The correct evaluation of the reproductive number $R$ for COVID-19 -- which characterizes the average number of secondary cases generated by each typical primary case -- is central in the quantification of the potential scope of the pandemic and the selection of an appropriate course of action. In most models, $R$ is modeled as a universal constant for the virus across outbreak clusters and individuals -- effectively averaging out the inherent variability of the transmission process due to varying individual contact rates, population densities, demographics, or temporal factors amongst many. Yet, due to the exponential nature of epidemic growth, the error due to this simplification can be rapidly amplified and lead to inaccurate predictions and/or risk evaluation. From the statistical modeling perspective, the magnitude of the impact of this averaging remains an open question: how can this intrinsic variability be percolated into epidemic models, and how can its impact on uncertainty quantification and predictive scenarios be better quantified? In this paper, we propose to study this question through a Bayesian perspective, creating a bridge between the agent-based and compartmental approaches commonly used in the literature. After deriving a Bayesian model that captures at scale the heterogeneity of a population and environmental conditions, we simulate the spread of the epidemic as well as the impact of different social distancing strategies, and highlight the strong impact of this added variability on the reported results. We base our discussion on both synthetic experiments -- thereby quantifying of the reliability and the magnitude of the effects -- and real COVID-19 data.
Background: The impact of individual non-pharmaceutical interventions (NPI) such as state-wide stay-at-home orders, school closures and gathering size limitations, on the COVID-19 epidemic is unknown. Understanding the impact that above listed NPI have on disease transmission is critical for policy makers, particularly as case counts increase again in some areas. Methods: Using a Bayesian framework, we reconstructed the incidence and time-varying reproductive number (Rt) curves to investigate the relationship between Rt, individual mobility as measured by Google Community Mobility Reports, and…
We propose a Bayesian Heterogeneity Learning approach for Susceptible-Infected-Removal-Susceptible (SIRS) model that allows underlying clustering patterns for transmission rate, recovery rate, and loss of immunity rate for the latest coronavirus (COVID-19) among different regions. Our proposed method provides simultaneously inference on parameter estimation and clustering information which contains both number of clusters and cluster configurations. Specifically, our key idea is to formulates the SIRS model into a hierarchical form and assign the Mixture of Finite mixtures priors for heterogen…
Faced with the 2020 SARS-CoV2 epidemic, public health officials have been seeking models that could be used to predict not only the number of new cases but also the levels of hospitalisation, critical care and deaths. In this paper we present a stochastic compartmental model capable of real-time monitoring and forecasting of the pandemic incorporating multiple streams of real-world data, reported cases, testing intensity, deaths, hospitalisations and critical care occupancy. Model parameters are estimated via a Bayesian particle filtering technique. The model successfully tracks the key variab…
Following the emergence of a novel coronavirus (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics. In response, many European countries have implemented unprecedented non-pharmaceutical interventions including case isolation, the closure of schools and universities, banning of mass gatherings and/or public events, and most recently, wide-scale social distancing including local and national lockdowns. In this technical update, we extend a semi-mechanistic Bayesian hierarchical model that infers the impact of these interventions and estimates the number of infec…
Background: The COVID-19 pandemic has had a profound impact on health, everyday life and economics around the world. An important complication that can arise in connection with a COVID-19 infection is acute kidney injury. A recent observational cohort study of COVID-19 patients treated at multiple sites of a tertiary care center in Berlin, Germany identified risk factors for the development of (severe) acute kidney injury. Since inferring results from a single study can be tricky, we validate these findings and potentially adjust results by including external information from other studies on …
In a recent paper, Jean Gaudart and colleagues studied the factors associated with the spatial heterogeneity of the first wave of COVID-19 in France. We make some critical comments on their work which may be useful for future, similar studies.
