Slide 1

COVID-19 Modelling and

Health System Readiness
Update

April 28, 2020

www.saskatchewan.ca/COVID19
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*This presentation is
EMBARGOED until
2:30 p.m. on Tuesday,
April 28, 2020*

saskatchewan.ca/COVID19
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PURPOSE
SHA services will adapt and
expand to meet the projected
COVID-19 patient demand,
while continuing to deliver
essential services to
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non-COVID-19 patients
throughout the duration of the
event.

saskatchewan.ca/COVID19
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OUTLINE

• Introduction
• Saskatchewan COVID-19 Modelling
Update
• Offensive Strategy Update
• Defensive Strategy Update
• Resumption of Health Services
• Questions

saskatchewan.ca/COVID19
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Saskatchewan COVID-19
Modelling Update

Update: COVID-19 Modelling

and Health System Readiness
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KEY DEFINITIONS

BASIC REPRODUCTIVE NUMBER (R0) EFFECTIVE REPRODUCTIVE NUMBER (Rt)

Average number of people one person Average number of people one person
with the virus could infect where the with the virus infects at the current time
entire population is susceptible and no after the effects of interventions.
interventions have been undertaken.

Purpose: support planning for health Purpose: guide decisions about public
system readiness. health measures.

Note: April 8 modelling presentation was based on Basic

Reproductive Number (R0)

saskatchewan.ca/COVID19
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HOW IS SK DOING WITH CURRENT INTERVENTIONS

Case count per

100,000 people
similar to BC

“Flattening the
curve” with a
hammer

saskatchewan.ca/COVID19
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COVID-19 GOOGLE COMMUNITY MOBILITY REPORTS

https://www.google.com/covid19/mobility/

saskatchewan.ca/COVID19
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COVID-19 GOOGLE COMMUNITY MOBILITY REPORTS

CANADA

https://www.google.com/covid19/mobility/

saskatchewan.ca/COVID19
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EFFECTIVE REPRODUCTIVE NUMBER (Rt)

• Describes how well the

various interventions are
decreasing the spread of
COVID-19 at the current time
• Also reflects fluctuating public
compliance
• Once Rt<1, virus is at the
tipping point
• Rt consistently <1 is a major
consideration in determining
public health measures
• ‘The Hammer and the Dance’ Effective Reproductive Number in SK
April 25 Rt= 0.7 (lagging indicator by 7-14 days)
This reflects strong SK compliance with public
health measures

saskatchewan.ca/COVID19
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SK’S EFFECTIVE REPRODUCTIVE NUMBER (Rt)
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BASIC REPRODUCTIVE NUMBER (R0) IN SK 12

R0 = Average number of people one person with the virus

could infect where the entire population is susceptible and
no interventions have been undertaken.

• Previously, no history of how it spreads in

Saskatchewan, so needed to use what we knew from
other areas that had experience

• SK case data has been used to estimate a SK R0 of 3.12,

to guide planning activities for a worst case scenario

saskatchewan.ca/COVID19
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BASIC REPRODUCTIVE NUMBER (R0) IN SK 13

Saskatchewan’s
Worst Case
Planning
Scenario (R0)

saskatchewan.ca/COVID19
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KEY MESSAGES
• Dynamic modelling is not a
prediction, it provides a range
of “what if” scenarios to
guide planning and will evolve
over time.

• The Rt value is helpful in

determining effectiveness of
current interventions right
now, and can be a guidepost
to use when choosing to
implement new measures, or Effective Reproductive Number in SK
loosen existing ones. April 25 Rt= 0.7
(lagging indicator by 7-14 days)
• Early warning system shared
with the public is key during
saskatchewan.ca/COVID19
the ‘dance.’
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Offensive Strategy
Update

Update: COVID-19 Modelling

and Health System Readiness
 Slide

COMMUNITY SURGE PLAN 16

• Our offensive strategy continues to progress and is rooted in the

SHA’s service delivery model: Connected Care for the People of
Saskatchewan

• As the province begins to re-open, care in the community

remains the foundation of our health care system

• The SHA has already implemented a number of initiatives to

support care in community to reduce the burden on the acute
care system

saskatchewan.ca/COVID19
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COMMUNITY SURGE PLAN 17

Testing strategy supports contain and delay approach

• Broad availability of testing based on guidelines that support testing for
virtually anyone with even a single symptom

• Work to further scale up testing is in progress including:

o Testing asymptomatic contacts identified through public health
contact and outbreak investigations
o Outreach to populations less likely to seek testing
o Sending consistent messages to the public and health care
providers regarding testing

• Over 50 testing sites are located across the province, including 18 on First
Nations

• Lab capacity is available to support more than 1,500 tests per day
o Ongoing expansion of access to rapid testing capability with
GeneExpert equipment across 8 sites to date with 11 more sites
in coming weeks (inclusive of SHA supporting 4 First Nations
sites)

saskatchewan.ca/COVID19
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COMMUNITY SURGE PLAN 18

Contact tracing surge plan

• Adoption of SHA Contact Tracing Application to streamline the
process and enhance reporting and monitoring
o Saskatchewan is a leader in adoption of this common
application

