In this paper, we develop an extension of standard epidemiological models, suitable for COVID-19. This extension incorporates the transmission due to pre-symptomatic or asymptomatic carriers of the virus. Furthermore, this model also captures the spread of the disease due to the movement of people to/from different administrative boundaries within a country. The model describes the probabilistic rise in the number of confirmed cases due to the concomitant effects of (incipient) human transmission and multiple compartments. The associated parameters in the model can help architect the public health policy and operational management of the pandemic. For instance, this model demonstrates that increasing the testing for symptomatic patients does not have any major effect on the progression of the pandemic, but testing rate of the asymptomatic population has an extremely crucial role to play. The model is executed using the data obtained for the state of Chhattisgarh in the Republic of India. The model is shown to have significantly better predictive capability than the other epidemiological models. This model can be readily applied to any administrative boundary (state or country). Moreover, this model can be applied for any other epidemic as well.
Repeat asymptomatic testing in order to identify and quarantine infectious individuals has become a widely-used intervention to control SARS-CoV-2 transmission. In some workplaces, and in particular health and social care settings with vulnerable patients, regular asymptomatic testing has been deployed to staff to reduce the likelihood of workplace outbreaks. We have developed a model based on data available in the literature to predict the potential impact of repeat asymptomatic testing on SARS-CoV-2 transmission. The results highlight features that are important to consider when modelling te…
As of December 2020, the COVID-19 pandemic has infected over 75 million people, making it the deadliest pandemic in modern history. This study develops a novel compartmental epidemiological model specific to the SARS-CoV-2 virus and analyzes the effect of common preventative measures such as testing, quarantine, social distancing, and vaccination. By accounting for the most prevalent interventions that have been enacted to minimize the spread of the virus, the model establishes a paramount foundation for future mathematical modeling of COVID-19 and other modern pandemics. Specifically, the mod…
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.
Modern Bayesian approaches and workflows emphasize in how simulation is important in the context of model developing. Simulation can help researchers understand how the model behaves in a controlled setting and can be used to stress the model in different ways before it is exposed to any real data. This improved understanding could be beneficial in epidemiological models, specially when dealing with COVID-19. Unfortunately, few researchers perform any simulations. We present a simulation algorithm that implements a simple agent-based model for disease transmission that works with a standard co…
The unprecedented coronavirus disease 2019 (COVID-19) pandemic is still a worldwide threat to human life since its invasion into the daily lives of the public in the first several months of 2020. Predicting the size of confirmed cases is important for countries and communities to make proper prevention and control policies so as to effectively curb the spread of COVID-19. Different from the 2003 SARS epidemic and the worldwide 2009 H1N1 influenza pandemic, COVID-19 has unique epidemiological characteristics in its infectious and recovered compartments. This drives us to formulate a new infecti…
Disease spread is a complex phenomenon requiring an interdisciplinary approach. Covid-19 exhibited a global spatial spread in a very short time frame resulting in a global pandemic. Data of web search effort in Greece on Covid-19 as a topic for one year on a weekly temporal scale were analyzed using governmental intervention measures such a s school closures, movement restrictions, national and international travelling restrictions, stay at home requirements, mask requirements, financial support measures, and epidemiological variables such as new cases and new deaths as potential explanatory c…
The role of epidemiological models is crucial for informing public health officials during a public health emergency, such as the COVID-19 pandemic. However, traditional epidemiological models fail to capture the time-varying effects of mitigation strategies and do not account for under-reporting of active cases, thus introducing bias in the estimation of model parameters. To infer more accurate parameter estimates and to reduce the uncertainty of these estimates, we extend the SIR and SEIR epidemiological models with two time-varying parameters that capture the transmission rate and the rate …
Scientific advice to the UK government throughout the COVID-19 pandemic has been informed by ensembles of epidemiological models provided by members of the Scientific Pandemic Influenza group on Modelling (SPI-M). Among other applications, the model ensembles have been used to forecast daily incidence, deaths and hospitalizations. The models differ in approach (e.g. deterministic or agent-based) and in assumptions made about the disease and population. These differences capture genuine uncertainty in the understanding of disease dynamics and in the choice of simplifying assumptions underpinnin…
Estimates from infectious disease models have constituted a significant part of the scientific evidence used to inform the response to the COVID-19 pandemic in the UK. These estimates can vary strikingly in their bias and variability. Epidemiological forecasts should be consistent with the observations that eventually materialise. We use simple scoring rules to refine the forecasts of a novel statistical model for multisource COVID-19 surveillance data by tuning its smoothness hyperparameter.
