scholarly journals A scenario modeling pipeline for COVID-19 emergency planning

Author(s):  
Joseph C. Lemaitre ◽  
Kyra H. Grantz ◽  
Joshua Kaminsky ◽  
Hannah R. Meredith ◽  
Shaun A. Truelove ◽  
...  

AbstractCoronavirus disease 2019 (COVID-19) has caused strain on health systems worldwide due to its high mortality rate and the large portion of cases requiring critical care and mechanical ventilation. During these uncertain times, public health decision makers, from city health departments to federal agencies, sought the use of epidemiological models for decision support in allocating resources, developing non-pharmaceutical interventions, and characterizing the dynamics of COVID-19 in their jurisdictions. In response, we developed a flexible scenario modeling pipeline that could quickly tailor models for decision makers seeking to compare projections of epidemic trajectories and healthcare impacts from multiple intervention scenarios in different locations. Here, we present the components and configurable features of the COVID Scenario Pipeline, with a vignette detailing its current use. We also present model limitations and active areas of development to meet ever-changing decision maker needs.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joseph C. Lemaitre ◽  
Kyra H. Grantz ◽  
Joshua Kaminsky ◽  
Hannah R. Meredith ◽  
Shaun A. Truelove ◽  
...  

AbstractCoronavirus disease 2019 (COVID-19) has caused strain on health systems worldwide due to its high mortality rate and the large portion of cases requiring critical care and mechanical ventilation. During these uncertain times, public health decision makers, from city health departments to federal agencies, sought the use of epidemiological models for decision support in allocating resources, developing non-pharmaceutical interventions, and characterizing the dynamics of COVID-19 in their jurisdictions. In response, we developed a flexible scenario modeling pipeline that could quickly tailor models for decision makers seeking to compare projections of epidemic trajectories and healthcare impacts from multiple intervention scenarios in different locations. Here, we present the components and configurable features of the COVID Scenario Pipeline, with a vignette detailing its current use. We also present model limitations and active areas of development to meet ever-changing decision maker needs.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Neil-Sztramko ◽  
M Dobbins

Abstract Issue It is well accepted that public health decision makers should use the best available research evidence in their decision-making process. However, research evidence alone is insufficient to inform public health decision making. Description of the problem As new challenges to public health emerge, there can be a paucity of high quality research evidence to inform decisions on new topics. Public health decision makers must combine various sources of evidence with their public health expertise to make evidence-informed decisions. The National Collaborating Centre for Methods and Tools (NCCMT) has developed a model which combines research evidence with other critical sources of evidence that can help guide decision makers in evidence-informed decision making. Results The NCCMT's model for evidence-informed public health combines findings from research evidence with local data and context, community and political preferences and actions and evidence on available resources. The model has been widely used across Canada and worldwide, and has been integrated into many public health organizations' decision-making processes. The model is also used for teaching an evidence-informed public health approach in Masters of Public Health programs around the globe. The model provides a structured approach to integrating evidence from several critical sources into public health decision making. Use of the model helps ensure that important research, contextual and preference information is sought and incorporated. Lessons Next steps for the model include development of a tool to facilitate synthesis of evidence across all four domains. Although Indigenous knowledges are relevant for public health decision making and should be considered as part of a complete assessment the current model does not capture Indigenous knowledges. Key messages Decision making in public health requires integrating the best available evidence, including research findings, local data and context, community and political preferences and available resources. The NCCMT’s model for evidence-informed public health provides a structured approach to integrating evidence from several critical sources into public health decision making.


Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ali Pormohammad ◽  
Mohammad Zarei ◽  
Saied Ghorbani ◽  
Mehdi Mohammadi ◽  
Saeideh Aghayari Sheikh Neshin ◽  
...  

The high transmissibility, mortality, and morbidity rate of the SARS-CoV-2 Delta (B.1.617.2) variant have raised concerns regarding vaccine effectiveness (VE). To address this issue, all publications relevant to the effectiveness of vaccines against the Delta variant were searched in the Web of Science, Scopus, EMBASE, and Medline (via PubMed) databases up to 15 October 2021. A total of 15 studies (36 datasets) were included in the meta-analysis. After the first dose, the VE against the Delta variant for each vaccine was 0.567 (95% CI 0.520–0.613) for Pfizer-BioNTech, 0.72 (95% CI 0.589–0.822) for Moderna, 0.44 (95% CI 0.301–0.588) for AstraZeneca, and 0.138 (95% CI 0.076–0.237) for CoronaVac. Meta-analysis of 2,375,957 vaccinated cases showed that the Pfizer-BioNTech vaccine had the highest VE against the infection after the second dose, at 0.837 (95% CI 0.672–0.928), and third dose, at 0.972 (95% CI 0.96–0.978), as well as the highest VE for the prevention of severe infection or death, at 0.985 (95% CI 0.95–0.99), amongst all COVID-19 vaccines. The short-term effectiveness of vaccines, especially mRNA-based vaccines, for the prevention of the Delta variant infection, hospitalization, severe infection, and death is supported by this study. Limitations include a lack of long-term efficacy data, and under-reporting of COVID-19 infection cases in observational studies, which has the potential to falsely skew VE rates. Overall, this study supports the decisions by public health decision makers to promote the population vaccination rate to control the Delta variant infection and the emergence of further variants.


