Epidemiologists are using complex models to help policymakers get ahead of the Covid-19 pandemic. But the leap from equations to decisions is a long one.
IN THE PAST few days, New York City’s hospitals have become unrecognizable. Thousands of patients sick with the novel coronavirus have swarmed into emergency rooms and intensive care units. From 3,000 miles away in Seattle, as Lisa Brandenburg watched the scenes unfold—isolation wards cobbled together in lobbies, nurses caring for Covid-19 patients in makeshift trash bag gowns, refrigerated mobile morgues idling on the street outside—she couldn’t stop herself from thinking: “That could be us.”
It could be, if the models are wrong.
Until this past week, Seattle had been the center of the Covid-19 pandemic in the United States. It’s where US health officials confirmed the nation’s first case, back in January, and its first death a month later. As president of the University of Washington Medicine Hospitals and Clinics, Brandenburg oversees the region’s largest health network, which treats more than half a million patients every year. In early March, she and many public health authorities were shaken by an urgent report produced by computational biologists at the Fred Hutchinson Cancer Research Center. Their analysis of genetic data indicated the virus had been silently circulating in the Seattle area for weeks and had already infected at least 500 to 600 people. The city was a ticking time bomb.
The mayor of Seattle declared a civil emergency. Superintendents started closing schools. King and Snohomish counties banned gatherings of more than 250 people. The Space Needle went dark. Seattleites wondered if they should be doing more, and they petitioned the governor to issue a statewide shelter-at-home order. But Brandenburg was left with a much grimmer set of questions: How many people are going to get hospitalized? How many of them will require critical care? When will they start showing up? Will we have enough ventilators when they do?
There’s no way to know those answers for sure. But hospital administrators like Brandenburg have to hazard an educated guess. That’s the only way they can try to buy enough ventilators and hire enough ICU nurses and clear out enough hospital beds to be ready for a wave of hacking, gasping, suffocating Covid-19 patients.
That’s where Chris Murray and his computer simulations come in.
Murray is the director of the Institute for Health Metrics and Evaluation at the University of Washington. With about 500 statisticians, computer scientists, and epidemiologists on staff, IHME is a data-crunching powerhouse. Every year it releases the Global Burden of Disease study—an alarmingly comprehensive report that quantifies the incidence and impact of every conceivable illness and injury in each of the world’s 195 countries and territories.
In February, Murray and a few dozen IHME employees turned their attention full-time to forecasting how Covid-19 will hit the US. Specifically, they were trying to help hospitals—starting with the UW Medicine system—prepare for the coming crisis. Brandenburg says the collaboration could turn out to be, quite literally, life-saving. “It’s one thing to know you may be getting a surge of patients,” she says. “If you can make that more tangible—here’s what it’s actually going to look like—then we’re in a much better place in terms of being able to plan for the worst.”
Adam Rogers, Megan Molteni – WIRED – March 30, 2020.
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