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HomeMy WebLinkAboutCOM 0843.169 2018-2020 COUNTY CLERK COUNTY OF HAWAII RECEIVED X� Mon 3/23/2020 9:19 AM Time 9'(4oM By UPJ Testimony Date MAR 2 3 2020 To: Council Testimony Iii! I'm a resident of Kailua Kona, and I have data based projections of what COVID-19 will do on the island if we do not lock it down. I request that the report be read in its entirety. Blessings, John Gillespie � � zz � 3 p f � Y�iii, pNIAL' as i. *" h c^4,447 _� ?,a r!!!4.01.410:1, -Y-r7Fa* ''.1444:14 A,4'<`44`“ Mk:'',/,'",8*411„,,,a4:7,,la WeiVAW p, s 4 Y yo KEA DIFFERENCE1.3Y Total Requiring Hospitalization W.4.ocks own INIOW —iL ckd wn Apra 1 No 1..4d4000% hiblesd'NW 5*, tINt 61e411* 20001500 1000 { 00 3t29 4,r. 1 1.' Comm. No. cb 4) 't kPCI Ref. To: N/A Ref. Date MAR 2 0 211211 April 21, 2020 - Data Analysis of COVID-19 Impact on Hawaii Island Dr. Donald J Curry. MD CCFP MPH John Gillespie, BSc Aero Engineering Executive Summary: Hawaii Island will experience hundreds of confirmed cases in the next 30 days. We can predict with confidence that Hawaii Island will face a crisis shortage of hospital beds island wide by as soon as 4/6. Catastrophic numbers of hospitalizations will occur beyond that date. Extreme lockdown measures, if implemented in the next 48-72 hours, can mitigate this crisis. Lockdown measures are recommended and advantages of an early lockdown outlined. Data is used from Wuhan, Hubei province in their discovery and fight against COVID-19. Statistical analysis has produced probable infection curves for Hawaii Island. Data Sources: The data from Wuhan, Hubei province, the epicenter of the COVID-19 outbreak, is now pub- lished and available. This data has been around the longest, and they are now seeing an end to their outbreak. We know that their lockdown measures and response worked. While there are differing amounts of confidence in data from various sources, the Wuhan data is not refuted. It gives a solid snapshot of the virus and its characteristics. Assumptions: The data calculations start with our Hawaii Island historical data from 3/17-3/20, and then pre- dictions are synthesized. Assumptions are as follows: • COVID-19 spreads easily if unrestricted. The amount of infected cases doubles in about every three days. This study uses this propagation rate. • The incubation period can range from 1-14 days, but the average incubation period is 5 days. This incubation period was used for this study. • Because of the incubation period, in any given area with known cases, there are a multiple of other cases. Various studies suggest there could be as many as 50 or 100 times more people infected than the known cases. For this study, we have assumed a multiple of 10 as the start- ing data. • According to Wuhan's data, once the Chinese government started the lockdown infections continued to rise for the following 12 days. This rise was at a reduced rate of about 16% per day, then started to decline beyond 12 days until the end of the lockdown. This study uses that same reduced rate of infection for the lockdown figures. • In Wuhan, about 15% of cases required hospitalization. This study assumes this same rate for Hawaii Island. • The number of hospital beds on Hawaii Island is 294 as best as we could determine, with 24 ICU beds and 39 ventilators. This study assumes that half of these beds are available today. Also assumed is with efforts to make more available, two more will become available per day from this point. Analysis For some time, the population of Hawaii Island has hoped that COVID-19 could be kept off our island. Unfortunately, that time has passed, and we now know that the virus is here, and will run it's course. As of 3/20, Hawaii Island has 3 known cases of COVID-19. In addition, many have been tested at the clinics and drive-through test centers, but most of those tests are being sent off island for analysis on the mainland. These tests are likely to take 7-10 days before a result is returned. It is therefore likely to assume we currently have 30 undiagnosed cases on the island. Using the data from our most documented case, Wuhan, and applying the same rates to our island and current situation, the numbers are staggering. Take for instance a policy of minimal lockdown, with only moderate social distancing, and large groupings still permitted. By April 19th we can expect to have 16,000 diagnosed cases and an additional 25,000 undiagnosed cases on the island. This is only one month from now. No Lockdown Model Known Cases — Actual Cases-NL Daily infected Cases .. Total Requiring Hospitalization-NL 50000 40000 30000 20000 10000 ,"... 0 3/22 3/29 4/5 4/12 4/19 Since a policy of zero intervention is clearly untenable, it is immediately clear that at some point the county government will have to institute a lockdown. Assuming a lockdown is the only solution, the question becomes when and how to institute that lockdown. The following chart demonstrates the infection curves of actual cases based on three different lockdown times. March 22. March 25. and April 1. For purpose of argument, the early lockdown case is called the SK model for South Korea, who locked down their nation ear- ly. The intermediate case is called the SK +3, for three days later than the South Korea model. Comparison-Actual Cases- 10/22 vs. 10/'25 vs.411 Lockdown a Actual Cases-SK * Actual Cases•IT ar. Actual Cases-SK+3 4000 _ _ _....... _._. _. __... _......... ......... _.._...._... _....... 