Inference of COVID-19 epidemiological distributions from Brazilian hospital data
Iwona Hawryluk, Thomas A. Mellan, Henrique H. Hoeltgebaum, Swapnil Mishra, Ricardo P. Schnekenberg, Charles Whittaker, Harrison Zhu, Axel Gandy, Christl A. Donn… 展开作者
Iwona Hawryluk, Thomas A. Mellan, Henrique H. Hoeltgebaum, Swapnil Mishra, Ricardo P. Schnekenberg, Charles Whittaker, Harrison Zhu, Axel Gandy, Christl A. Donnelly, Seth Flaxman, Samir Bhatt
Knowing COVID-19 epidemiological distributions, such as the time from patient admission to death, is directly relevant to effective primary and secondary care planning, and moreover, the mathematical modelling of the pandemic generally. We determine epidemiological distributions for patients hospitalised with COVID-19 using a large dataset ($N=21{,}000-157{,}000$) from the Brazilian Sistema de Informação de Vigilância Epidemiológica da Gripe database. A joint Bayesian subnational model with partial pooling is used to simultaneously describe the 26 states and one federal district of Brazil, and shows significant variation in the mean of the symptom-onset-to-death time, with ranges between 11.2-17.8 days across the different states, and a mean of 15.2 days for Brazil. We find strong evidence in favour of specific probability density function choices: for example, the gamma distribution gives the best fit for onset-to-death and the generalised log-normal for onset-to-hospital-admission. Our results show that epidemiological distributions have considerable geographical variation, and provide the first estimates of these distributions in a low and middle-income setting. At the subnational level, variation in COVID-19 outcome timings are found to be correlated with poverty, deprivation and segregation levels, and weaker correlation is observed for mean age, wealth and urbanicity.
We collected individualized (unidentifiable) and aggregated openly available data from various sources related to suspected/confirmed SARS-CoV-2 infections, vaccinations, non-pharmaceutical government interventions, human mobility, and levels of population inequality in Brazil. In addition, a data structure allowing real-time data collection, curation, integration, and extract-transform-load processes for different objectives was developed. The granularity of this dataset (state- and municipality-wide) enables its application to individualized and ecological epidemiological studies, statistica…
Rule-based models have been successfully used to represent different aspects of the COVID-19 pandemic, including age, testing, hospitalisation, lockdowns, immunity, infectivity, behaviour, mobility and vaccination of individuals. These rule-based approaches are motivated by chemical reaction rules which are traditionally solved numerically with the standard Gillespie algorithm proposed in the context of molecular dynamics. When applying reaction system type of approaches to epidemiology, generalisations of the Gillespie algorithm are required due to the time-dependency of the problems. In this…
Using the classical Susceptible-Infected-Recovered epidemiological model, an analytical formula is derived for the number of beds occupied by Covid-19 patients. The analytical curve is fitted to data in Belgium, France, New York City and Switzerland, with a correlation coefficient exceeding 98.8%, suggesting that finer models are unnecessary with such macroscopic data. The fitting is used to extract estimates of the doubling time in the ascending phase of the epidemic, the mean recovery time and, for those who require medical intervention, the mean hospitalization time. Large variations can be…
In this paper, we estimate epidemiological data of the COVID-19 pandemic in Hungary using only the daily number of hospitalized patients, and applying well-known techniques from systems and control theory. We use a previously published and validated compartmental model for the description of epidemic spread. Exploiting the fact that an important subsystem of the model is linear, first we compute the number of latent infected persons in time. Then an estimate can be given for the number of people in other compartments. From these data, it is possible to track the time dependent reproduction num…
Solid estimates describing the clinical course of SARS-CoV-2 infections are still lacking due to under-ascertainment of asymptomatic and mild-disease cases. In this work, we quantify age-specific probabilities of transitions between stages defining the natural history of SARS-CoV-2 infection from 1,965 SARS-CoV-2 positive individuals identified in Italy between March and April 2020 among contacts of confirmed cases. Infected contacts of cases were confirmed via RT-PCR tests as part of contact tracing activities or retrospectively via IgG serological tests and followed-up for symptoms and clini…
Probability generating functions for epidemiological time series
The Roux Institute, Northeastern University（东北大学鲁克斯学院）；Network Science Institute, Northeastern University（东北大学网络科学研究所）；School of Electrical Engineering and Computer Science, University of Ottawa（渥太华大学电气与计算机工程学院）
Background: By the beginning of December 2020, some vaccines against COVID-19 already presented efficacy and security, which qualify them to be used in mass vaccination campaigns. Thus, setting up strategies of vaccination became crucial to control the COVID19 pandemic. Methods: We use daily COVID-19 reports from Chicago and NYC from 01-Mar2020 to 28- Nov-2020 to estimate the parameters of an SEIR-like epidemiological model that accounts for different severity levels. To achieve data adherent predictions, we let the model parameters to be time-dependent. The model is used to forecast different…
