This study projected the COVID-19–associated demand for hospital and ICU beds within the United States via an age-structured dynamic model of SARS–CoV-2 transmission, parameterized with the US population demographics and latest estimates from global COVID-19 outbreaks.

In the wake of community coronavirus disease 2019 (COVID-19) transmission in the United States, there is a growing public health concern regarding the adequacy of resources to treat infected cases. Hospital beds, intensive care units (ICUs), and ventilators are vital for the treatment of patients with severe illness.

To project the timing of the outbreak peak and the number of ICU beds required at peak, this study simulated a COVID-19 outbreak parameterized with the US population demographics.

Using scenario analyses, the authors simulated disease spread under a range of scenarios for self-isolation and the basic reproduction number R₀.

They found that without self-isolation, when R₀ = 2.5, the treatment of critically ill individuals at the outbreak peak would require 3.8 times more ICU beds than exist in the United States. Self-isolation by 20% of cases 24 h after symptom onset would delay and flatten the outbreak trajectory, reducing the number of ICU beds needed at the peak by 48.4% (interquartile range 46.4–50.3%), although still exceeding existing capacity.

When R₀ = 2, twice as many ICU beds would be required at the peak of outbreak in the absence of self-isolation. In this scenario, the proportional impact of self-isolation within 24 h on reducing the peak number of ICU beds is substantially higher at 73.5% (interquartile range 71.4–75.3%).

These estimates underscore the inadequacy of critical care capacity to handle the burgeoning outbreak.

Policies that encourage self-isolation, such as paid sick leave, may delay the epidemic peak, giving a window of time that could facilitate emergency mobilization to expand hospital capacity.