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. 2020 Apr;76(2):147-155.
doi: 10.1016/j.mjafi.2020.03.022. Epub 2020 Apr 2.

Healthcare impact of COVID-19 epidemic in India: A stochastic mathematical model

Kaustuv Chatterjee  1 , Kaushik Chatterjee  2 , Arun Kumar  3 , Subramanian Shankar  4
Affiliations

Healthcare impact of COVID-19 epidemic in India: A stochastic mathematical model

Kaustuv Chatterjee et al. Med J Armed Forces India. 2020 Apr.

Abstract

Background: In India, the SARS-CoV-2 COVID-19 epidemic has grown to 1251 cases and 32 deaths as on 30 Mar 2020. The healthcare impact of the epidemic in India was studied using a stochastic mathematical model.

Methods: A compartmental SEIR model was developed, in which the flow of individuals through compartments is modeled using a set of differential equations. Different scenarios were modeled with 1000 runs of Monte Carlo simulation each using MATLAB. Hospitalization, intensive care unit (ICU) requirements, and deaths were modeled on SimVoi software. The impact of nonpharmacological interventions (NPIs) including social distancing and lockdown on checking the epidemic was estimated.

Results: Uninterrupted epidemic in India would have resulted in more than 364 million cases and 1.56 million deaths with peak by mid-July. As per the model, at current growth rate of 1.15, India is likely to reach approximately 3 million cases by 25 May, implying 125,455 (±18,034) hospitalizations, 26,130 (±3298) ICU admissions, and 13,447 (±1819) deaths. This would overwhelm India's healthcare system. The model shows that with immediate institution of NPIs, the epidemic might still be checked by mid-April 2020. It would then result in 241,974 (±33,735) total infections, 10,214 (±1649) hospitalizations, 2121 (±334) ICU admissions, and 1081 (±169) deaths.

Conclusion: At the current growth rate of epidemic, India's healthcare resources will be overwhelmed by the end of May. With the immediate institution of NPIs, total cases, hospitalizations, ICU requirements, and deaths can be reduced by almost 90%.

Keywords: COVID-19; Coronavirus; Epidemiology; Models; Quarantine; SARS-CoV-2; Theoretical.

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Conflict of interest statement

The authors have none to declare.

Figures

Fig. 1
Fig. 1
The SEIR epidemiological model. ∗The infectious group when symptomatic is Isolated, when asymptomatic is Quarantined. In practice, only a fraction of exposed are infectious, but ideally all E should be quarantined.
Fig. 2
Fig. 2
Model of natural spread of COVID-19-in Indian population yielding peak of infected cases.
Fig. 3
Fig. 3
COVID-19 growth across countries. (a) Rate of growth; (b) log scale representation.
Fig. 4
Fig. 4
COVID-19 cases per million as on 22 Mar 2020.
Fig. 5
Fig. 5
Age-stratified hospitalizations, ICU admissions, and deaths on 13 May (1 million cases) at the current growth rate. ICU, intensive care unit.
Fig. 6
Fig. 6
Effectiveness of quarantine / isolation (Inflection point achieved at 50%).
Fig. 7
Fig. 7
SEIR model of COVID-19: peak infections in India at effective quarantine levels of infectious individuals (a) 20%, (b) 40%, (c) 50%, and (d) 90%.
Fig. 8
Fig. 8
Effect of suppressive measures from q1% to q50%, resulting in bending of the curve.
See this image and copyright information in PMC

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