There are several reports in India that indicate hospitals and quarantined centers are COVID-19 hotspots. In the absence of efficient contact tracing tools, Govt. and the policymakers may not be paying attention to the risk of hospital-based transmission. To explore more on this important route and its possible impact on lockdown effect, we developed a mechanistic model with hospital-based transmission. Using daily notified COVID-19 cases from six states (Maharashtra, Delhi, Madhya Pradesh, Rajasthan, Gujarat, and Uttar Pradesh) and overall India, we estimated several important parameters of t…
There is increasing evidence that one of the most difficult problems in trying to control the ongoing COVID-19 epidemic is the presence of a large cohort of asymptomatic infectives. We develop a SIR-type model taking into account the presence of asymptomatic, or however undetected, infective, and the substantially long time these spend being infective and not isolated. We discuss how a SIR-based prediction of the epidemic course based on early data but not taking into account the presence of a large set of asymptomatic infectives would give wrong estimate of very relevant quantities such as th…
Several epidemiological models have been proposed to study the evolution of COVID-19 pandemic. In this paper, we propose an extension of the SUIHTER model, first introduced in [Parolini et al, Proc R. Soc. A., 2021] to analyse the COVID-19 spreading in Italy, which accounts for the vaccination campaign and the presence of new variants when they become dominant. In particular, the specific features of the variants (e.g. their increased transmission rate) and vaccines (e.g. their efficacy to prevent transmission, hospitalization and death) are modeled, based on clinical evidence. The new model i…
This paper uses Covasim, an agent-based model (ABM) of COVID-19, to evaluate and scenarios of epidemic spread in New York State (USA), the UK, and the Novosibirsk region (Russia). Epidemiological parameters such as contagiousness (virus transmission rate), initial number of infected people, and probability of being tested depend on the region's demographic and geographical features, the containment measures introduced; they are calibrated to data about COVID-19 spread in the region of interest. At the first stage of our study, epidemiological data (numbers of people tested, diagnoses, critical…
We propose a compartmental mathematical model for the spread of the COVID-19 disease, showing its usefulness with respect to the pandemic in Portugal, from the first recorded case in the country till the end of the three states of emergency. New results include the compartmental model, described by a system of seven ordinary differential equations; proof of positivity and boundedness of solutions; investigation of equilibrium points and their stability analysis; computation of the basic reproduction number; and numerical simulations with official real data from the Portuguese health authoritie…
Whole genome sequencing of pathogens from multiple hosts in an epidemic offers the potential to investigate who infected whom with unparalleled resolution, potentially yielding important insights into disease dynamics and the impact of control measures. We considered disease outbreaks in a setting with dense genomic sampling, and formulated stochastic epidemic models to investigate person-to-person transmission, based on observed genomic and epidemiological data. We constructed models in which the genetic distance between sampled genotypes depends on the epidemiological relationship between th…
The prevalence of COVID-19 has been the most serious health challenge of the 21th century to date, concerning national health systems on a daily basis, since December 2019 when it appeared in Wuhan City. Nevertheless, most of the proposed mathematical methodologies aiming to describe the dynamics of an epidemic, rely on deterministic models that are not able to reflect the true nature of its spread. In this paper, we propose a SEIHCRDV model - an extension/improvement of the classic SIR compartmental model - which also takes into consideration the populations of exposed, hospitalized, admitted…
The COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at a steep economic price. We design analytical tools to support these decisions and combat the pandemic. Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. By leveraging cohort-leve…
We propose an SEIR-type meta-population model to simulate and monitor the Covid-19 epidemic evolution. The basic model consists of seven compartments, namely susceptible (S), exposed (E), three infective classes, recovered (R), and deceased (D). We define these compartments for n age and gender groups in m different spatial locations. So, the resulting model has, for each age group, gender, and place, all epidemiological classes. The mixing between them is accomplished by means of time-dependent infection rate matrices. The model is calibrated with the curve of daily new infections in New York…
The COVID-19 epidemic is the last of a long list of pandemics that have affected humankind in the last century. In this paper, we propose a novel mathematical epidemiological model named SUIHTER from the names of the seven compartments that it comprises: susceptible uninfected individuals (S), undetected (both asymptomatic and symptomatic) infected (U), isolated (I), hospitalized (H), threatened (T), extinct (E), and recovered (R). A suitable parameter calibration that is based on the combined use of least squares method and Markov Chain Monte Carlo (MCMC) method is proposed with the aim of re…