We propose a forecasting method for predicting epidemiological health series on a two-week horizon at the regional and interregional resolution. The approach is based on model order reduction of parametric compartmental models, and is designed to accommodate small amount of sanitary data. The efficiency of the method is shown in the case of the prediction of the number of infected and removed people during the two pandemic waves of COVID-19 in France, which have taken place approximately between February and November 2020. Numerical results illustrate the promising potential of the approach.
This paper extends the canonical model of epidemiology, SIRD model, to allow for time varying parameters for real-time measurement of the stance of the COVID-19 pandemic. Time variation in model parameters is captured using the generalized autoregressive score modelling structure designed for the typically daily count data related to pandemic. The resulting specification permits a flexible yet parsimonious model structure with a very low computational cost. This is especially crucial at the onset of the pandemic when the data is scarce and the uncertainty is abundant. Full sample results show …
We propose a novel methodology for estimating the epidemiological parameters of a modified SIRD model (acronym of Susceptible, Infected, Recovered and Deceased individuals) and perform a short-term forecast of SARS-CoV-2 virus spread. We mainly focus on forecasting number of deceased. The procedure was tested on reported data for Poland. For some short-time intervals we performed numerical test investigating stability of parameter estimates in the proposed approach. Numerical experiments confirm the effectiveness of short-term forecasts (up to 2 weeks) and stability of the method. To improve t…
The subset selection problem of linear algebra is applied to identify independent patterns of COVID-19 evolution within Brazil. The data consist of a set of mortality curves in states of Brazil. A subset of the most independent curves is selected by using a functional version of the QR matrix decomposition technique with column pivoting. The selected subset is used next as a basis to represent the remaining curves filtering out any data redundancy. For each independent curve, an associated epidemiological region of influence is defined. The results show two main independent curves with a simil…
The coronavirus pandemic has rapidly evolved into an unprecedented crisis. The susceptible-infectious-removed (SIR) model and its variants have been used for modeling the pandemic. However, time-independent parameters in the classical models may not capture the dynamic transmission and removal processes, governed by virus containment strategies taken at various phases of the epidemic. Moreover, very few models account for possible inaccuracies of the reported cases. We propose a Poisson model with time-dependent transmission and removal rates to account for possible random errors in reporting …
Mathematical models have been used to understand the spread patterns of infectious diseases such as Coronavirus Disease 2019 (COVID-19). The transmission component of the models can be modelled in an age-dependent manner via introducing contact matrix for the population, which describes the contact rates between the age groups. Since social contact patterns vary from country to country, we can compare and group the countries using the corresponding contact matrices. In this paper, we present a framework for clustering countries based on their contact matrices with respect to an underlying epid…
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 growing literature on the propagation of COVID-19 relies on various dynamic SIR-type models (Susceptible-Infected-Recovered) which yield model-dependent results. For transparency and ease of comparing the results, we introduce a common representation of the SIR-type stochastic epidemiological models. This representation is a discrete time transition model, which allows us to classify the epidemiological models with respect to the number of states (compartments) and their interpretation. Additionally, the transition model eliminates several limitations of the deterministic continuous time e…
This study presents a new risk-averse multi-stage stochastic epidemics-ventilator-logistics compartmental model to address the resource allocation challenges of mitigating COVID-19. This epidemiological logistics model involves the uncertainty of untested asymptomatic infections and incorporates short-term human migration. Disease transmission is also forecasted through a new formulation of transmission rates that evolve over space and time with respect to various non-pharmaceutical interventions, such as wearing masks, social distancing, and lockdown. The proposed multi-stage stochastic model…
Data Science Institute（数据科学研究所）；Imperial College London（伦敦帝国理工学院）
The global pandemic of the 2019-nCov requires the evaluation of policy interventions to mitigate future social and economic costs of quarantine measures worldwide. We propose an epidemiological model for forecasting and policy evaluation which incorporates new data in real-time through variational data assimilation. We analyze and discuss infection rates in China, the US and Italy. In particular, we develop a custom compartmental SIR model fit to variables related to the epidemic in Chinese cities, named SITR model. We compare and discuss model results which conducts updates as new observation…
According to the current perception, symptomatic, presymptomatic, and asymptomatic infectious persons can infect the healthy population susceptible to the SARS-Cov-2. More importantly, various reports indicate that the number of asymptomatic cases can be several-fold higher than the reported symptomatic cases. In this article, we take the reported cases in India and various states within the country till September 1, as the specimen to understand the progression of the COVID-19. Employing a modified SEIRD model, we predict the spread of COVID-19 by the symptomatic as well as asymptomatic infec…
We discuss how the presence of a large set of asymptomatic infectives changes our estimate of the COVID-19 basic reproduction number, also known as $R_0$.
