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Centra says updated model shows earlier peak, earlier demand

Centra officials had a much different forecast for how COVID-19 will impact Virginia this week compared to last week, during a Tuesday, April 7, video press conference, though Centra’s bed and ventilator capacities are not yet being challenged.

Dr. Andrew “Andy” T. Mueller, president and CEO of Centra, said some of the big things that have changed from last week are epidemiological models used to predict the novel coronavirus’ effect.

Andrew “Andy” T. Mueller

“One in particular that has been referenced quite a bit by the president’s task force is the University of Washington model, which has really shown a significant change in the estimated period of peak usage,” he said. “So originally, it was projecting to be around May 20. Now the model has changed, and it’s looking like, if that model is accurate, (Virginia’s) peak will be in approximately two weeks on April 20.”

Mueller noted that as the governor and the governor’s office have appropriately cautioned, it probably makes some sense to not necessarily put all trust in any one model, but at the same time just recognize that Virginia may be seeing greater demand for services sooner rather than later.

“At the same time too, we’ve seen the model change twice since the last time we were together,” he said. “And so we suddenly, as I reported last week, were thinking that we were going to be a relatively unscathed state in terms of the size of the peak and the number of fatalities.”

He said this changed dramatically mid-week last week when the model was updated.

“It showed a substantially increased number of fatalities in the state ranging in the 3,200 number range,” he said. “Since that time, the model has been reforecast and it shows that declining to around 1,400 fatalities in the state.”

The challenge with that is that in looking at other states, Virginia is projected to have significantly more fatalities based on even the corrected, most recent model, than many neighboring states, Mueller said.

“So for example, in the update, North Carolina is projected to have something like 600 fatalities, so even though the numbers have come down, we are still outpacing many other states, including states that have a larger population than ours,” he added.

He put things in further perspective by noting California, with nearly 40 million residents, is projected to have around 1,700 deaths, while Virginia is not far from that total with only 8.5 million residents.

“While I don’t know what all of the reasons are, some of it may be the phenomenon of the large metropolitan concentrated areas in the state that we have in Tidewater and Northern Virginia,” he said. “The president’s task force specifically called out their interest in Washington, D.C., as a potential hotspot, and certainly that probably has a bleed-over effect into our region.”

Centra Chief Medical Officer Dr. Chris Thomson noted how the updated model impacted the forecasted need for beds.

“In short, without having the numbers right in front of me, the numbers of total beds required did go down slightly,” he said. “The number of intensive care unit (ICU) beds did go up slightly, and that’s in the state, and so that doesn’t necessarily tell us what is going to happen here locally, although we’re doing the best to infer how our rates then compare with the rest of the state of Virginia.

“I would say that many, many beds can be utilized for non-ICU care, and so (with) the ability to expand into our non-traditional spaces — and we’ve mentioned the school of nursing — other buildings that have been mentioned can be equipped to be a regular hospital room quite easily.”

Even ICU capabilities can be extended to new sites as well, he added.

“Each health care system that is dealing with this pandemic has been responding to that by creating more space, and that’s why you’ve heard so much about ventilators, because that is one thing that can’t be really created on the spot,” he said. “Those are things that are somewhat fixed in capacity, which is why everyone is trying to utilize those. You can take a ventilator and create an ICU-type space that has those capabilities, but you can’t generate a ventilator on the spot.”

Mueller said the increase in projected COVID-19 deaths in Virginia shows that now is the time for Virginians to really adhere to the governor’s recommendations of really doubling down on social distancing and making sure to stay home as much as humanly possible.