COVID-19 in ICE Facilities Could Overwhelm Local ICUs

Nearby Hospitals Likely to Be Overwhelmed, Study Shows

Results from a recent modeling study suggest that Van Gorder and Gross are right to be worried. The model predicts that intensive care units (ICUs) in more than half of hospitals within 10 miles of an ICE detention facility would be overwhelmed by day 90 in the event of a COVID-19 outbreak. Expanding that radius to 50 miles lessens the risks, but 8% of hospitals would still be unable to meet the need for ICU beds, the study authors warn.

“As COVID-19 continues to spread in communities, and inevitably into the nation’s detention centers, it is critical that we understand the U.S. healthcare system’s capacity to care for a large influx of patients who require critical care,” write Daniel Coombs, PhD, MSc, of the Department of Mathematics and Institute of Applied Mathematics at the University of British Columbia, Canada, and colleagues. The researchers published the results of their modeling study April 28 in the Journal of Urban Health.

Coombs and colleagues used ICE detainee population data available on the ICE Enforcement and Removal Operations website as of March 2 of this year, to estimate the COVID-19 transmission rate within 111 ICE detention facilities and studied the effects on regional ICU capacity. Their model considered multiple transmission rates (basic reproduction numbers [R0s] of 2.5, 3.5, and 7), outbreak duration (30, 60, and 90 days), and number of detainees in the facility (50, 100, 500, and 1000 detainees).

This “carefully constructed simulation study…uses the most common model for epidemic modeling,” F. Perry Wilson, MD, MSCE, associate professor of medicine and interim director, Program of Applied Translational Research, Yale University School of Medicine, New Haven, Connecticut, told Medscape Medical News.

Nevertheless, “the outcome varies depending on the assumptions the modelers make,” he said. The R0 of 2.5 is consistent with the general population and it could be even higher because of the close conditions in detention facilities, But, Wilson noted, it could be lower if authorities enforced social distancing. “[T]hese individuals in theory could be forced to engage in social distancing that the general population cannot,” he said.