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N.L. COVID-19 projections forecast July ICU crunch, November caseload peak


ST. JOHN'S, N.L. — Models projecting the impact of the COVID-19 pandemic in Newfoundland and Labrador suggest cases could peak around mid-November and ICU bed capacity could be exceeded by mid-July, even if current preventive measures remain in place.

The scenario, run by the Canadian Institute for Health Information, looked at the possibility that 32 per cent of the province's population would be infected with COVID-19 over two years.

Health Minister John Haggie, Premier Dwight Ball and Dr. Janice Fitzgerald, the province's chief medical officer of health, addressed the province by video on Wednesday along with Dr. Proton Rahman, a clinical scientist and professor of medicine at Memorial University of Newfoundland.

The presentations showed that, even with a rapid rise in cases over the last month due to a cluster that spread from a funeral home, the curve of the outbreak has been flattening over the last week.

It's now similar to other provinces such as British Columbia, suggesting public health measures like contact tracing, physical distancing and non-essential service shutdowns have been effective so far.

"The organized response has really helped avert a disaster," Rahman said.

The funeral home cluster, which represents 75 per cent of the province's known cases, created a challenge for modelling, Rahman said, adding that it illustrates the immense impact one event can have.

Two people have died from COVID-19 in Newfoundland and Labrador, making the sample too small to project for a possible number of deaths, officials said.

However, in the short term, the Newfoundland and Labrador Centre for Health Information projects that under current measures, a "best case" scenario would see approximately 25 hospitalizations due to the illness by April 30.

In a "worst case" scenario, without public health measures, approximately 200 people would be hospitalized by April 30. Both scenarios are manageable with the province's current bed capacity, the projections note.

Projections related to ICU beds, which looked at 57 of the province's 98 ICU beds as available, predicted that a best case scenario would see about 10 patients occupying intensive care beds by April 30.

In a worst case scenario, the province would exceed its ICU capacity by the same date, with approximately 65 people in ICU beds with COVID-19.

Haggie compared the models, which were adapted to Newfoundland and Labrador's situation and unique caseload, to a weather forecast. He said while it's uncertain to predict the future, the models have practical uses like allowing the province's four health authorities to plan ahead.

Haggie said more scenarios will be run as more data becomes available, allowing for more precise planning.

He said the province is looking into contingency plans to prepare for a predicted shortfall in intensive care beds.

Assuming 32 per cent of the population contracts the illness, the Canadian Institute for Health Information predicts that Newfoundland and Labrador will need more ICU beds by July.

However, the same model predicted the province would stay within its acute care and ventilator capacity over the next year.

Another scenario, in which 51 per cent of the population contracts COVID-19, cases would peak in September, ventilator supply would be exceeded by mid-July and ICU capacity would be exceeded in mid-June. Acute care needs would exceed capacity in July in that scenario.

Newfoundland and Labrador has the second-highest number of infections per capita across Canadian provinces and territories, after Quebec, according to the presentation that used numbers from Tuesday.

Among the 17 people hospitalized, six have gone into the ICU.

Rahman said the people admitted to hospital had a median of two underlying health conditions.

The province reported four new confirmed cases of COVID-19 on Wednesday, bringing the provincial total to 232.

Ball said the numbers present a "clear yet stark picture" of why all residents must remain vigilant and keep up with preventive measures like physical distancing as the peak of cases approaches.

"What we do this weekend and beyond will make it or break it," the premier said.

He also pointed to higher rates of hospitalizations and ICU admissions among those aged 55 and above, noting that his province has the highest median age in Canada.

"That's me, that's some of you. We are the ones that end up in ICU and when you look at our population, well, there's more of us than anyone else," Ball said. 

Fitzgerald thanked residents for their efforts adhering to public health orders, but stressed that now is a "critical" time in containing the spread.

"While this information is encouraging, I need you all to understand that this is just the beginning and our work is not done," she said.

"If we ease up on our efforts, two weeks from now will be a very different picture and two months from now will be catastrophic."

This report by The Canadian Press was first published April 8, 2020.

Holly McKenzie-Sutter, The Canadian Press

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