World-renowned health data analysts believe Malta’s coronavirus peak could occur around April 22, with a total of 19 deaths to be registered by August.

The Institute for Health Metrics and Evaluation (IHME), a health research centre at the University of Washington’s UW Medicine, has worked out projections for various countries by analysing hospital resource use and the number of deaths per day to be expected in the coming weeks. 

According to the data for Malta, the island will reach its peak during the third week of April, when eight patients will require treatment at the hospital’s Intensive Care Unit (ICU). The figure will start going down around the first week of May, the projections suggest, before dwindling to no critical patients by May 19. 

On deaths, the researchers predict the peak will occur at around the same time, on April 23, although the study suggests there will still only be one patient that dies on that day.  

Malta registered its first COVID-19 death on Wednesday, when a 92-year-old Gozitan woman with underlying medical conditions died. The next day, a 79-year-old man became Malta's second COVID-19 victim. 

As of Friday morning, Malta had registered 337 COVID-19 cases, with 16 patients considered to have recovered. 

The IHME projections also suggest that Malta would have registered a total of 19 coronavirus deaths by August 4.

Deaths per day predicted for Malta. The IHME data predicts one daily death during Malta's peak, though there is significant uncertainty baked into those predictions.

According to the data, Malta is unlikely to see its healthcare systems overwhelmed if it sticks to its current trajectory. The projections suggest that there are enough hospital beds, intensive care beds and ventilators to handle surges in case numbers.

The dataset was last updated on April 8. Both of Malta's COVID-19 deaths were not in the projections. 

Data includes 'uncertainty range'

As the study is based on predictions, the IHME also highlights what it calls the ‘uncertainty range’ - the range of values that the analysts believe is likely to include the correct projected estimate for a given data category. 

This means that while, for instance, it projected the deaths per day to peak at one case on April 23, this could actually be anywhere between zero and seven. 

This is also the case with the predictions on people at the ICU: the number could be anything between zero and 28 patients.

“Larger uncertainty intervals can result from limited data availability, small studies, and conflicting data, while smaller uncertainty intervals can result from extensive data availability, large studies, and data that are consistent across sources,” the IHME said in its report.

The IHME said it used the time from the implementation of social distancing measures to the peak of deaths in locations where this peak has already been reached or passed in order to model this relationship for locations where daily deaths have not yet reached their maximum.

According to Dominic Cortis, an actuary and lecturer with the University of Malta's Department of Insurance, the fact that the IHME report gives its uncertainty range helps with identifying the study’s limitations.

The analysts' projections about intensive care beds required. Shaded areas reflect uncertainty.

It is not clear, he said, whether the range given is a range of best-estimates or a range of what the worse scenario could be. It seems to be a range of best-estimates, he said, therefore this too could be subject to some fluctuations.

One issue with the study, however, is that while it provides an uncertainty range for the number of cases, variability over time is not given. It is more likely that the peak is not on the day given, April 22, than it being that day, Cortis said.

Another issue to keep in mind when dealing with such projections is the fact that Malta’s numbers are very small. Even one single fluctuation could impact the over all predictions.

What are the local authorities saying?

As of Friday, the health authorities had not yet published their own projections, despite repeated requests to do so by Times of Malta.

Both Health Minister Chris Fearne and the Superintendent of Public Health Charmaine Gauci have insisted Malta had yet to reach its peak and that the country was still in the early days of the outbreak.

But despite those words of caution, they have given no further information about their projections, with one small exception. 

A single detail on these projections was divulged on April 7, when the highest number of daily cases - 52 - was registered. Announcing the figure, Fearne had said the numbers did not take the authorities by surprise and they had actually been predicting the spike to occur a week earlier.

Repeated questions on whether the projections will actually be published and when have remained unanswered.

Both Fearne and Gauci have also urged the public not to look at a single day in isolation when making certain predictions but rather to analyse the situation based on a number of successive days.