These are unprecedented times

 
Let us make no mistake about it and let us not be in denial but most importantly, let us not be fearful. These are unprecedented times. The Covid-19 (aka Coronavirus) has crept up on us with such a speed that we are still reeling from a sense of shock. Relaxed views have given way to worry, concern, fear of losing loved ones. Our entire lifestyles need changing, we need to think about how we interact, move, behave.
 
None of us alive today have ever witnessed a pandemic of this scale – of what is coming. Already today we observe hospital infrastructures in Italy being so overwhelmed that the elderly and weak with Covid-19 are not even admitted anymore and left to face certain death. The same will occur in other countries. This harsh reality emphasises the urgent need for good predictive planning and other efforts to stem this tide. There absolutely are things we can do and technology has a key role to play.
 
Meanwhile the spread of Covid-19 rages on, like wildfire. In the panic that is growing daily, with mounting infections and deaths, the systems and people that run them need to continue their work. Many at great risk. Cleaners, garbage collectors, policemen and all sorts of other service providers – many of them not well paid and thus overall more vulnerable. But the ones who need special mention now are our health care providers. Doctors, hospital administrators, laboratory staff, ambulance and general support staff and most of all, the nurses. The rapidly growing flows of Covid-19 cases are threatening to stretch our hospital systems to breaking point.
The term “flattening the curve” is making the rounds a lot now. The adjacent figure explains what this is.  Our hospitals face this challenge today as the Covid-19 virus is causing them to be inundated with case flows not seen before. Almost like in a war zone. China showed that to be the case, Italy and Spain are today and many other countries are already following. This will cause a variety of problems such as space, bed, equipment, as well as staff shortages. Indeed, staff will be overworked and some will likely die in their efforts to save others.
 
The rapidly growing pressure on health systems is already manifesting itself in a variety of ways. In many countries hospitals have to report the number of available emergency beds. In Switzerland, for example,  there are 82 intensive care units with 950 to 1,000 beds, around 850 of which are equipped with respirators. For Covid-19 treatment, respirators are a crucial piece of equipment. 
 
Flattening the flow
Governments face very tough choices now. Whether a policy of containment, phased exposure or mass accelerated exposure is adopted (ref. Global Forecaster www.davidmurrin.co.uk), any choice will have massive repercussions on our societies and systems within. In any case most of our hospitals will be totally overwhelmed.
 
This calls for the urgent need of not only good planning but effective predictive planning that helps hospital staff and health system authorities to be a step ahead and optimize the use of resources as best as possible.
 

Enter Calyps Artificial Intelligence platform

Since 2017 Calyps has been developing an Artificial Intelligence driven platform to help hospitals (and other sectors) to optimize their planning and scheduling challenges, specifically with flow predictions and associated resources impact predictions. Since 2019 the platform is up and running at the Valenciennes General Hospital (CHV) in Northern France, with an initial focus on patient flow predictions into their Emergency Ward. The high prediction accuracies (7 days lookahead) have significantly helped CHV manage their EW patient flows more efficiently and through to other wards.
 
CALYPS has been tracking the Covid-19 spread since mid January and, while we still were not sure where it would go, it was clear that something unusual was happening. Today we know more. Thinking through the impending challenges to hospitals, it was obvious that much of what we had learned from predicting emergency ward flows, could also be applied to Covid-19 case flows. This prompted the start of the fast track development of a Pandemic Flow Management Module. While still under development we aim to have first screens with flow predictions ready by end March/early April 2020. Not only will there be predictive results for individual hospitals but also for flows amongst a hospital network within a Covid-19 cluster, enabling a broader system view. The same for associated resources planning which will be driven by case flows.
 
The aim is to optimize the use of time, staff and hardware resources. Also, to ensure that cases needing hospital care can immediately find a hospital with capacity, without futile travelling around. The vision we at CALYPS have in mind is that we apply available technology much better and deliberately – and we will help develop it in our sphere, as others in theirs. Crucial prerequisites to this being successful lie maybe less in technology than in the acceptance and adoption by i) future users (hospitals themselves), ii) government authorities (being aware, being informed and dismantling slowing bureaucracy) and iii) potential funders (being more willing to fund  more rapidly and with a modified set of motives).
 
On the technology front, data is key. With that however comes the urgent need for data interoperability, transparency, availability of fit-for-purpose and holistic databases, no “regional thinking”, reduced language barriers, less politics. Data science combined with IT advances (soft- and hardware) can deliver incredible, life saving outcomes if we abandon old habits and get this right. CALYPS’s role in the crucial collective effort of “flattening the curve” is to “flatten the flows”.
 
Team CALYPS

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