CITY OF SIOUX FALLS April 17, 2020 A Collaborative Effort Avera • Dr. David Basel • Dr. Michael Elliott • Dr. Amy Elliott and Avera Research Institute Sanford • Dr. Jeremy Cauwels • Dr. Michael Wilde South Dakota State • Dr. Joshua Clayton City of Sioux Falls • • • • Christopher Anderson Aileen Profir Albert Schmidt Lauri Sohl Flatten the Curve Health care system capacity Without Protective Measures With Protective Measures OF Sioux FALLS Current Progress 700 600 . gNo Socual 500 pistancing Hospitalized Persons 400 25% Reduced 300 Social Contact 200 C) ?may Mar Jun9 Jun 24 Ju 9 Ju 24 AugS - on: Sioux FALLS Potential Flattening with Increased Social Distancing Hospitalized Persons HOO l000 900 800 700 600 500 400 300 200 100 0 No Social pistancing 25% Reduced Social Contact 35% Reduced I, Social Contact Mar Jun9 Jun 24 Ju 9 Julle AugB 0F I SIOUX FALLS Health Impact Model for Epidemics (CHIME) Susceptible Infected Recovered 260K 220K 200K 180K 160K 0 '5 l?iOK 3 3 120K 100K 80K 60K 40K 20K 100 110 120 Days Since First Hospitalization CITY OF Fl SIOUX FALLS Epidemiological Modeling Considerations • Models are simplifications of the real world • Careful consideration of the variables used is required • Models are dynamic: they are meant to be continually re-evaluated as new information become available • Models are tools for thinking about disease progression not oracles of the future City of Sioux Falls CHIME Parameters Parameter Population Size (Minnehaha/Lincoln County – 2019) Currently Hospitalized (COVID-19) Date of First Hospitalization (start date) Hospitalization Rate (% of total infections) Intensive Care Unit (ICU) Rate (% of total infections) Ventilation Rate (% of total infections) Value 259,153 40 March 20, 2020 0.8% (8% of confirmed cases) 0.2% (25% of hospitalized cases) 0.15% (75% of ICU patients) City of Sioux Falls CHIME Parameters Parameter Infectious Days Average Length of Hospital Stay Average Days in the ICU Average Days on Ventilator Social Distancing (%) Value 14 13 10 8 0% / 25% / 35% Peak Infection Time with Social Distoncing Factors (Minnehoho Lincoln Only) item No Social Distancing Craig: April 27 No Social Diatancing Current Senna ?Z'Irgrcar' mg: Current Peat Daf?m May 21 SEQ-IE I?liiT?I? 35% Eff-K Peak?. Eta-?e: June 04 Infected Population r-Well :3 Aug 7 Aug: 32 Sep IE- 590 ii lib-K No Social Distancing Ph?al?: Lha?j?i April 27 Tic-r: i-a LII afar Current (25Wo) Peal? [rd-te- May 21 riia Jistar? 35% ?Ear: F?e?je. Daie: June 04 Infected Population lee-"v 3r slap-r Ll} Apr 34 '21 [13135?xng 7 23,ng .22 Sep I3 Sep. 2i OF SIOUX FALLS Resource (Minnehaha Lincoln Only35% Distancing Distancing 650 {00 I Hospitalized Census {00 I Hospitalized Census '1 ICU Census ICU Census 350 I Ventilated Census ?0 I Ventilated Census 500 500 .300 sou 250 2.50 200 500 150 .. 1?l'v'lay 24 L. 8 .Iur 23 _.He}. 9 :13; E. 5:7 3- lug. .4. OF Sioux FALLS Comparison of Social Distancing Scenarios No Social Distancing 25% Reduction 35% Reduction in Social Contact in Social Contact Peak Infection Day April 27 May 21 June 4 Number of Infected 109,034 77,631 40,187 Peak Healthcare Day April 25 May 19 May 30 Peak Hospitalized 924 725 329 Peak ICU 189 143 64 Peak Ventilated 115 87 39 Estimating Social Distancing Percentage Cuebiq is a measurement and analytics company that provides free and open access to location data in response to natural disasters, urban development and disease prevention. Data remains anonymous through de-identified, largescale, aggregation of their data. The company tracks cell phone data through a private network of partners. Users opted-in to share their data and can easily opt-out at any time. Source: https://cuebiq.com Cases Chang Cases Cases 