MA Coronavirus: New Projection Doubles Likely Death Toll

MASSACHUSETTS — Despite widespread compliance with a stay-at-home advisory, a closely watched estimate of the state's likely death toll from the new coronavirus more than doubled recently, owing partly to a shortage of intensive-care beds.

The Seattle-based Institute for Health Metrics and Evaluation forecast last month that the pandemic could take more than 2,300 lives over the next four months. But its latest revision put that figure at 5,625*, based in part on the state's failure to mandate social distancing measures and stay-at-home orders, as other states have.

Massachusetts is projected to have the second-worst bed shortage in the country, behind only Connecticut.

A separate MIT Technology Review analysis of the IHME data found that Massachusetts will need 10 times as many intensive care beds as it now has, falling over 2,700 short of the 3,000 needed at the projected peak of the crisis on April 18. By comparison, California, with more than five times the population of Massachusetts, is projected to have only 1,783 deaths by Aug. 4, thanks to its surplus of 1,500 ICU beds. California has had a stay-at-home order in place since March 19.

The MIT analysis was conducted by using projections from April 5. The report underscores the importance of social distancing, which health care leaders have stressed is crucial in preventing hospitals from becoming overwhelmed with coronavirus patients.

The IHME, affiliated with the University of Washington and supported by the Bill and Melinda Gates foundation, formulated its projections using the expected peak of the infection in each state and the number of overall hospital beds, intensive-care beds and ventilators available for COVID-19 patients when most needed. White House officials have cited IHME projections when giving social distancing guidance.

The IHME figures are revised periodically as the disease progresses.

Amelia Apfel, a spokesperson for the institute, said the projection for Massachusetts was increased in part because the state has not implemented all four recommended government-mandated social distancing measures: closing schools, banning non-essential services, ordering residents to stay at home and limiting travel.

"We assume that states will put three of the four social distancing measures in place within seven days of the latest model run," Apfel said. "Projections worsen as states go further without putting at least three of the four in place."

In Massachusetts, schools were closed March 17 and non-essential services were ordered closed March 24, but the state has not limited travel or imposed a stay-at-home order. Gov. Charlie Baker issued a stay-at-home advisory on March 24, but it's not a mandate. According to cell phone tracking data, residents have complied well with the advisory, reducing trips to retail and recreation locations by 59 percent.

"I do not believe I can or should order U.S. citizens to keep confined to their homes for days on end," Baker said when he announced the advisory. "It doesn’t make sense from a public health point of view, and it’s not realistic."

Baker's office declined to comment on the IHME's latest projection.

The state uses it own model, which projects a shortfall of some 500 intensive-care beds at the peak of the crisis, April 10 to 20. Baker said Thursday that under the state's model, 705 to 2,580 people could die if the current fatality rate holds.

As of Tuesday, 356 had died in Massachusetts.

State officials are working on building intensive-care capacity and have encouraged strict adherence to the stay-at-home advisory.

In Massachusetts, the institute projects the crisis will peak on April 20, when the number of beds available for coronavirus patients will fall 3,180 short of the 8,028 needed, and the number of intensive-care beds will fall 1,596 short of the 1,873 needed.

On that date, deaths are expected to total 213, and 5,625 Massachusetts residents could die by Aug. 4, the institute said.

For the United States as a whole, the institute predicted that coronavirus infections would peak on April 11, when the nationwide supply of hospital beds for COVID-19 patients would fall 16,000 short of the supply and the supply of intensive-care beds for such patients would fall short by 9,000. Nationwide deaths on that date will top 2,212, the institute predicted, and would total more than 60,000 by Aug. 4.

The authors of the research article containing these findings wrote, “Our estimate of 81 thousand deaths in the US over the next 4 months is an alarming number, but this number could be substantially higher if excess demand for health system resources is not addressed and if social distancing policies are not vigorously implemented and enforced across all states.”

In making projections for the states, the institute took note of whether and when they issued stay-at-home orders, closed schools, closed other non-essential services and imposed travel bans.

“The estimated excess demand on hospital systems is predicated on the enactment of social distancing measures in all states that have not done so already within the next week and maintenance of these measures throughout the epidemic, emphasizing the importance of implementing, enforcing, and maintaining these measures to mitigate hospital system overload and prevent deaths,” the authors wrote.

*Editor's note: This story, published Tuesday night, originally reported an estimate by the Institute for Health Metrics and Evaluation that 8,254 people would die of coronavirus-related illness in Massachusetts by Aug. 4. On Wednesday morning, the IHME revised its estimate downward, to 5,625 deaths. The story and headline have been updated to reflect these and other figures in the story citing institute figures.