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      Mid-Epidemic Forecasts of COVID-19 Cases and Deaths: A Bivariate Model Applied to the UK

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      Interdisciplinary Perspectives on Infectious Diseases
      Hindawi

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          Abstract

          Background

          The evolution of the COVID-19 epidemic has been accompanied by efforts to provide comparable international data on new cases and deaths. There is also accumulating evidence on the epidemiological parameters underlying COVID-19. Hence, there is potential for epidemic models providing mid-term forecasts of the epidemic trajectory using such information. The effectiveness of lockdown or lockdown relaxation can also be assessed by modelling later epidemic stages, possibly using a multiphase epidemic model.

          Methods

          Commonly applied methods to analyse epidemic trajectories or make forecasts include phenomenological growth models (e.g., the Richards family of densities) and variants of the susceptible-infected-recovered (SIR) compartment model. Here, we focus on a practical forecasting approach, applied to interim UK COVID data, using a bivariate Reynolds model (for cases and deaths), with implementation based on Bayesian inference. We show the utility of informative priors in developing and estimating the model and compare error densities (Poisson-gamma, Poisson-lognormal, and Poisson-log-Student) for overdispersed data on new cases and deaths. We use cross validation to assess medium-term forecasts. We also consider the longer-term postlockdown epidemic profile to assess epidemic containment, using a two-phase model.

          Results

          Fit to interim mid-epidemic data show better fit to training data and better cross-validation performance for a Poisson-log-Student model. Estimation of longer-term epidemic data after lockdown relaxation, characterised by protracted slow downturn and then upturn in cases, casts doubt on effective containment.

          Conclusions

          Many applications of phenomenological models have been to complete epidemics. However, evaluation of such models based simply on their fit to observed data may give only a partial picture, and cross validation against actual trends is also valuable. Similarly, it may be preferable to model incidence rather than cumulative data, although this raises questions about suitable error densities for modelling often erratic fluctuations. Hence, there may be utility in evaluating alternative error assumptions.

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          Most cited references65

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          An interactive web-based dashboard to track COVID-19 in real time

          In December, 2019, a local outbreak of pneumonia of initially unknown cause was detected in Wuhan (Hubei, China), and was quickly determined to be caused by a novel coronavirus, 1 namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak has since spread to every province of mainland China as well as 27 other countries and regions, with more than 70 000 confirmed cases as of Feb 17, 2020. 2 In response to this ongoing public health emergency, we developed an online interactive dashboard, hosted by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, Baltimore, MD, USA, to visualise and track reported cases of coronavirus disease 2019 (COVID-19) in real time. The dashboard, first shared publicly on Jan 22, illustrates the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries. It was developed to provide researchers, public health authorities, and the general public with a user-friendly tool to track the outbreak as it unfolds. All data collected and displayed are made freely available, initially through Google Sheets and now through a GitHub repository, along with the feature layers of the dashboard, which are now included in the Esri Living Atlas. The dashboard reports cases at the province level in China; at the city level in the USA, Australia, and Canada; and at the country level otherwise. During Jan 22–31, all data collection and processing were done manually, and updates were typically done twice a day, morning and night (US Eastern Time). As the outbreak evolved, the manual reporting process became unsustainable; therefore, on Feb 1, we adopted a semi-automated living data stream strategy. Our primary data source is DXY, an online platform run by members of the Chinese medical community, which aggregates local media and government reports to provide cumulative totals of COVID-19 cases in near real time at the province level in China and at the country level otherwise. Every 15 min, the cumulative case counts are updated from DXY for all provinces in China and for other affected countries and regions. For countries and regions outside mainland China (including Hong Kong, Macau, and Taiwan), we found DXY cumulative case counts to frequently lag behind other sources; we therefore manually update these case numbers throughout the day when new cases are identified. To identify new cases, we monitor various Twitter feeds, online news services, and direct communication sent through the dashboard. Before manually updating the dashboard, we confirm the case numbers with regional and local health departments, including the respective centres for disease control and prevention (CDC) of China, Taiwan, and Europe, the Hong Kong Department of Health, the Macau Government, and WHO, as well as city-level and state-level health authorities. For city-level case reports in the USA, Australia, and Canada, which we began reporting on Feb 1, we rely on the US CDC, the government of Canada, the Australian Government Department of Health, and various state or territory health authorities. All manual updates (for countries and regions outside mainland China) are coordinated by a team at Johns Hopkins University. The case data reported on the dashboard aligns with the daily Chinese CDC 3 and WHO situation reports 2 for within and outside of mainland China, respectively (figure ). Furthermore, the dashboard is particularly effective at capturing the timing of the first reported case of COVID-19 in new countries or regions (appendix). With the exception of Australia, Hong Kong, and Italy, the CSSE at Johns Hopkins University has reported newly infected countries ahead of WHO, with Hong Kong and Italy reported within hours of the corresponding WHO situation report. Figure Comparison of COVID-19 case reporting from different sources Daily cumulative case numbers (starting Jan 22, 2020) reported by the Johns Hopkins University Center for Systems Science and Engineering (CSSE), WHO situation reports, and the Chinese Center for Disease Control and Prevention (Chinese CDC) for within (A) and outside (B) mainland China. Given the popularity and impact of the dashboard to date, we plan to continue hosting and managing the tool throughout the entirety of the COVID-19 outbreak and to build out its capabilities to establish a standing tool to monitor and report on future outbreaks. We believe our efforts are crucial to help inform modelling efforts and control measures during the earliest stages of the outbreak.
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            Bayesian Data Analysis

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              A New Framework and Software to Estimate Time-Varying Reproduction Numbers During Epidemics

              Abstract The quantification of transmissibility during epidemics is essential to designing and adjusting public health responses. Transmissibility can be measured by the reproduction number R, the average number of secondary cases caused by an infected individual. Several methods have been proposed to estimate R over the course of an epidemic; however, they are usually difficult to implement for people without a strong background in statistical modeling. Here, we present a ready-to-use tool for estimating R from incidence time series, which is implemented in popular software including Microsoft Excel (Microsoft Corporation, Redmond, Washington). This tool produces novel, statistically robust analytical estimates of R and incorporates uncertainty in the distribution of the serial interval (the time between the onset of symptoms in a primary case and the onset of symptoms in secondary cases). We applied the method to 5 historical outbreaks; the resulting estimates of R are consistent with those presented in the literature. This tool should help epidemiologists quantify temporal changes in the transmission intensity of future epidemics by using surveillance data.
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                Author and article information

                Contributors
                Journal
                Interdiscip Perspect Infect Dis
                Interdiscip Perspect Infect Dis
                ipid
                Interdisciplinary Perspectives on Infectious Diseases
                Hindawi
                1687-708X
                1687-7098
                2021
                12 February 2021
                : 2021
                : 8847116
                Affiliations
                School of Geography, Queen Mary University of London, Mile End Road, London E1 4NS, UK
                Author notes

                Academic Editor: Massimiliano Lanzafame

                Author information
                https://orcid.org/0000-0003-1934-9205
                Article
                10.1155/2021/8847116
                7881738
                33628235
                5b7a16b0-cf93-43e7-8710-9689df00861d
                Copyright © 2021 Peter Congdon.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 September 2020
                : 18 December 2020
                : 23 January 2021
                Categories
                Research Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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