A quantitative COVID-19 model that incorporates hidden asymptomatic patients is developed, and an analytic solution in parametric form is given. The model incorporates the impact of lockdown and resulting spatial migration of population due to announcement of lockdown. A method is presented for estimating the model parameters from real-world data. It is shown that increase of infections slows down and herd immunity is achieved when symptomatic patients are 4-6\% of the population for the European countries we studied, when the total infected fraction is between 50-56 \%. Finally, a method for …
The ongoing COVID-19 pandemic has overwhelmingly demonstrated the need to accurately evaluate the effects of implementing new or altering existing nonpharmaceutical interventions. Since these interventions applied at the societal level cannot be evaluated through traditional experimental means, public health officials and other decision makers must rely on statistical and mathematical epidemiological models. Nonpharmaceutical interventions are typically focused on contacts between members of a population, and yet most epidemiological models rely on homogeneous mixing which has repeatedly been …
We present a compartmental SEIAR model of epidemic spread as a generalization of the SEIR model. We believe that the asymptomatic infectious cohort is an omitted part of the understanding of the epidemic dynamics of disease COVID-19. We introduce and derive the basic reproduction number as the weighted arithmetic mean of the basic reproduction numbers of the symptomatic and asymptomatic cohorts. Since the asymptomatic subjects people are not detected, they can spread the disease much longer, and this increases the COVID-19 $R_0$ up to around 9. We show that European epidemic outbreaks in vario…
An analysis of the COVID-19 epidemic is proposed on the basis of the epiMOX dashboard (publicly accessible at https://www.epimox.polimi.it) that deals with data of the epidemic trends and outbreaks in Italy from late February 2020. Our analysis provides an immediate appreciation of the past epidemic development, together with its current trends by fostering a deeper interpretation of available data through several critical epidemic indicators. In addition, we complement the epiMOX dashboard with a predictive tool based on an epidemiological compartmental model, named SUIHTER, for the forecast …
To represent the complex individual interactions in the dynamics of disease spread informed by data, the coupling of an epidemiological agent-based model with the ensemble Kalman filter is proposed. The statistical inference of the propagation of a disease by means of ensemble-based data assimilation systems has been studied in previous work. The models used are mostly compartmental models representing the mean field evolution through ordinary differential equations. These techniques allow to monitor the propagation of the infections from data and to estimate several parameters of epidemiologi…
We measure the effect of different public health regulations to the spread of COVID-19, based on a SEIRA model -- a SEIR model including asymptomatic transmissions. The cumulative confirmed cases and death show nonlinear positive relationship with the value of asymptomatic rate. Based on this model, we analyze the inhibit effects to COVID-19 of three types of public health policies, i.e. isolation of laboratory confirmed cases, general personal protection and quarantine (lock-down). The simulations conclude that the isolation display limited effects to the asymptomatic viral carriers. The gene…
Asymptomatic individuals in the context of malarial disease refers to subjects who carry a parasite load but do not show clinical symptoms. A correct understanding of the influence of asymptomatic individuals on transmission dynamics will provide a comprehensive description of the complex interplay between the definitive host (female \textit{Anopheles} mosquito), intermediate host (human) and agent (\textit{Plasmodium} parasite). The goal of this article is to conduct a rigorous mathematical analysis of a new compartmentalized malaria model accounting for asymptomatic human hosts for the purpo…
Macroscopic growth laws, solutions of mean field equations, describe in an effective way an underlying complex dynamics. They are applied to study the spreading of infections, as in the case of CoviD-19, where the counting of the cumulated number $N(t)$ of detected infected individuals is a generally accepted, coarse-grain, variable to understand the epidemic phase. However $N(t)$ does not take into account the unknown number of asymptomatic, not detected, cases $A(t)$. Therefore, the question arises if the observed time series of data of $N(t)$ is a reliable tool for monitoring the evolution …
We have studied the dynamic evolution of the Covid-19 pandemic in Argentina. The marked heterogeneity in population density and the very extensive geography of the country becomes a challenge itself. Standard compartment models fail when they are implemented in the Argentina case. We extended a previous successful model to describe the geographical spread of the AH1N1 influenza epidemic of 2009 in two essential ways: we added a stochastic local mobility mechanism, and we introduced a new compartment in order to take into account the isolation of infected asymptomatic detected people. Two funda…
