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When Medtronic executives said in late August that COVID-19 cases in the US were nearing their peak, they had been listening to a medical employee in New York whose surgical practice gives him first-rate experience. hand with the pandemic.

Dr. John de Csepel is Medtronic’s vice president of medical affairs and also leads a group of physicians who have been assisting the company’s ongoing crisis and risk management team.

While still working his main job at Medtronic, he and other doctors and nurses helped the medical device maker manage everything from internal policies on masking and coronavirus testing to a company-wide push for vaccines.

Because Medtronic’s business relies heavily on scheduled medical procedures that are postponed as hospitals care for COVID-19 patients, a key part of De Csepel’s work is focused on mentoring senior executives on what could happen with the pandemic.

“When we do these projections, we do not do it with any degree of bravado,” he said. “There is much more to learn about this virus.”

Forecasting requires humility given the novelty of the SARS-CoV-2 virus and the surprising twists and turns of the pandemic so far, said de Csepel, who spends weekends performing surgery at a New York City hospital. That medical center was particularly hard hit when COVID-19 first arrived in the US, prompting De Csepel to collaborate with intensive care patients.

“It got so bad that they even asked a surgeon like me to run a COVID ICU,” he said.

“These patients are the sickest patients in the hospital, they need the most sophisticated critical care. But we opened so many ICUs in the hospital, it seemed that every free room in the hospital had become a COVID ICU, they needed other doctors beyond those who are [specialized] in critical care to staff and manage those patients. “

Medtronic is one of the nation’s largest medical device manufacturers with more than 90,000 employees, including nearly 11,000 in Minnesota. Headquartered in Ireland, the company has its operational headquarters in Fridley.

In developing their perspective, the Medtronic team considers forecasts that are generated from but not based exclusively on sophisticated pandemic models developed by academic groups, de Csepel said.

They also attempt to understand the pandemic through medical literature, government data sources, and guidance from leading professionals in the field.

Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, is a referral source, de Csepel said, adding that he has listened to all 70 Osterholm pandemic podcasts.

“This is how we do our projections, it’s not that we have some kind of secret model,” de Csepel said. “It’s more really trying to understand the epidemiology of COVID and the dynamics of this virus.”

Trends in the UK tend to be a pretty good indicator of what could happen in the US, De Csepel said, because vaccination rates have been comparable in the two countries. Health systems generate somewhat similar patient outcomes, he added, and the population of the two countries mixes similarly in urban, suburban and rural areas.

The study of this year’s experience with the delta variant in England, where cases increased for about two months before starting to decline, helped inform the team’s guidance to CEO Geoff Martha, who said during the earnings call that Medtronic expected COVID-19 infection rates to increase. peak in the United States in early September. At the time, some equity analysts and academic models were also talking about a spike in early September.

The key message to investors was that Medtronic expected medical procedures using the company’s products to pick up in the company’s second quarter, which ends at the end of October.

“We think this is shorter and easier to handle than previous waves,” Martha said.

Three weeks later, the national numbers appeared to match the forecast of De Csepel and his team, de Csepel said.

As of Sept. 21, the Centers for Disease Control and Prevention were reporting a seven-day average of 127,655 new cases per day in the U.S., down from that measure’s recent peak of nearly 160,000 new cases on Sept. 1. September.

Image varies by state. New cases in Minnesota continue to rise, while Florida, which was one of the nation’s COVID-19 hot spots in August, has been reporting sharp declines for more than three weeks.

“We are seeing the states that were most affected in the southeast, where hospital capacity … was taken to extreme levels, now we have seen them fall quite markedly, not all, but in several states”, from Csepel. said.

The projection stemmed from the observation that, in the UK, the delta variant peaked about eight weeks after the first appearance, de Csepel said. In the US, Delta began pushing case totals in early July, so a spike for Labor Day seemed reasonable.

However, the British pattern is not always predictive.

In late 2020, England suffered a surge in cases fueled by an earlier variant of the virus. The influx had a huge impact on hospitals and led Osterholm and some other experts to warn that the UK variant was like a powerful hurricane threatening to hit the US shores.

In the end, though, it didn’t cause the national troubles that were feared, although Michigan and, to a lesser extent, Minnesota saw sudden spikes. Experience illustrates how there is always uncertainty with projections about COVID-19.

“[Osterholm] I would be the first to tell you that this virus is so humiliating, “said de Csepel.” And it has been absolutely humbling for us. “

If the national case count continues to fall as states like Minnesota, which was a little late for the summer delta surge, join places like Florida to see case declines, what’s next on the horizon with the pandemic?

It’s getting harder to predict, De Csepel said, as students return to schools and compliance with public health guidelines wanes. Still, Martha told investors at a recent conference: “We expect the headwinds from this latest wave to be transitory. And we look forward to a full recovery and a strong second half of our fiscal year.”


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