MetroHealth Releases COVID-19 Projections

Modeling done by The MetroHealth System suggests the peak for COVID-19 in Cuyahoga County may be significantly lower in the number of infections than originally expected, and that the county could see sustained impact driven by clusters of infection rather than a single large surge.

“The leadership from Governor DeWine, Dr. Acton and others has saved lives and radically altered the spread of coronavirus. The public distancing response is historic and has changed the trajectory of the infection from being driven by widespread communal transmission to infection in clusters of people in close contact.” said MetroHealth CEO and President Akram Boutros, MD, FACHE.

The bell-shaped infection curves that people have seen numerous times, assume widespread contact and are not applicable to rigorous containment efforts. In contrast, the jagged sustained curve predicted by the MetroHealth models are based on network effect and contact limitation. The models were developed to help MetroHealth prepare for and respond to the COVID-19 epidemic in our community.

The MetroHealth models show new infections in Cuyahoga County gradually increasing until around late April, followed by irregular outbreaks in clusters throughout the year. A similar pattern is expected statewide, with Ohio having significantly lower number of daily new infections than previously expected and continuing at flat rate through the remainder of the year.

The importance of social distancing cannot be overstated. These models do not mean people can or should go back to life as normal. In fact, they assume people will continue to stay home if they have symptoms, frequently wash or disinfect their hands, not touch their face, and stay at least six feet apart when in public, Dr. Boutros said. If we were to become lax or immediately go back to numerous unprotected close contacts, the bell-shaped surge would return.

MetroHealth physicians and public health officials have already observed clusters of infection involving people who have attended funerals, after religious celebrations, in nursing homes, the Cuyahoga County Jail, and confined workspaces.

A lower number of infections obviously results in fewer deaths and hospitalizations than unfettered community-wide infection. He credits Ohio’s leadership on social distancing practices for lowering the actual number of infections. He believes the models should be viewed in context of the overall health of Cuyahoga County and Northeast Ohio.

“The models have serious policy implications and raise important questions about how to best provide health care to our community,” Dr. Boutros said. “If this scenario continues to play out over several months, one question we as health leaders must address is, at what point do should we resume preventive screenings such as mammograms and colonoscopies? We will need to provide health care treatment that is now being put on hold, while at the same time containing the spread of coronavirus.”

The State of Ohio ordered the cessation of elective surgeries and most preventive screenings in mid-March as part of an effort to reduce the number of people coming into the hospital and potentially spreading the virus. That decision also helped preserve personal protective equipment and blunted the spread of coronavirus.

“It is too early to declare victory, but this is a signal that here in Northeast Ohio we might be in a difficult, sustained campaign instead of a relatively short but intense war,” Dr. Boutros said. “We will continue to prioritize the health and wellness of our patients, our employees and our community. We will get through this by working together.”