The goal of this article is to analyze some compartmental models specially designed to model the spread of a disease whose transmission has the same features as COVID-19. The major contributions of this article are: (1) Rigorously find sufficient conditions for the outbreak to only have one peak, i.e. for no second wave of infection to form; (2) Investigate the formation of other waves of infection when such conditions are not met; (3) Use numerical simulations to analyze the different roles asymptomatic carriers can have. We also argue that dividing the population into non-interacting groups …
Considering the propagation characteristics of COVID-19 in different regions, the dynamics analysis and numerical demonstration of long-term and short-term models of COVID-19 are carried out, respectively. The long-term model is devoted to investigate the global stability of COVID-19 model with asymptomatic infections and quarantine measures. By using the limit system of the model and Lyapunov function method, it is shown that the COVID-19-free equilibrium $V^0$ is globally asymptotically stable if the control reproduction number $\mathcal{R}_{c}<1$ and globally attractive if $\mathcal{R}_{c}=…
This paper provides a mathematical model to show that the incorrect estimation of r, the fraction of asymptomatic COVID-19 carriers in the general population, can account for much of the world's failure to contain the pandemic in its early phases. The SE(A+O)R model with infectives separated into asymptomatic and ordinary carriers, supplemented by a model of the data generation process, is calibrated to standard datasets for several countries. It is shown that certain fundamental parameters, notably r, are unidentifiable with this data. A number of potential types of policy intervention are an…
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…
The COVID-19 epidemic has been spreading around the world for nearly three years, and asymptomatic infections have exacerbated the spread of the epidemic. To evaluate the role of asymptomatic infections in the spread of the epidemic, we develop mathematical models to assess the proportion of asymptomatic infections caused by different strains of the main covid-19 variants. The analysis shows that when the control reproduction number is less than 1, the disease-free equilibrium point of the model is globally asymptotically stable; and when the control reproduction number is greater than 1, the …
The COVID-19 pandemic has posed significant challenges in modeling its complex epidemic transmissions, infection and contagion, which are very different from known epidemics. The challenges in quantifying COVID-19 complexities include effectively modeling its process and data uncertainties. The uncertainties are embedded in implicit and high-proportional undocumented infections, asymptomatic contagion, social reinforcement of infections, and various quality issues in the reported data. These uncertainties become even more apparent in the first two months of the COVID-19 pandemic, when the rele…
Testing for infection with SARS-CoV-2 is an important intervention in reducing onwards transmission of COVID-19, particularly when combined with the isolation and contact-tracing of positive cases. Many countries with the capacity to do so have made use of lab-processed Polymerase Chain Reaction (PCR) testing targeted at individuals with symptoms and the contacts of confirmed cases. Alternatively, Lateral Flow Tests (LFTs) are able to deliver a result quickly, without lab-processing and at a relatively low cost. Their adoption can support regular mass asymptomatic testing, allowing earlier det…
We consider the transmission dynamics of COVID-19 which is characterized by two distinct features. One is the existence of asymptomatic carriers which is a hidden variable in the problem. The other is the issue of latency which means that among the symptomatic carriers there could be a fraction whose symptoms develop after a couple of days. Our modelling is restricted to what we call the Phase -1 of the disease. During this phase the disease sets in and the number of infected people starts growing fast ( the number of new cases per day keeps growing on an average ) and then it slows down ( the…
Coronavirus disease 2019 (COVID-19) is a continuously devastating public health and the world economy. One of the major challenges in controlling the COVID-19 outbreak is its asymptomatic infection and transmission, which are elusive and defenseless in most situations. The pathogenicity and virulence of asymptomatic COVID-19 remain mysterious. Based on the genotyping of 20656 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) genome isolates, we reveal that asymptomatic infection is linked to SARS-CoV-2 11083G>T mutation, i.e., leucine (L) to phenylalanine (F) substitution at the res…
