A semi-parametric mixed model for short-term projection of daily COVID-19 incidence in Canada

Projecting COVID-19 intensive care admissions for policy advice, the Netherlands, February 2020 to January 2021

BackgroundModel projections of coronavirus disease 2019 (COVID-19) incidence help policymakers about decisions to implement or lift control measures. During the pandemic, policymakers in the Netherlands were informed on a weekly basis with short-term projections of COVID-19 intensive care unit (ICU) admissions.AimWe aimed at developing a model on ICU admissions and updating a procedure for informing policymakers.MethodThe projections were produced using an age-structured transmission model. A consistent, incremental update procedure integrating all new surveillance and hospital data was conducted weekly. First, up-to-date estimates for most parameter values were obtained through re-analysis of all data sources. Then, estimates were made for changes in the age-specific contact rates in response to policy changes. Finally, a piecewise constant transmission rate was estimated by fitting the model to reported daily ICU admissions, with a changepoint analysis guided by Akaike's Information Criterion.ResultsThe model and update procedure allowed us to make weekly projections. Most 3-week prediction intervals were accurate in covering the later observed numbers of ICU admissions. When projections were too high in March and August 2020 or too low in November 2020, the estimated effectiveness of the policy changes was adequately adapted in the changepoint analysis based on the natural accumulation of incoming data.ConclusionThe model incorporates basic epidemiological principles and most model parameters were estimated per data source. Therefore, it had potential to be adapted to a more complex epidemiological situation with the rise of new variants and the start of vaccination.

A proportional incidence rate model for aggregated data to study the vaccine effectiveness against COVID-19 hospital and ICU admissions

We develop a proportional incidence model that estimates vaccine effectiveness (VE) at the population level using conditional likelihood for aggregated data. Our model assumes that the population counts of clinical outcomes for an infectious disease arise from a superposition of Poisson processes with different vaccination statuses. The intensity function in the model is calculated as the product of per capita incidence rate and the at-risk population size, both of which are time-dependent. We formulate a log-linear regression model with respect to the relative risk, defined as the ratio between the per capita incidence rates of vaccinated and unvaccinated individuals. In the regression analysis, we treat the baseline incidence rate as a nuisance parameter, similar to the Cox proportional hazard model in survival analysis. We then apply the proposed models and methods to age-stratified weekly counts of COVID-19-related hospital and ICU admissions among adults in Ontario, Canada. The data spanned from 2021 to February 2022, encompassing the Omicron era and the rollout of booster vaccine doses. We also discuss the limitations and confounding effects while advocating for the necessity of more comprehensive and up-to-date individual-level data that document the clinical outcomes and measure potential confounders.

Penalized splines model to estimate time-varying reproduction number for Covid-19 in India: A Bayesian semi-parametric approach

Statistical modelling is pivotal in assessing intensity of a stochastic processes. Novel Corona virus disease demanded proactive measures to understand the severity of disease spread and to plan its control accordingly. We propose estimation of reproduction number as a crucial factor to monitor the random dynamics of Covid-19 in India. In the present paper, semi-parametric regression based on penalized splines embedded under Bayesian formulation is utilised to estimate reproduction number while incorporating effects of underreporting and delay in reporting for the actual number of daily occurrences. Monte Carlo Markov Chain approximations are utilised to perform simulation study and thereby to assess the impact of the reporting probability and misspecification of delay pattern on potential for further substance of the pandemic. For a cycle of reporting on weekly basis, the proposed penalized spline Bayesian framework fits closest to the empirical data drawn for a two-day delay in reporting with approximately half of the actual cases being reported. The present paper is a contribution towards estimation of the true daily reproduction number of Covid-19 incidences in its next generation cycle.