The expected number of secondary infections arising from each index case, referred to as the reproduction or $R$ number, is a vital summary statistic for understanding and managing epidemic diseases. There are many methods for estimating $R$; however, few explicitly model heterogeneous disease reproduction, which gives rise to superspreading within the population. We propose a parsimonious discrete-time branching process model for epidemic curves that incorporates heterogeneous individual reproduction numbers. Our Bayesian approach to inference illustrates that this heterogeneity results in le…
In August 2020, as Texas was coming down from a large summer COVID-19 surge, forecasts suggested that Hurricane Laura was tracking towards 6M residents along the East Texas coastline, threatening to spread COVID-19 across the state and cause pandemic resurgences. To assist local authorities facing the dual-threat, we integrated survey expectations of coastal residents and observed hurricane evacuation rates in a statistical framework that combined with local pandemic conditions predicts how COVID-19 would spread in response to a hurricane. For Hurricane Laura, we estimate that 499,500 [90% Cre…
We propose a high dimensional Bayesian inference framework for learning heterogeneous dynamics of a COVID-19 model, with a specific application to the dynamics and severity of COVID-19 inside and outside long-term care (LTC) facilities. We develop a heterogeneous compartmental model that accounts for the heterogeneity of the time-varying spread and severity of COVID-19 inside and outside LTC facilities, which is characterized by time-dependent stochastic processes and time-independent parameters in $\sim$1500 dimensions after discretization. To infer these parameters, we use reported data on t…
Covid-19 vaccination has posed crucial challenges to policymakers and health administrations worldwide. In addition to the pressure posed by the pandemic, government administration has to strive against vaccine hesitancy, which seems to be considerably higher concerning previous vaccination rollouts. To increase the vaccination protection of the population, Ohio announced a monetary incentive as a lottery for those who decided to vaccinate. This first example was followed by 18 other states, with varying results. In this paper, we want to evaluate the effect of such policies within the potenti…
Pooled testing offers an efficient solution to the unprecedented testing demands of the COVID-19 pandemic, although with potentially lower sensitivity and increased costs to implementation in some settings. Assessments of this trade-off typically assume pooled specimens are independent and identically distributed. Yet, in the context of COVID-19, these assumptions are often violated: testing done on networks (housemates, spouses, co-workers) captures correlated individuals, while infection risk varies substantially across time, place and individuals. Neglecting dependencies and heterogeneity m…
In this paper, we apply statistical methods for functional data to explain the heterogeneity in the evolution of number of deaths of Covid-19 over different regions. We treat the cumulative daily number of deaths in a specific region as a curve (functional data) such that the data comprise of a set of curves over a cross-section of locations. We start by using clustering methods for functional data to identify potential heterogeneity in the curves and their functional derivatives. This first stage is an unconditional descriptive analysis, as we do not use any covariate to estimate the clusters…
For hospitals, realistic forecasting of bed demand during impending epidemics of infectious diseases is essential to avoid being overwhelmed by a potential sudden increase in the number of admitted patients. Short-term forecasting can aid hospitals in adjusting their planning and freeing up beds in time. We created an easy-to-use online on-request tool based on local data to forecast COVID-19 bed demand for individual hospitals. The tool is flexible and adaptable to different settings. It is based on a stochastic compartmental model for estimating the epidemic dynamics and coupled with an expo…
In the recent COVID-19 pandemic, a wide range of epidemiological modelling approaches have been used to predict the effective reproduction number, R(t), and other COVID-19 related measures such as the daily rate of exponential growth, r(t). These candidate models use different modelling approaches or differing assumptions about spatial or age mixing, and some capture genuine uncertainty in scientific understanding of disease dynamics. Combining estimates using appropriate statistical methodology from multiple candidate models is important to better understand the variation of these outcome mea…
Assessing the impact of an intervention using time-series observational data on multiple units and outcomes is a frequent problem in many fields of scientific research. In this paper, we present a novel method to estimate intervention effects in such a setting by generalising existing approaches based on the factor analysis model and developing a Bayesian algorithm for inference. Our method is one of the few that can simultaneously: deal with outcomes of mixed type (continuous, binomial, count); increase efficiency in the estimates of the causal effects by jointly modelling multiple outcomes a…
Coronavirus COVID-19 spreads through the population mostly based on social contact. To gauge the potential for widespread contagion, to cope with associated uncertainty and to inform its mitigation, more accurate and robust modelling is centrally important for policy making. We provide a flexible modelling approach that increases the accuracy with which insights can be made. We use this to analyse different scenarios relevant to the COVID-19 situation in the UK. We present a stochastic model that captures the inherently probabilistic nature of contagion between population members. The computat…
