We've built a forecasting tool here at Rush. We've been using it for our planning. We also
made it publicly available so anybody in the country can use it. And we've been using this
to forecast actually how many beds we may need. There's two types of patterns that we've
been seeing nationally that have to do with how fast there's growth.
One is called exponential growth,
and what exponential growth is — every few days, the number of cases
double. And so the actual number increase goes up over time. So if you have two cases
today, you end up with four cases in about two to three days. It's what New York has seen,
for example — between two and three days. In the past they were having doubling of
cases. What happens, though, is that ends up generating really large numbers really
quick. So if you have a thousand cases today, in two days, you'll end up with 2,000 cases.
And so it's really hard for a hospital to handle huge volumes that increase day after day.
There's a second type of growth, which is called quadratic growth. And the name isn't
as important, but what it means is the rate of change isn't so fast. It's a little bit
slower, how quickly things get worse or how quickly cases increase. And
the good news is in Illinois, while we initially were on that exponential growth path, it's
feeling more and more like we're on that other path, which is not as fast growth. It's still
there — quadratic growth. It's still there that it goes up, but it's not as rapid as
exponential growth. So we may see that our cases double every 10 days or every six days.
Where that's really important is as we have patients coming in the hospital, we have time
to help them improve, let them be discharged, and then make beds available for additional
patients to come. So there's early evidence that
we have flattened the curve that, and so this is on the left hand side. These are general
medical floors and on the right hand side, these are the ICUs. And what you can see is
that the yellow line is what we forecast for our exponential growth model. And the red
line is what we forecast with our quadratic growth model. And we were kind of rising
in our general medical floor beds, but we've just started stabilizing, and we might be
declining. And in our ICU bed use, we're still going up, but it's below our forecasts for
this polynomial growth. So meaning we're growing but we're not growing as fast as the worst-case
scenario really with the timeframes, this really does seem like this is the statewide
shelter at home taking effect, but we're starting to feel maybe that this will, we'll
start to see a peak soon, maybe in the next week, and we'll start to see a decline.
We are the way China has been and Singapore and South Korea. We will see a continuing
decline until there may actually be very few new cases. And that may take several, several
weeks to a month or two. We do think there's going to be potentially a second wave. And
so Scott Gottlieb, who was the former head of the FDA, a few other folks who have nationally
been speaking on this, feel like there might be an outbreak in the Southern hemisphere
that will come and then that will get spared at that time, but then it will come
back in the fall and we'll start to see cases here in the U.S. again. What we hope is that
by that time we'll have experience on how to keep this under control. You know, we really
stood up a lot of change over about three weeks.
We'll have a little bit more time to be thoughtful and plan very carefully how we do our entire
scope of operations and potentially not become fully focused on COVID — manage COVID — while
we do other things. And then the other part of it is we're starting to think about treatments
and vaccines. There's a vaccine trial. There are several actually that are going on right now.
And hopefully by later this year we'll have some really good results. In addition, there's
a number of treatment trials that Russia's participating in that may be other things
that we can really use and have some data behind it. So I think we'll be in a very different
place in the fall if there were to be an increase in cases again. I think we're really well
positioned in the research side of things. We have a group through the university that's
been flagging every potential trial and research opportunity, and we have a number of investigators
applying for funding and we have a really well characterized database and biorepository
plans. So we can participate in those trials. And I think from the standpoint of how we
look at the fall and how we're positioned for then, I think we're in a really good position.