COVID-19 in Sask: Treatment capacity scaled back as new projections reduce worst-case to 3,000 deaths

• Projected number of deaths in worst-case scenario is now around 3,000.

• Overall number of cases in worst-case now projected at about 255,000.

• New calculations include rate of transmission based on compliance with restrictions.

• SHA to reduce maximum capacity by 1,000 hospital beds, 400 ICU beds and 400 ventilators.

The Saskatchewan Health Authority (SHA) will reduce the number of hospital beds, intensive care beds and ventilators it plans to make available based on new, lower projections for the number of COVID-19 cases and deaths in Saskatchewan, including figures based on public compliance with restrictions.

The updated COVID-19 Modelling and Health System Readiness document, updated from the first projections unveiled on April 8, shows the SHA is preparing for a worst-case scenario of about 3,000 total deaths and 60 daily intensive care admissions.

"We have flattened the curve based on what's gone on in the province: the three-legged stool around testing, contact-tracing and those severe public health restrictions," said SHA CEO Scott Livingstone at a news conference on Tuesday. 

"What the model will help us do on a daily basis, weekly basis, monthly basis, is allow us to measure what's happening in the province, whether it's us reopening the health care system or the economy continuing on in phases."

Read the full document released Tuesday, April 28, here:

The April 8 report said the authority was planning for between 3,000 to 8,300 deaths, and approximately 20 to 200 daily intensive care admissions, from COVID-19 at its peak. 

The overall number of cases it is preparing for is now about 255,000. The April 8 document put that number between 153,000 and 408,000.

The SHA will reduce its maximum capacity by 1,000 hospital beds, 400 ICU beds and 400 ventilators. The original modelling said the province thought it might need 963 ICU beds and 860 ventilators but did not specify how many hospital beds overall.

The SHA said it will still have 83 more ventilators than it would need under the new projected scenarios. 

'New normal'

Despite the more positive outlook, Livingstone said what happens next is largely in the hands of the public.

"Our new normal is a normal with COVID in our population and in our province until a vaccine arrives and we need to plan that way."

The original modelling was based on a basic reproductive rate, or R0, which is the average number of people that one person with the virus could infect,  of 2.4 to 4.0. This was based on if no interventions — such as restrictions and closures — had been taken.

Under the new modelling, which the SHA described as an "improved outlook," the SHA is planning for an R0 of 3.12. The projection of about 3,000 deaths is based on that number.

New calculations show current trend

The new document also includes a new calculation: the effective reproductive number, or Rt. 

According to the document, that number reflects the current trend and describes how well the various interventions are slowing the spread of COVID-19, with a lower Rt value being better. It also reflects fluctuating public compliance.

On April 25, that number was pegged at 0.7, which the SHA said shows strong compliance with public health measures. The document notes that number could be lagging by 7-14 days. 

"If we don't stay flat then we know we're going to have to back off what we're doing with respect to providing more services and we will redirect those resources to COVID and we may have to start instilling more restrictions in the province again," said Livingstone.

The new document states that the virus has reached a "tipping point" if the effective reproductive number reaches 1 or higher.

"Rt consistently [higher than] 1 is a major consideration in determining public health measures," said the document.

"The Rt value is helpful in determining effectiveness of current interventions right now, and can be a guidepost to use when choosing to implement new measures, or loosen existing ones." 

The Rt number will now be shared with the public weekly, the SHA said. 

"We definitely will be watching it and the goal of having the effective reproductive number is to be able to be aware and adjust as we need depending on how the loosening of the restrictions work as well as how everyone responds to them," said senior medical information officer Dr. Jenny Basran at Tuesday's news conference.

She said there are efforts underway to develop Rt numbers for each region individually, but no specific numbers are available for the outbreak area in the far north at this time. 

Basran said it is critical that the public continues to practice physical distancing and follow hand-washing guidelines. 

The new modelling document does not set a date to resume elective surgeries and other medical services that are on pause.

Livingstone said any resumption of those services will happen in phases to balance COVID-19 care needs. 

He said people have started shying away from seeking medical care from doctors and hospitals due to fear. 

Data is now being used to try to assess how many people there are in the community with unmet medical needs, Livingstone added, to inform the next steps.

"The last thing we want to do is start burning through elective surgeries only to have our facilities fill up with people that have medical needs that we haven't met, or diagnostic needs that went postponed," said Livingstone.

More details about the provincial strategy to increase testing — a measure promised to coincide with the loosening of restrictions — are also included in the new document.

One of those measures is to start testing "asymptomatic contacts" identified through public health contact and outbreak investigations, along with outreach to populations perceived to be less likely to seek testing. 

It said testing is available at 50 sites across the province and the number of lab processing sites is being expanded from eight to 19.

Tuesday's modelling document also includes Google data that indicates people in Saskatchewan have reduced their visits to grocery stores, pharmacies, transit stations and workplaces, but not as dramatically as in Canada overall.

SHA's "improved outlook" for the province comes as leaders in northern Saskatchewan call for funding to help address an outbreak that has led to a public health order to restrict travel to and from the region. 

As of Monday, there were 42 active cases reported in the far north and 10 in the north.