[Intensive care bed requirements for COVID-19 in the fall/winter of 2021 : Simulation of different scenarios under consideration of incidences and vaccination rates].

backgroundDespite the increasing vaccination rates against SARS-CoV‑2, there is a risk of a renewed wave of infections in autumn 2021 due to the high seasonality of the pathogen, with the associated renewed possible heavy burden on intensive care. In the following manuscript we simulated different scenarios using defined mathematical models to estimate the burden of intensive care treatment by COVID-19 patients within certain limits during the coming autumn.

methodsThe simulation of the scenarios uses a stationary model supplemented by the effect of vaccinations. The age group-specific risk profile for intensive care unit (ICU)-associated disease progression is calculated using third wave ICU admission data from sentinel hospitals, local DIVI registry occupancy data and the corresponding local incidence rates by linear regression with time lag. We simulated vaccination rates of 15% for the over 18-year-old cohort, 70% for the 15-34 year cohort, 75%/80%/85% for the 35-59 year cohort and 85%/90%/95% for the over 60-year-old cohort. The simulations take into account that vaccination provides 100% protection against disease progression requiring intensive care. Regarding protection against infection in vaccinated persons the simulations are depicted for the scenario of 70% protection against infection in vaccinated persons and for the scenario of 85% protection against infection in vaccinated persons.

resultsThe incidence is proportional to ICU bed occupancy. The proportionality factor is higher than in the second and third waves, so that comparable ICU bed occupancy is only achieved at a higher incidence. A 10% increase in vaccination rates of the over 35-year-olds to 85% and of the over 60-year-olds to 95% leads to a significant reduction in ICU bed occupancy. DISCUSSION: There will continue to be a close and linear relationship between SARS-CoV‑2 incidence and ICU bed occupancy in the coming months. Even above incidences of 200/100,000 a considerable burden of ICUs with more than 3000 COVID-19 patients can be expected again, unless the vaccination rate is significantly increased. A few percentage points in the vaccination rate have a significant impact on potential ICU occupancy in the autumn, so efforts to increase vaccination acceptance should be a priority in the coming weeks. For intensive care medicine, the vaccination rate of those over 35 years of age is crucial.