During the first months, the Covid-19 pandemic has required most countries to implement complex sequences of non-pharmaceutical interventions, with the aim of controlling the transmission of the virus in the population. To be able to take rapid decisions, a detailed understanding of the current situation is necessary. Estimates of time-varying, instantaneous reproduction numbers represent a way to quantify the viral transmission in real time. They are often defined through a mathematical compartmental model of the epidemic, like a stochastic SEIR model, whose parameters must be estimated from …
We demonstrate the ability of statistical data assimilation to identify the measurements required for accurate state and parameter estimation in an epidemiological model for the novel coronavirus disease COVID-19. Our context is an effort to inform policy regarding social behavior, to mitigate strain on hospital capacity. The model unknowns are taken to be: the time-varying transmission rate, the fraction of exposed cases that require hospitalization, and the time-varying detection probabilities of new asymptomatic and symptomatic cases. In simulations, we obtain accurate estimates of undetect…
PyRoss is an open-source Python library that offers an integrated platform for inference, prediction and optimisation of NPIs in age- and contact-structured epidemiological compartment models. This report outlines the rationale and functionality of the PyRoss library, with various illustrations and examples focusing on well-mixed, age-structured populations. The PyRoss library supports arbitrary structured models formulated stochastically (as master equations) or deterministically (as ODEs) and allows mid-run transitioning from one to the other. By supporting additional compartmental subdivisi…
The Covid-19 pandemic has made clear the need to improve modern multivariate time-series forecasting models. Current state of the art predictions of future daily deaths and, especially, hospital resource usage have confidence intervals that are unacceptably wide. Policy makers and hospitals require accurate forecasts to make informed decisions on passing legislation and allocating resources. We used US county-level data on daily deaths and population statistics to forecast future deaths. We extended the SIR epidemiological model to a novel model we call the PECAIQR model. It adds several new v…
The severe acute respiratory syndrome COVID-19 has been in the center of the ongoing global health crisis in 2020. The high prevalence of mild cases facilitates sub-notification outside hospital environments and the number of those who are or have been infected remains largely unknown, leading to poor estimates of the crude mortality rate of the disease. Here we use a simple model to describe the number of accumulated deaths caused by COVID-19. The close connection between the proposed model and an approximate solution of the SIR model provides a system of equations whose solutions are robust …
In this work, using a detailed dataset furnished by National Health Authorities concerning the Province of Pavia (Lombardy, Italy), we propose to determine the essential features of the ongoing COVID-19 pandemic in term of contact dynamics. Our contribution is devoted to provide a possible planning of the needs of medical infrastructures in the Pavia Province and to suggest different scenarios about the vaccination campaign which possibly help in reducing the fatalities and/or reducing the number of infected in the population. The proposed research combines a new mathematical description of th…
Standard epidemiological models for COVID-19 employ variants of compartment (SIR) models at local scales, implicitly assuming spatially uniform local mixing. Here, we examine the effect of employing more geographically detailed diffusion models based on known spatial features of interpersonal networks, most particularly the presence of a long-tailed but monotone decline in the probability of interaction with distance, on disease diffusion. Based on simulations of unrestricted COVID-19 diffusion in 19 U.S cities, we conclude that heterogeneity in population distribution can have large impacts o…
We are currently living in a state of uncertainty due to the pandemic caused by the Sars-CoV-2 virus. There are several factors involved in the epidemic spreading such as the individual characteristics of each city/country. The true shape of the epidemic dynamics is a large, complex system such as most of the social systems. In this context, Complex networks are a great candidate to analyze these systems due to their ability to tackle structural and dynamical properties. Therefore this study presents a new approach to model the COVID-19 epidemic using a multi-layer complex network, where nodes…
SARS-CoV-2 has disrupted the life of billions of people around the world since the first outbreak was officially declared in China at the beginning of 2020. Yet, important questions such as how deadly it is or its degree of spread within different countries remain unanswered. In this work, we exploit the `universal' growth of the mortality rate with age observed in different countries since the beginning of their respective outbreaks, combined with the results of the antibody prevalence tests in the population of Spain, to unveil both unknowns. We validate these results with an analogous antib…
