, and deaths, the needs in ICU beds per Region and the reaching date of ICU capacity limits. At the national level, the total number of infected cases is expected to range from 22,872 in the best case (R0=1.5) to 161,832 in the worst case (R0=3), while the total number of deaths would vary from 1,021 to 11,032, respectively. At the regional level, all ICU capacities may be overrun in the worst scenario. Only seven Regions may lack ICU beds in the mild scenario (R0=2.25) and only one in the best case. In the three scenarios, Corse may be the first Region to see its ICU capacities overrun. The two other Regions, whose capacity will be overrun shortly after are Grand-Est and Bourgogne-Franche-Comté. Our analysis shows that, even in the best-case scenario, the French healthcare system will very soon be overwhelmed. While drastic social distancing measures may temper our results, a massive reorganization leading to an expansion of French ICU capacities seems to be necessary to manage the coming wave of critically affected COVID-19 patients.
Introduction
On December 31, 2019, Chinese authorities informed the WHO of grouped pneumonia cases. The majority of these cases were linked to the Huanan South China Seafood Market, in the city of Wuhan, Hubei province, China. A novel coronavirus, SARS-Cov-2, was identified on January 7, 2020, as the cause of this outbreak. On January 13, the first case outside of China was confirmed in Thailand. The first cases on the European continent were confirmed in France on January 24. The World Health Organization (WHO), declared the outbreak a Public Health Emergency of International Concern on 30 January 2020 and announced a name for the disease on February 11: COVID-19.
As of March 5, the European Centre for Disease Prevention and Control (ECDC) reported 91,315 COVID19 confirmed cases in 81 countries, and 3,282 deaths (3.4%). In Europe, 38 countries reported cases, Italy accounting for the majority of them, with 3,089 cases out of 4,290 (72%), and 107 deaths out of 113 (94.7%). France was ranked second with 423 cases and 5 deaths (1.2%).6 On March 11, WHO declared a pandemic, as 106 countries reported 118,628 confirmed cases and 4,292 deaths (3.6%). In Europe, the number of countries affected increased to 47, Italy still accounting for the majority of cases.
Figure 1 shows the number of cases in metropolitan France from January 22 to March 14 (source Santé Publique France). As of March 10, midnight, 2,030 cases were confirmed, leading to 44 deaths (2.2%).8 The two Regions the most impacted were Grand Est and Île-de-France, with 489, and 468 cases, respectively. People aged over 75 years accounted for 19% of the cases but around 75% of the deaths.8 As of March 10, 102 cases had been hospitalized into Intensive Care Units (ICU), 38% of them aged 65 years or less. The doubling time is approximately 72h, as the number of cases increased from 1,126 to 2,269 between March 8 and March 11, and from 2,269 to 4,469 between March 11 and March 14. It must be noted that it is likely that the number of confirmed cases is underestimating the true number of cases as all cases are not necessarily identified due to logistical issues in some Regions.
Conclusion
While preliminary, our analysis shows that, even in the best-case scenario, the French healthcare system will very soon be overwhelmed. While drastic social distancing measures may temper our results, a massive reorganization leading to an expansion of French ICU capacities seems to be necessary to manage the coming wave of critically affected COVID-19 patients.(best-case scenario the french healthcare)
About KSRA
The Kavian Scientific Research Association (KSRA) is a non-profit research organization to provide research / educational services in December 2013. The members of the community had formed a virtual group on the Viber social network. The core of the Kavian Scientific Association was formed with these members as founders. These individuals, led by Professor Siavosh Kaviani, decided to launch a scientific / research association with an emphasis on education.
KSRA research association, as a non-profit research firm, is committed to providing research services in the field of knowledge. The main beneficiaries of this association are public or private knowledge-based companies, students, researchers, researchers, professors, universities, and industrial and semi-industrial centers around the world.
Our main services Based on Education for all Spectrum people in the world. We want to make an integration between researches and educations. We believe education is the main right of Human beings. So our services should be concentrated on inclusive education.
The KSRA team partners with local under-served communities around the world to improve the access to and quality of knowledge based on education, amplify and augment learning programs where they exist, and create new opportunities for e-learning where traditional education systems are lacking or non-existent.
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PredictedFrenchHospitNeeds-EHESP-20200316Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
The study was funded by the French national research agency (ANR) through the SPHINx (Spread of Pathogens on Healthcare Institutions Networks) project.
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
Paper in collection COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv
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Professor Siavosh Kaviani was born in 1961 in Tehran. He had a professorship. He holds a Ph.D. in Software Engineering from the QL University of Software Development Methodology and an honorary Ph.D. from the University of Chelsea.