• Load leveling of resources across the province to support outbreaks

• Surge capacity available to stay ahead of demand and respond to

outbreaks
o Current capacity available for more than 300 new cases
per day
o Modelled potential new cases per day of 618 was used to
inform planned capacity of 460 full time equivalent staff

saskatchewan.ca/COVID19
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COMMUNITY SURGE PLAN 19

Assessment and treatment sites

• 16 sites available across Saskatchewan and more opening soon

Virtual Care
• Total clinician users: 2,000
• Total sessions: 35,000

Protecting our most vulnerable

• Early implementation of screening of staff and visitors in long-term care
facilities
• Cohorting strategy to restrict staff to work in a single facility

Continuation of home care services, maintaining Seniors House Calls and Community
Paramedicine programs

Meeting the needs of our vulnerable populations and supporting the homeless

Contingency plans to use hotels to cohort COVID-19 positive patients who require
intermediate care

saskatchewan.ca/COVID19
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Defensive Strategy
Update

Update: COVID-19 Modelling

and Health System Readiness
 Slide

ACUTE SURGE PLANNING 21

• Opportunity to adjust planning scenario based on

updated modelling information
• Sustain conservative capacity estimates and
contingency to be prepared for a worst case surge
• Retain staged response to patient demand

saskatchewan.ca/COVID19
 Planning
ORIGINAL PLANNING SCENARIO Scenario Slide 22
mid-point
between
COVID-19 patients only
Upper Range Original Mid Range Low Range
Peak values, except where Scenario 1 Planning Scenario 2 Scenario 3
cumulative (R0 = 4.0) Scenario (R0 = 2.76) (R0 = 2.4)

Cumulative total cases 408,000 335,000 262,000 153,000

Hospital admissions/ day 710 458 205 60
Hospital census 4,265 2,765 1,265 390
ICU admissions /day 215 138 60 20
ICU census 1,280 830 380 120
Patients requiring 1,230 800 370 120
ventilation
Cumulative total deaths 8,370 6,815 5,260 3,075

saskatchewan.ca/COVID19
 PLANNING SCENARIO Revised
Planning
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Scenario
COVID-19 patients only
Upper Range Original Sask Age Mid Range Low Range
Peak values, except Scenario 1 Planning Stratified Scenario 2 Scenario 3
where cumulative (R0 = 4.0) Scenario Scenario Revised Planning(R0 = 2.4)
(R0 = 2.76)
(R0=3.12)
Scenario:
Cumulative total cases 408,000 335,000 254,756 Ensures SK remains
• 262,000 153,000
prepared for a major
Hospital admissions/ day 710 458 190 205 60
surge
Hospital census 4,265 2,765 1,736 • Informed
1,265 SK R0390
in new
modelling
ICU admissions /day 215 138 60 60 20
• Max capacity can be
ICU census 1,280 830 412 380
reduced 120
by 1,000
Patients requiring 1,230 800 403 hospital
370 beds, 400
120 ICU
beds, 400 ventilators
ventilation (total ventilators in planned
scenario of 403 are within
Cumulative total deaths 8,370 6,815 3,050 5,260 3,075
current ventilator capacity of
486 ventilators)

saskatchewan.ca/COVID19
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PLANNING UPDATE 24

• SHA is currently adjusting local surge plans based on

the updated planning scenario
• Cohorting of COVID-19 patients forms the foundation
of a staged response
• Staged activation of COVID-19, non-COVID-19 and
mixed hospitals remains part of the response plan
• Timing and trigger points for deployment of the plan
may be adjusted

saskatchewan.ca/COVID19
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FIELD HOSPITALS 25

Prepare field hospitals with two stages of activation:

• Stage one: Required base infrastructure preparation

complete and equipment available for activation within a
predetermined amount of time
• Stage two: Capacity available for expansion of services as
needed

Stage 1 Stage 2 Total beds

Beds Additional Beds
Saskatoon (Merlis Belsher) 125 125 250
Regina (Evraz Place) 184 216 400
Total 309 341 650

saskatchewan.ca/COVID19
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Health System Service

Resumption

Update: COVID-19 Modelling

and Health System Readiness
 Slide
HEALTH SYSTEM SERVICE RESUMPTION 27

• SHA and Ministry of Health are developing a plan to resume, in a

staged approach, community services, elective surgeries and
diagnostics that were impacted by the service slowdown
• The plan will include a methodical and cautious reintroduction of
services
• Identification of which services to resume will consider factors
such as highest priority patient needs, risk of transmission of the
virus, impact on COVID-19 surge capacity, impact on personal
protective equipment inventory, and other considerations
• The system must remain able to respond to potential COVID-19
surge in demand

saskatchewan.ca/COVID19
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SUMMARY 28

• Updated modelling information provides insight into

Saskatchewan situation and potential scenarios

• Offensive strategy aims to sustain low rates of transmission

Continued vigilance by the public has the most impact

• Defensive strategy provides surge capacity for potential future

demand

• Resumption of Health Services plan will be phased to support

non-COVID-19 patient care while ensuring ability to respond to
potential COVID-19 surge in demand

saskatchewan.ca/COVID19
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QUESTIONS
COVID-19 Modelling and
Health System Readiness Update

saskatchewan.ca/COVID19
Healthy People, Healthy Saskatchewan
The Saskatchewan Health Authority works in the spirit of truth and reconciliation,
acknowledging Saskatchewan as the traditional territory of First Nations and Métis People. Slide 30