3000 2000 1000 _._. _... _. _.. _...... _. _...... _.... 3/22 3/29 4/5 4/12 4/19 The final case is called the IT model for Italy, who instituted a lockdown, but too late in the curve to make a powerful impact. They are paying the price. It's important to note that these numbers are for actual cases, while the confirmed case num- bers will be about 5 days behind, based on the average incubation period. The difference in numbers is striking. • The SK model levels out at under 600 cases island wide by April 12th. • The SK +3 model has almost double the total cases, leveling out a week later on April 19th. • The IT model doesn't even level out by the end of the study period, bursting its way past 4000 cases on the island by April 19th. Even more sobering is the comparison of these figures to the available hospital beds on the island. Comparison- Hospital Beas Required-3/22 vs 3/25 vs.01 Lockdown Total Requiring hospitalization-SK ; Total Requiring l tospitalization-IT Island Wide I lospital Beds .. Total Requiring hospitalization•SK*3 600 400 _...... _.._. _.. 200 3/22 ---- 3/29 4/5 4/12 4/19 Assuming 15% of the sick will need a hospital bed, and plotting against the predicted available hospital beds, it's clear that a lockdown has to be enacted by 3/25. or we will quickly outstrip the available beds by several times capacity. Above the yellow line is the zone where people begin to die. Lots of them. Early lockdown will not overstretch our healthcare facilities, and will keep people from dying. This point cannot be overstated. One final chart underlines the need for an immediate lockdown. A delay of just a few weeks will prove fatal to a large portion of Hawaii Islands population. Observe the predicted hospital bed requirement with a zero lockdown policy. The amount of needed hospital beds is so large, the available hospital beds are almost impos- sible to see. Comparison -Hospital Beds needed Total Requiring hospitalization-5K Total Requiring Hospitalization-IT Island Wide Hospital Beds — Total Requiring Hospitalization-NL 8000 6000 __ _....... _.... .... 4000 2000 _. ____. ........_.. 0 3/22 3/29 4f5 4/12 4!19 It is the opinion of the authors of this document that a lockdown will be necessary for Hawaii islands population. There are two options: • soon, with immediate social and economic consequence, or, • later, with more social and economic consequence, as well as the agony of increased suffer- ing for a wider portion of the population. enough Thequestion is when and how will the lockdown be implemented, and will it be earlye p 9 to effectively slow the infection rate on the island. Recommendations Epidemics grow exponentially, therefore it is of paramount importance that the following rec- ommendations are enacted as soon as possible, and that the full cooperation of Hawaii Is- land's population is assured. Every day counts. Recommendations include: • The reduction of all commercial flights in and out of the island to only emergency or compas- sionate travel. • A 15 day mandatory "Shelter in Place" order for the entire island population, with a probable extension to 21 days. Only workers in essential services are allowed to leave their homes, and they observe a policy of extreme social distancing at work. Essential services would in- clude: • government • healthcare • first responders • supply chain • infrastructure • pharmacies • Grocery stores • public safety • A county-wide curfew of 9pm, like Kauai has instituted • Required closure of all schools, high schools, preschools, daycares, etc until April 30th. Advantages of an Early Lockdown Unlike Italy, who moved too slow to avoid catastrophe, Hawaii island still has an opportunity to avoid disaster. It's possible for us to be a success story like South Korea. By locking down the island population in a swift and complete manner, there are several key advantages: • Hospital beds will be available for the sick that need them. Healthcare workers and services will be stretched, but not overworked or inundated. The critical cases will be manageable. • This could lead to Hawaii Island becoming the island that had no deaths from COVID-19. • California is currently on lockdown. Tourism here is already massively suffering as a result. If Hawaii Island locks down in sync with California, by the time California has recovered, we will be ahead of them in recovery and ready to bounce back quickly from the resumption of nor- mal life and tourism. The opposite is true if we are late to lock down—we will be behind Cali- fornia and the rest of the country, and our branding and attractiveness will suffer as a result. • Hawaii Island has the opportunity to become one of the model stories across the nation of a swift and timely response by the leadership, that safeguarded the population and minimized the economic impact of this virus. We can be a sanctuary from the virus. Summary Epidemics grow exponentially, therefore it is of paramount importance that the recommenda- tions be enacted as soon as possible, and that the full cooperation of Hawaii Island's popula- tion is assured. Every day counts. We are still in the window to have a positive outcome, but the window is closing quickly.