1200 1100 1000 (300 800 7 00 600 500 ,300 ZOO 100 1100 1000 900 :3 C) 700 600 JSOD 400 3) C) (J 200 100 Sioux Falls declares emergency,- no gatherings 250 in city?owned facilities; schools close 5 cases, 1 death reported in South Dakota ivSioux Falls declares emergency,- no gatherings 250 in city?owned facilities; schools close 5 cases, 1 death reported in South Dakota KIT 3 r' i 2 City offices close to the pubic; 10 cases statewide i City offices close to the pubic; 10 cases statewide Mobility over Previous Year Park amenities close No Loite ring; Gatherings Ii rnited to 10 persons Wee ke (I Travel d7 ?xprPark amenities No Loitering; Gatherings limited to 10 persons Weekend Travel ?l i Apr ll 'Viar 27 Apr 1 Stay?at?home Proclamation in up Pubch Health Emergency Declared; Smithfield Hotspot Apr 6. Apr ll Stay?at?horne Proclamation Public Health Emergency Declared; Smithfield Hotspot Apr (5 Percent Change in Mobilityover 2019 Percent Change in Mobilityover 2019 OF SIOUX FALLS COVID-19 Cases & Changes in Mobility over Previous Year From March 23 to April 5, Cuebiq data showed about a 25% decrease in overall travel compared to the same period in 2019. COVID-19 Cases & Changes in Mobility over Previous Year During the first week of April, Cuebiq mobility data indicates a much smaller reduction (less than 10%) in mobility over the same period last year. COVID-19 Cases & Changes in Mobility over Previous Year A reduction in the percentage of social distancing would cause a shift in our modeled peak to an increased number of infections, hospitalizations, and critical care patients. What is 35% Social Distancing? % Reduction of Social Contact School Closings 4% Restrict to ≤ 10 persons 15% School Closures + Restrict to ≤ 10 persons 31% + All non-essential employees stay home Intervention Source: Draugelis & Hanish, March 18, 2020 – CHIME comparison with Imperial College % Reduction in Number of Critical Care Beds Needed 15% 42% 65% Peak Infection rug: Current . May 21 35% Current mo 35% Infected Population if 25 ?59 Apr 24 l?v?lay g; F'uflcv 24 Jurfew SGK :Bngz Current (25Wo) . May 21 55v Infected Population J'JlSIOUX FALLS ANY Links & Resources • CHIME model – https://code-for-philly.gitbook.io/chime/what -is-chime/sir-modeling • Minnesota Dept. of Health – https://mn.gov/covid19/data/modeling • Cuebiq Mobility Data – https://cuebiq.com/visitations-insights-covid19 South Dakota Bed Needs Model 2 Beds Mm 1000 . ?330 15hv..\* mo 400 200 0 2020 '03-10 2020-63-25 2020704 19 2076 b5 09 2020 65-05 zen?bros 2020-63 0? 202011906 IT 4/16/2020 JSIOUX Current Progress No Social Distancing Hasmmized Persons 25% Reduction in Social Contact OF Sioux FALLS Potential Flattening with Increased Social Distancing No Social ?5 - - 25% Distancmg Social Distancing 35% Social Distancing an: I SIOUX FALLS Peak Infection Infected Population No Social Distancing lineal-q Dave-z April 27 ND Social Distancing Current 35% Cm; Di gtarr??lgz Current (25' June 04 40,187 ?lap-km .E i? 2 . Infected Population A &4 Jul 123:?Ep 2; to l? (l l'vSocial Distancing Peal-1 [rail?3: April 27 Water" 35% June 04 Cil?igSIOUX FALLS P. Resource (Minnehoho Lincoln Only) Number of Individuals May 19 Hospital beds: 725 25% Social Distancing I Hospitalized Census ICU Census I Ventilated Census May 17 IC Bedsrelay 9 himJul 2.: Number oflndividuals 35% Social Distancing I Hospitalized Census ICU Census I Ventilated Census May 30 Hospital Beds: 329 May 28 ICU Beds: 64 May 27 Ventilatorsiur; 22 OF Sioux FALLS Peak Infection 5cm 9 7-: CUFFEHJE {25gb} War-:2: 40,187 mo 35% Infected Population F'v?lay 9 Pa?Step '3 been 4; aiming: Current May 21 77,631 8C3- 75H 7? U1 35% June 04 .40,187 Infected Population (?Caper ?ESIOUX FALLS