COVID-19: Projecting the impact in Rohingya refugee camps and beyond

Shaun A Truelove; Orit Abrahim; Chiara Altare; Andrew Azman; Paul B Spiegel

We assume that in this setting hospitalization would be limited to those with severe disease (defined as tachypnea (≧30 breaths/ min) or oxygen saturation ≤93% at rest, or PaO2/FIO2 <300, and/or lung infiltrates >50% of the lung field within 24-48 hours), 19 and not used as a means of isolation. Thus, we assumed the proportion hospitalized was equivalent to the age-adjusted severe disease proportion calculated for the population and applied this to incident infections from the model simulations. 18 We assumed 26.4% of severe cases would require intensive care and estimated deaths assuming a 10% case fatality risk rate among hospitalizations/severe disease. We conservatively did not account for potential increases in mortality when healthcare resources are exhausted. We assumed hospitalization occurs a median of 3.42 days after symptom onset (lognormally distributed, standard deviation=0.79), 18 hospitalized cases are discharged after a mean of 11.5 days (95% CI, 8.0-17.3), and deaths occur after a mean of 11.2 days (95% CI, 8.7-14.9). 14 Additionally, early reports from the outbreak in China indicate that mechanical ventilation was required by approximately 25% of patients with severe disease, while the remaining 75% required only oxygen supplementation. 19