2019 ◽  
Vol 374 (1776) ◽  
pp. 20180431 ◽  
Author(s):  
Robin N. Thompson ◽  
Oliver W. Morgan ◽  
Katri Jalava

The World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterizing an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognized transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This issue is linked with the earlier theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.


2019 ◽  
Vol 15 (1) ◽  
pp. 128-140 ◽  
Author(s):  
Emma Frew ◽  
Katie Breheny

AbstractLocal authorities in England have responsibility for public health, however, in recent years, budgets have been drastically reduced placing decision makers under unprecedented financial pressure. Although health economics can offer support for decision making, there is limited evidence of it being used in practice. The aim of this study was to undertake in-depth qualitative research within one local authority to better understand the context for public health decision making; what, and how economics evidence is being used; and invite suggestions for how methods could be improved to better support local public health decision making. The study included both observational methods and in-depth interviews. Key meetings were observed and semi-structured interviews conducted with participants who had a decision-making role to explore views on economics, to understand the barriers to using evidence and to invite suggestions for improvements to methods. Despite all informants valuing the use of health economics, many barriers were cited: including a perception of a narrow focus on the health sector; lack of consideration of population impact; and problems with translating long timescales to short term impact. Methodological suggestions included the broadening of frameworks; increased use of natural experiments; and capturing wider non-health outcomes that resonate with the priorities of multiple stakeholders.


2020 ◽  
Author(s):  
Denis Pierron ◽  
Veronica Pereda-Loth ◽  
marylou Mantel ◽  
Maëlle Moranges ◽  
Emmanuelle Bignon ◽  
...  

In response to the COVID-19, many governments have taken unprecedented measures in peacetime, to avoid an overflow of intensive care units and critical care resuscitation units (CCRUs). Due to the heavy societal and economic impact of measure such as the lockdown1, accurate means to characterize the spread of the disease would be extremely helpful for the reopening strategies. Concurrently, smell and taste changes have been identified as among the most specific symptoms of COVID-192,3. Here, we show that self-reports of smell/taste changes are more closely associated with hospital overload and are much earlier than the current governmental indicators. We also show a decrease of new onset as early as 5 days after the lockdown enforcement, which is consistent with a rapid effect of the lockdown on the pandemic. Cross-country comparisons show countries with the most stringent lockdown measures (France and Italy) present a faster decline in new reports of the onset of smell/taste changes after the lockdown than a country with less stringent measures (United Kingdom). Public health decision makers could thus monitor self-reported changes in the ability to smell or taste i/as an early and specific indicator of the COVID-19 pandemic, and ii/to evaluate the success of reopening strategies.


2020 ◽  
Author(s):  
Cornelia Ilin ◽  
Sébastien Annan-Phan ◽  
Xiao Hui Tai ◽  
Shikhar Mehra ◽  
Solomon Hsiang ◽  
...  

AbstractPolicymakers everywhere are working to determine the set of restrictions that will effectively contain the spread of COVID-19 without excessively stifling economic activity. We show that publicly available data on human mobility — collected by Google, Facebook, and other providers — can be used to evaluate the effectiveness of non-pharmaceutical interventions and forecast the spread of COVID-19. This approach relies on simple and transparent statistical models, and involves minimal assumptions about disease dynamics. We demonstrate the effectiveness of this approach using local and regional data from China, France, Italy, South Korea, and the United States, as well as national data from 80 countries around the world.SummaryBackgroundPolicymakers everywhere are working to determine the set of restrictions that will effectively contain the spread of COVID-19 without excessively stifling economic activity. In some contexts, decision-makers have access to sophisticated epidemiological models and detailed case data. However, a large number of decisions, particularly in low-income and vulnerable communities, are being made with limited or no modeling support. We examine how public human mobility data can be combined with simple statistical models to provide near real-time feedback on non-pharmaceutical policy interventions. Our objective is to provide a simple framework that can be easily implemented and adapted by local decision-makers.MethodsWe develop simple statistical models to measure the effectiveness of non-pharmaceutical interventions (NPIs) and forecast the spread of COVID-19 at local, state, and national levels. The method integrates concepts from econometrics and machine learning, and relies only upon publicly available data on human mobility. The approach does not require explicit epidemiological modeling, and involves minimal assumptions about disease dynamics. We evaluate this approach using local and regional data from China, France, Italy, South Korea, and the United States, as well as national data from 80 countries around the world.FindingsWe find that NPIs are associated with significant reductions in human mobility, and that changes in mobility can be used to forecast COVID-19 infections. The first set of results show the impact of NPIs on human mobility at all geographic scales. While different policies have different effects on different populations, we observed total reductions in mobility between 40 and 84 percent. The second set of results indicate that — even in the absence of other epidemiological information — mobility data substantially improves 10-day case rates forecasts at the county (20.75% error, US), state (21.82 % error, US), and global (15.24% error) level. Finally, for example, country-level results suggest that a shelter-in-place policy targeting a 10% increase in the amount of time spent at home would decrease the propagation of new cases by 32% by the end of a 10 day period.InterpretationIn rapidly evolving disease outbreaks, decision-makers do not always have immediate access to sophisticated epidemiological models. In such cases, valuable insight can still be derived from simple statistic models and readily-available public data. These models can be quickly fit with a population’s own data and updated over time, thereby capturing social and epidemiological dynamics that are unique to a specific locality or time period. Our results suggest that this approach can effectively support decision-making from local (e.g., city) to national scales.


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