Confusion and concern over new SA COVID modeling

Doctors are “confused” over conflicting modeling showing the estimated increase in COVID-19 cases and hospitalization rates when South Australia opens its borders, saying government-commissioned data released today appears to contradict SA Health estimates, that was presented to them last week.

The South Australian Salaried Medical Officers Association (SASMOA) is asking SA Health to clarify how many extra acute care and intensive care beds will be taken up when the coronavirus delta variant finds its way across the border, following the release of modeling here to morning, which appears to contradict information that the union says was presented to doctors on Wednesday.

According to the SA Health-commissioned University of Adelaide modeling released publicly today, the average maximum occupancy of the ward would be 36 beds if South Australia reopened its borders while maintaining restrictions on public health and social distance. ward beds ”.

Peak ICU occupancy is estimated at a median of nine beds with an extremely small chance of demand exceeding 30, while the median forecast for total deaths is 13 over 300 days, with a total range between four and 51.

But SASMOA says doctors in the central Adelaide local health network were presented with various data on Wednesday, predicting that 300 emergency beds and about 60 intensive care units would be needed when the state reopens its borders.

According to slides from the presentation of the Central Adelaide Local Health Network (CALHN) – seen by InDaily – SA Health estimated that the state would register approximately 3000 cases, but 85 percent of these infections could be treated at home, while a further 10 percent would be transferred to media hotels.

Once the state reaches its 90 percent vaccination target, the SA Health model presented to physicians shows that over 60 acute care beds and more than 15 intensive care beds will be needed.

SASMOA says the data was collected by SA Health and presented by CALHN executives the day after the government released its long-awaited “COVID-Ready” plan outlining when the state will begin lifting restrictions.

This was told by the union’s industrial manager Bernadette Mulholland InDaily that there were “significant differences” between the two data sets, causing confusion among physicians.

“They’s confused about what they’re told … but they’re also confused about why we’re going through a series of processes given the new modeling that’s coming out,” she said.

“In fairness to the local health network, they said they had not received (commissioned University of Adelaide) modeling at the time, and they predicted the resources based on numbers they had seen.

“But certainly, this second modeling that they used was a much bigger demand and impact on our hospital sector.”

Mulholland said it was possible the data presented to doctors on Wednesday was based on a “worse case”.

“We do not know until the limits are dropped and we have a much more likely chance that there will be a greater number of COVID patients,” she said.

In a statement, a spokesman for CALHN said its initial planning was based on national modeling using approximate figures, while the South Australian-specific modeling of the University of Adelaide was being completed.

“We will now review plans and adjust in accordance with SA-specific models,” the spokesman said.

The Adelaide University study, conducted by Professor Joshua Ross of the Adelaide School of Mathematical Sciences and Dr. Thomas Prowse of the School of Biological Sciences, found that reopening borders at 80 percent with all existing public health measures in place would provide an estimated 27 percent chance of an “outbreak” – defined as “on average more than 100 cases per day over a period of three days”.

During the modeling, the chance of an outbreak increases if the mandate to wear the mask was removed to 64 percent, with researchers predicting that this “involves risks of being able to handle cases, especially in terms of intensive care unit capacity”.

Peak ward occupancy would hit a median of 70 beds – and as many as 203, with a three percent chance of demand of over 200 beds, while the average ICU occupancy rate would be 18 beds, with a 20 percent chance of exceeding 30.

Under this scenario, the average number of deaths is modeled at 55.

If southern Australia removed all its restrictions on those fully vaccinated, the median total deaths would rise to 315, with a range between eight and 424.

Dr. Michelle Atchison of the Australian Medical Association’s State Department described the data as “scary” and said South Australia’s hospitals already had 100 per cent capacity.

“It emphasizes maintaining our current public health measures and saying that if our current public health measures continue, then we are likely to be in a pretty good state of hospital demand and hospital capacity,” she said.

“If our public health measures are relaxed, or if people do not comply with public health measures, there may well be some overcapacity in our hospitals.

“Anything where modeling starts to say ‘we may not be able to cope’ makes AMA very anxious.”

Prime Minister Steven Marshall announced last week that borders would reopen on November 23, with broader restrictions to be eased when SA hit a vaccination rate of 90 percent of the population over 12 – which Marshall predicted would happen before Christmas.

However, the Adelaide University modeling includes a table suggesting that the 80 percent vaccination rate is expected by the end of November – however, after the 23rd.rd – 90 percent benchmark is not expected to be met until January, and even then only for people aged 16 and over.

In a statement to in daily, Ross and Prowse said “uncertainty exists as to when vaccination coverage will be reached”.

They said the graphs used data captured on October 24 and “more and more updated data is becoming available all the time”.

“The exact date when some coverage has been reached is not too important for the modeling process itself, it is the vaccination coverage at the time that is important,” they said.

“If 80 percent is reached on November 23, or a little before or a little after, it does not matter from a modeling perspective, as long as the limits are assumed to be opened by 80 percent (16+) vaccination coverage.

“Our forecasts are continuously updated based on the latest data.

“In general, recent data has moved past dates where different vaccination coverage will be reached.”

Atchison said it was not guaranteed that southern Australia would reach its 80 per cent vaccination target by November 23, and doctors were concerned about the impending increase in COVID cases.

But Business SA policy director Andrew McKenna said companies “need a level of security around these dates, especially for international borders”.

“What we are more concerned about is hitting the 90 percent (rate), because without a broader (vaccine) mandate, we may not actually reach the 90 percent, or if we do, it could be much longer than Christmas. as indicated by the modeling, ”he said.

“If it’s already into January, it gives some concern.”

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