The aim of this study is to propose a modified Susceptible-Exposed-Infectious-Removed (SEIR) model that describes the behaviour of symptomatic, asymptomatic and hospitalized patients of COVID-19 epidemic, including the effect of demographic variation of population. It is shown that considering a population growth proportional to the total population leads to solutions with a qualitative behaviour different from the behaviour obtained in many studies, where constant growth ratio is assumed. An exhaustive theoretical study is carried out and the basic reproduction number $R_0$ is computed from t…
COVID-19--a viral infectious disease--has quickly emerged as a global pandemic infecting millions of people with a significant number of deaths across the globe. The symptoms of this disease vary widely. Depending on the symptoms an infected person is broadly classified into two categories namely, asymptomatic and symptomatic. Asymptomatic individuals display mild or no symptoms but continue to transmit the infection to otherwise healthy individuals. This particular aspect of asymptomatic infection poses a major obstacle in managing and controlling the transmission of the infectious disease. I…
We develop and analyze in this work an epidemiological model for COVID-19 using Tunisian data. Our aims are first to evaluate Tunisian control policies for COVID-19 and secondly to understand the effect of different screening, quarantine and containment strategies and the rule of the asymptomatic patients on the spread of the virus in the Tunisian population. With this work, we show that Tunisian control policies are efficient in screening infected and asymptomatic individuals and that if containment and curfew are maintained the epidemic will be quickly contained.
A mathematical model was developed describing the dynamic of the COVID-19 virus over a population considering that the infected can either be symptomatic or not. The model was calibrated using data on the confirmed cases and death from several countries like France, Philippines, Italy, Spain, United Kingdom, China, and the USA. First, we derived the basic reproduction number, $\mathcal{R}_0$, and estimated the effective reproduction $\mathcal{R}_{\rm eff}$ for each country. Second, we were interested in the merits of interventions, either by distancing or by treatment. Results revealed that to…
We present an epidemiological compartment model, SAIR(S), that explicitly captures the dynamics of asymptomatic infected individuals in an epidemic spread process. We first present a group model and then discuss networked versions. We provide an investigation of equilibria and stability properties for these models, and present simulation results illustrating the effects of asymptomatic-infected individuals on the spread of the disease. We also discuss local isolation effects on the epidemic dynamics in terms of the networked models. Finally, we provide initial parameter estimation results base…
This paper is concerned with nonlinear modeling and analysis of the COVID-19 pandemic currently ravaging the planet. There are two objectives: to arrive at an appropriate model that captures the collected data faithfully, and to use that as a basis to explore the nonlinear behavior. We use a nonlinear SEIR (Susceptible, Exposed, Infectious & Removed) transmission model with added behavioral and government policy dynamics. We develop a genetic algorithm technique to identify key model parameters employing COVID19 data from South Korea. Stability, bifurcations and dynamic behavior are analyzed. …
Repeated asymptomatic screening for SARS-CoV-2 promises to control spread of the virus but would require too many resources to implement at scale. Group testing is promising for screening more people with fewer test resources: multiple samples tested together in one pool can be excluded with one negative test result. Existing approaches to group testing design for SARS-CoV-2 asymptomatic screening, however, do not consider dilution effects: that false negatives become more common with larger pools. As a consequence, they may recommend pool sizes that are too large or misestimate the benefits o…
The COVID-19 infection cases have surged globally, causing devastations to both the society and economy. A key factor contributing to the sustained spreading is the presence of a large number of asymptomatic or hidden spreaders, who mix among the susceptible population without being detected or quarantined. Here we propose an effective non-pharmacological intervention method of detecting the asymptomatic spreaders in contact-tracing networks, and validated it on the empirical COVID-19 spreading network in Singapore. We find that using pure physical spreading equations, the hidden spreaders of …
Digital contact tracing is a public health intervention. It should be integrated with local health policy, provide rapid and accurate notifications to exposed individuals, and encourage high app uptake and adherence to quarantine. Real-time monitoring and evaluation of effectiveness of app-based contact tracing is key for improvement and public trust.
