North Carolina hospitals will become overwhelmed by COVID-19 if social distancing measures don't remain in place, models show

RALEIGH, N.C. (WTVD) -- In a telephone news conference Monday, North Carolina health experts released projections that show what will happen to hospital capacity in the state if social distancing measures are lifted at the end of April.

The three models that were used all showed that there will likely be a shortage of beds in the state if social distancing guidelines are lifted on April 29, the date Gov. Roy Cooper's stay-at-home order is set to expire. The models differ on when that bed shortage will happen.

The epidemiologists and data scientists from Blue Cross and Blue Shield of NC, Duke University, data science start-up NoviSci, RTI International and the University of North Carolina developed a simple "weather forecasting" modeling approach that relies on best-available information from three independent research models.

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They found that maintaining social distancing policies, like those in place now, will give us the best chance of making sure the health care system in North Carolina has sufficient capacity to manage the growing number of cases.

"Like a weather forecast, the composite results don't predict an absolute outcome, but they predict a probability that an outcome will occur," said Duke adjunct professor and NovaSci CEO Dr. Aaron McKethan.

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Specifically, if the state maintains some forms of social distancing into at least early May, the peak stress on hospitals will likely occur in mid-to-late May. At that time, researchers say there's about a 25 percent chance that bed capacity will be insufficient to meet growing COVID-19-related demand.

However, if all social distancing policies are fully lifted after April 30, there's a 50 percent chance that hospital beds will not be able to meet new demand from COVID-19 patients throughout the state.

There's little room for error when it comes to hospital capacity in North Carolina

The three models show different points at which the hospitals would become overwhelmed. For example, one model shows it would happen in May while another predicts it would be closer to June or July.

Additionally, the models showed that if hospital systems worked to prepare for surge by increasing available hospital beds and hiring more health care workers for higher demand, it could provide some help, but will not significantly reduce the probability of bed shortages in the absence of some form of social distancing. "Put simply, our analysis suggests that in the absence of sufficient social distancing, we cannot 'surge' our hospital capacity to the extent we may need," the report says.

The models' estimates indicate that approximately 750,000 people in North Carolina may be infected with the virus by June 1. That's if the social distancing policies are fully lifted at the end of April and are not replaced by other policies with equal effectiveness aimed to reduce transmission.

On the other hand, if the same or similar policies remain in place, the estimates indicate that about one-third of that -- an estimated 250,000 North Carolinians -- may be infected by June 1.

"We should err on the side of caution--expand bed capacity and increase our understanding of the rate of infection," UNC professor and economist Dr. Mark Holmes said.

Epidemiologist Kimberly Powers explained why these models are vastly different than the widely-cited IHME models from the University of Washington.

For one thing, the IHME model showed that on Sunday there would be 1,300 hospitalizations in North Carolina, when in fact there are only 270 currently.

So, Powers said, the model was predicting a much earlier upswing than we've actually seen.

Additionally, she said the IHME model was based on a very, very strict social distancing policy based on what was happening in Wuhan after the outbreak there and not the actual guidelines being implemented here.

Still, state officials understand there are many challenges to maintaining social distancing so the preliminary report is not recommending that current policies can or should remain in place indefinitely. But it does recommend that North Carolina leaders implement a comprehensive strategy to maintain lower levels of transmission going forward, including a gradual reopening of the state.

As of Monday morning, 2,870 cases of COVID-19 have been reported in North Carolina out of 40,726 completed tests. At least 33 deaths have been reported at this time.

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