Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries


McCabe R, Kont MD, Schmit N, Whittaker C, Løchen A, Baguelin M,


tions of COVID-19 patients is used to estimate the demand for and resultant spare capac- ity of ICU beds, staff and ventilators under different epidemic scenarios in France, Germany and Italy across the 2020–2021 winter period. The effect of implementing lock- downs triggered by different numbers of COVID-19 patients in ICUs under varying levels of effectiveness is examined, using a ‘dual-demand’ (COVID-19 and non-COVID-19) pa- tient model. Results: Without sufficient mitigation, we estimate that COVID-19 ICU patient numbers will exceed those seen in the first peak, resulting in substantial capacity deficits, with beds being consistently found to be the most constrained resource. Reactive lockdowns could lead to large improvements in ICU capacity during the winter season, with pres- sure being most effectively alleviated when lockdown is triggered early and sustained under a higher level of suppression. The success of such interventions also depends on baseline bed numbers and average non-COVID-19 patient occupancy. Conclusion: Reductions in capacity deficits under different scenarios must be weighed against the feasibility and drawbacks of further lockdowns. Careful, continuous decision- making by national policymakers will be required across the winter period 2020–2021


International Journal of Epidemiology