In this work, we adapt the epidemiological SIR model to study the evolution of the dissemination of COVID-19 in Germany and Brazil (nationally, in the State of Paraiba, and in the City of Campina Grande). We prove the well posedness and the continuous dependence of the model dynamics on its parameters. We also propose a simple probabilistic method for the evolution of the active cases that is instrumental for the automatic estimation of parameters of the epidemiological model. We obtained statistical estimates of the active cases based the probabilistic method and on the confirmed cases data. …
Spatiotemporal modelling of infectious diseases such as COVID-19 involves using a variety of epidemiological metrics such as regional proportion of cases or regional positivity rates. Although observing their changes over time is critical to estimate the regional disease burden, the dynamical properties of these measures as well as cross-relationships are not systematically explained. Here we provide a spatiotemporal framework composed of six commonly used and newly constructed epidemiological metrics and conduct a case study evaluation. We introduce a refined risk model that is biased neither…
Several analytical models have been used in this work to describe the evolution of death cases arising from coronavirus (COVID-19). The Death or `D' model is a simplified version of the SIR (susceptible-infected-recovered) model, which assumes no recovery over time, and allows for the transmission-dynamics equations to be solved analytically. The D-model can be extended to describe various focuses of infection, which may account for the original pandemic (D1), the lockdown (D2) and other effects (Dn). The evolution of the COVID-19 pandemic in several countries (China, Spain, Italy, France, UK,…
The COVID-19 pandemic has placed unprecedented demands on local public health units in Ontario, Canada, one of which was the need for in-house epidemiological-modelling capabilities. To address this need, Ontario Tech University and the Durham Region Health Department developed a native Windows desktop app that performs epidemiological modelling of infectious diseases. The app is an implementation of a multi-stratified compartmental epidemiological model that can accommodate multiple virus variants and levels of vaccination, as well as public health measures such as physical distancing, contac…
The aim of this paper consists in the application of a recent epidemiological model, namely SEIR with Social Distancing (SEIR--SD), extended here through the definition of a social distancing function varying over time, to assess the situation related to the spreading of the coronavirus Covid--19 in Italy and in two of its most important regions, i.e., Lombardy and Campania. To profitably use this model, the most suitable values of its parameters must be found. The estimation of the SEIR--SD model parameters takes place here through the use of Differential Evolution, a heuristic optimization t…
An epidemiological model is developed for the spread of COVID-19 in South Africa. A variant of the classical compartmental SEIR model, called the SEIQRDP model, is used. As South Africa is still in the early phases of the global COVID-19 pandemic with the confirmed infectious cases not having peaked, the SEIQRDP model is first parameterized on data for Germany, Italy, and South Korea - countries for which the number of infectious cases are well past their peaks. Good fits are achieved with reasonable predictions of where the number of COVID-19 confirmed cases, deaths, and recovered cases will …
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…
The infection fatality rate (IFR) of COVID-19 is one of the measures of disease impact that can be of importance for policy making. Here we show that many of the studies on which these estimates are based are scientifically flawed for reasons which include: nonsensical equations, unjustified assumptions, small sample sizes, non-representative sampling (systematic biases), incorrect definitions of symptomatic and asymptomatic cases (identified and unidentified cases), typically assuming that cases which are asymptomatic at the time of testing are the same as completely asymptomatic (never sympt…
