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New models predict over 350 deaths

Bermuda could suffer more than 350 Covid-19 deaths — even if people stick to strict shelter-in-place and quarantine rules.

David Burt, the Premier, said last week that public health experts had predicted a worst-case scenario where more than 700 people in Bermuda could die if strict rules to curb the spread were not followed.

The Ministry of Health later told The Royal Gazette it estimated that healthcare demand could be “reduced by up to two thirds and deaths by half”, if government-imposed measures were adhered to. A ministry spokeswoman said the island's public health modelling for the Covid-19 pandemic was guided by Public Health England and Imperial College London.

She said: “Generally, they are estimating an 80 per cent infection attack rate without mitigation strategies, with a significant proportion of subclinical infections — that is, asymptomatic infections and mild disease.

“They are secondly estimating a 50 per cent clinical attack rate, that is symptomatic persons. Of these, eight per cent may require hospitalisation”.

The spokeswoman added: “Preliminary modelling shows that with the mitigation strategies Bermuda has implemented such as case isolation, household quarantine of family members and social-distancing, healthcare demand can be reduced by up to two thirds and deaths by half.”

The figures suggest that without the measures imposed by the Government, about 50,400 people on the island would be infected.

About 25,200 would have symptoms and need clinical care and about 2,016 of those would have to be admitted to hospital.

The Royal Gazette asked the health ministry for further details on what reducing healthcare demand by up to two thirds might look like in terms of the numbers of people estimated to become infected, hospitalised and in need of a ventilator.

The ministry did not respond by press time.

Mr Burt told a press conference last night that modelling information would be released once it was seen by the Progressive Labour Party caucus and the Opposition and after “some tweaks” from the Cabinet.

The Premier emphasised that the 700-plus death rate was the “worst-case scenario”.

He added: “We will share those numbers of what we consider better-case scenarios if we are doing the things of which the country must do.”

Cheryl Peek-Ball, the Chief Medical Officer, said on Monday that the Bermuda Hospitals Board was best able to give figures on the number of ventilators available and the predicted requirement for them.

Dr Peek-Ball said: “That is a hospital question. I do know that they have been very, very meticulous estimating the need, anticipating the need and acquiring additional equipment but I would prefer that you put that to them to give you precise numbers.”

The King Edward VII Memorial Hospital has 20 ventilators and said last month that it had ordered eight more because of the Covid-19 outbreak.

A BHB spokeswoman said that the eight extra machines had still to arrive.

She added: “Although since we spoke of the order of eight, due to global shortages, supply chain issues have meant BHB has tried different orders and requests through different suppliers and connections. At this point in time, potentially 12 could arrive this month, although another six more on order have been delayed until June.

“We currently could provide ventilation for 29 ventilated patients, significantly more than our usual critical care capacity.”

The spokeswoman explained that nine of the available ventilators were upgraded machines kept on standby in normal times.

She said: “Ideally when the new ventilators arrive they will be used instead.”

Michael Richmond, the BHB's chief of staff, told the press conference that KEMH had increased its intensive care capacity from nine beds to “the ability to ventilate, at this moment in time, close to 30 patients using alternative facilities”.

The spokeswoman said: “Our focus has to remain on flattening the curve and decreasing the acute and critical care demand so that we do not exceed capacity. The actions of each one of us in the community will impact whether the hospital can cope.

“The hospital has done, is doing and will do everything it can. We have increased our acute and critical care capacity, we have purchased medication and supplies that we may need in greater quantities and cross-trained and upskilled staff.”

But she warned: “In this case, the hospital preparations alone will not be enough. Everyone must play their part to stop the spread so the healthcare system can manage the needs of all those most seriously ill.”

She said the BHB's ethics committee had set up a subgroup to draw up guidelines to help decide which patients would be ventilated if there were not enough machines to go around. She added that the board was also looking at medical guidance from countries which had been through the worst of the pandemic.

The spokeswoman said: “It's an impossibly difficult and heartbreaking situation to consider and we hope that we do not reach that stage, even though we have to plan for it.”

Cheryl Peek-Ball, the Chief Medical Officer, deferred to the Bermuda Hospitals Board over the number of available ventilators (Photograph by Blaire Simmons)

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Published April 15, 2020 at 9:00 am (Updated April 15, 2020 at 7:55 am)

New models predict over 350 deaths

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