A global model by the Institute for Health Metrics & Evaluation projected that Wisconsin’s peak resource use would arrive April 11 with the University of Wisconsin Health Chief Quality and Safety Officer predicting the peak in the number of COVID-19 cases for Dane County is still a few weeks out.
Dr. Jeff Pothof, UW Health Chief Quality and Safety Officer, said that though UW Health doesn’t have an exact date for when the peak will hit Dane county, he is still cautiously optimistic about UW Health’s preparedness.
UW Health started preparing for COVID-19 before any models came out, Pothof said. They planned for the worst-case scenario, making sure they had enough resources and staff for maximum surge capacity.
“You need a room with a ventilator, medication and other equipment,” Pothof said. “But the most important thing is how you’re going to be able to staff it.”
Pothof said to build its staff pool, UW Health reduced its non-emergency services. Over 1,000 nurses and doctors who would normally not work with urgent cases have been cross-trained to work in the Intensive Care Unit, Pothof said.
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UW Health can manage the current number of COVID-19 patients without using additional resources, Pothof said. Social distancing appears to be working, but if a surge occurs, Pothof said the hospital has other plans ready to go.
“It’d be awesome if we could know when the peak is going to be,” Pothof said. “Because what we’re doing now is planning for an infinite peak, so that we’ll never have a moment when we could look back and say, ‘We could’ve done more.’”
According to its FAQ page, the IHME model was created to help hospitals anticipate when their peak COVID-19 resource use would occur. The model calculated how many hospital beds, ICU beds — which are different from normal beds in that they can run a ventilator — and ventilators each state would need for their peak number of COVID-19 cases. It projected that Wisconsin would have sufficient resources.
UW professor Laura Albert, an expert on mathematical modeling and analytics, said that mathematical models — such as IHME’s — tend to be very sensitive to assumptions. This helps the models chart variables which data scientists understand well, like disease transmission. But for variables the scientists do not know well, like data on hospitals, the model can neglect the big picture, Albert said. Albert said that a shortage of personal protective equipment and infection of health care staff were examples of variables that the IHME model ignores.
Pothof said UW Health is using data more specific to Dane County to model its COVID-19 trajectory. He said since the IHME model predicts at a national level, it might have had to use older data — resulting in an inaccurate projection for Dane County. Pothof said that even data scientists at UW Health are having a hard time predicting when the peak will hit.
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The peak’s arrival depends on many variables, Pothof said. Even between two neighboring cities— like Madison and Milwaukee — the spread of COVID-19 could look very different.
How emergency medical services can use limited resources to respond to emergencies is something Albert is currently studying. Albert serves on the Wisconsin EMS board, where she said the pandemic has challenged them on everything — from how to renew their EMS provider’s credentials to deciding which calls EMS providers should respond to.
“It takes so much longer to treat patients,” Albert said. “The EMS providers have to put on the PPE, and some hospitals are at full capacity, so they might have to drive to a further hospital. Even though there’s not a massive surge of calls, the EMS is pretty overwhelmed.”
Another problem EMS is facing is a shortage of Personal Protection Equipment, Albert said. EMS providers are currently rationing their PPEs, Albert said, but once the third shipment of PPE from the Strategic National Stockpile arrives, they should be in better shape.
Despite the challenges EMS agencies are facing, Albert said that, as a researcher, she is excited about the potential for the nation to reimagine emergency health care. She said that system engineers like herself can improve their thinking so that when the next big threat comes, they’ll be ready.
“I’m excited about the research potential,” Albert said. “I’m only sad that it’s because of a pandemic.”
Fighting COVID-19 is a comprehensive effort, Pothof said. UW Health is working with Dane County, the state emergency operations center and other hospitals such as St. Mary’s to slow the virus. If the curve flattens in Dane County, Pothof said UW Health would help other areas, like Milwaukee.
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Right now, UW Health is still preparing for a worst-case scenario hitting Dane County. There just is not enough data to be say anything certain, Pothoff said.
“I’m cautiously optimistic,” Pothof said. “I’m not gonna say we won’t have bad things happen, but at the same time, I’ve been impressed by all the doctors and nurses who make up UW Health. They’ve really rallied as a team.”