West Virginia has about a month until coronavirus peaks here.
And when it does, about 500 West Virginians — give or take a few hundred — are expected to die, according to current projections from the University of Washington’s Institute for Health Metrics and Evaluation.
Dr. Ali Mokdad, one of the researchers working on the projections, said deaths in the state may be high per capita because West Virginia’s population is high risk. Coronavirus has hit older adults and people with underlying health conditions the hardest.
In an interview with West Virginia Public Broadcasting, Mokdad said residents of the state should be mindful of those demographics by adhering to mitigation practices.
“So you have to be extra careful in enforcing these [measures] and making sure that people stay at home,” Mokdad said.
However, Mokdad said it is possible to improve outcomes depending on what governments do to stop the spread of the disease and whether residents adhere to public guidance. The researchers are taking these mitigation practices into consideration as part of their projections.
“We assume, unlike anybody else, that there are measures in place to fight the pandemic,” Mokdad said.
For example, he said, a stay at home measure, the closure of the schools and shutting down non-essential businesses will help reduce the number of cases a state experiences. West Virginia has implemented all of those measures.
“So, like, you cannot assume a fire will run wild,” Mokdad said. “You will have [firemen] and fire trucks working against it.”
And having those fire trucks, so to speak, available, may make all the difference — especially in a place like West Virginia that actually has time to prepare.
The most current projections show West Virginia will see the worst impact of the coronavirus in early May.
"That gives time for hospitals in West Virginia to prepare, to get more ventilators on time. And then, for example, some of the operating rooms or some of the recovery rooms after an operation could be switched to be an ICU bed,” Mokdad said. “So, that fact that the peak is delayed is very good news for West Virginia.”
Right now, Mokdad and his team are trying to forecast the impact of the coronavirus on each state in the U.S. But, looking into the future has its challenges.
“We don't know how many people have coronavirus in the U.S. right now – because as, you know, we are lagging in testing,” he explained. “We don't have enough tests and we don't know how many people are sick.”
The main goal of their work is to pinpoint when states will see the highest number of cases. As cases rise, hospitals will experience surges, which can cause shortages of resources like intensive care unit beds and ventilators. When hospitals don’t have enough of those resources in place, more people die — as was seen in Italy.
So Mokdad and others on the team at the University of Washington are using reported deaths and mitigation practices to project trends on when deaths will spike in the U.S. and in individual states.
“In the United States now, with all the reporting, we know for sure that people are dying from coronavirus and how many of them are dying on a daily basis,” he said.
The researchers are updating their projections when new data on reported deaths becomes available — usually daily, but sometimes more frequently.
Based on the institute’s current projections, West Virginia will likely have enough hospital beds available to handle the expected surge in COVID-19 cases. But, there’s also likely to be some real challenges ahead. If the projected curve rings true, the state will be short dozens of ICU beds when the virus peaks.
The more a population stays at home, Mokdad said, the more likely it is to reduce the spread of the virus and prevent resource strains at hospitals — which, in turn, could reduce deaths.
Dr. Clay Marsh is vice president and executive dean of health sciences at West Virginia University. Last week, Gov. Jim Justice appointed Marsh to be the state’s coronavirus czar.
Marsh said in a phone interview with West Virginia Public Broadcasting, that while modeling is a good guide for officials leading the response to the virus, these are unprecedented times.
“I think that the benefit of these kind of models, it starts to demonstrate what are the critical things that you can do as a state, as a person and as a community — that are within your control to do — to change models that look like bad things are going to happen and replace it with models or the reality that shows that it's not nearly that bad,” Marsh said.
Marsh said the state’s supply of ventilators should be enough to cover the expected need when the peak hits West Virginia. He also said hospitals should be able to flex resources to make sure enough ICU beds are available when a surge happens.
And, as Marsh noted at Thursday’s virtual news conference, projections for West Virginia continue to improve.
“The projection is [that] we'll need less ICU beds today than we did yesterday and that fewer people are predicted to to die from this COVID-19 pandemic than was [predicted] yesterday,” Marsh said. “And as we talked about — although following these trends can be very useful as a guide for us — the future will be written by what we keep doing, not what we've done to date.”
Marsh cautions that there is a reality to the pandemic that is inescapable at this point.
“It doesn't mean that people aren't gonna get sick from the virus. They will. It doesn't mean that people won't die from the virus here in West Virginia. They will,” Marsh said. "That doesn’t mean that we're not going to see celebrities and people that we have seen on TV and maybe even some of our friends die — because that's going to happen, too, I believe."
But Marsh said he’s hopeful that — if West Virginians continue following public guidance — the state can have outcomes better than what projections currently show.