The second group researching on COVID-19 at BCAM is made up of several researchers from the center’s Applied Statistics research line in collaboration with the University of the Basque Country.
• Coordinators: Inmaculada Arostegui (BCAM-UPV/EHU), Dae-Jin Lee, M.Xosé Rodriguez (BCAM-Ikerbasque)
• BCAM team: Moumita Das, Fernando García García, Joaquín Martínez-Minaya, Abelardo Monsalve and Carlos J. Peña
This group is working on 3 different approaches to analyze the evolution of the pandemic.
1) A Bayesian SEIR Model for predicting COVID19 hospital admissions and infected cases in the Basque Country
• Collaborators: Department of Health of the Basque Government and Osakidetza
The first group is working with an age-stratified Bayesian SEIR Model for predicting COVID-19 hospital admissions, infected cases and deaths in the Basque Country based on the work by
Riou et al. (2020). The model is fitted to data provided by the Department of Health of the Basque Government on daily and age-stratified number of positive cases, hospital admissions, ICU, deaths and discharges due to COVID-19. With this model they can provide short-term predictions of hospital admissions and deaths for both the whole population and stratified by age.
Some of the strengths of this model are that it is age-stratified, it allows for uncertainty quantification and allows including prior knowledge.
Ikerbasque Research Fellow Maria Xosé (Coté) Rodriguez, an expert in applied statistics and software development with experience in evaluation of diagnostic and prognostic biomarkers, explains that from the beginning of the health crisis this group has provided health managers periodic reports with the predictions, for seven days, of positive cases and hospital admission for both the Basque Country and its main Integrated Health Organizations (OSI).
Future developments:
To improve the model researchers are considering modelling the time-dependent forcing function using splines and including hospital admissions, ICU cases, deaths and recoveries in the ODE System.
2) Predicting the need for hospital beds and ICU by methods of simulation and operations research
Collaborators:
• Fermín Mallor, Quantitative Methods for Uplifting the Performance of Health Service group at the Public University of Navarre.
• Clinical Research Unit at the Galdakao-Usansolo Hospital.
• Department of Health of the Basque Government and Osakidetza.
Researchers from our Applied Statistics group have also been working on a tool for the dimensioning of hospital beds and in the intensive care units (ICU) through simulation.
Fernando Garcia García, a postdoc fellow working on artificial Intelligence in prediction for clinical practice (with the support of the Basque Government) who regularly collaborates with the Galdakao-Usansolo Hospital, explains that the system is divided into two steps:
“First, work is done with confirmed incidence data; that is, with the new daily cases of positive COVID-19 tests. For these, a general growth model is adjusted according to the Gompertz function. The adjustment of the data is done by means of Bayesian techniques (under a negative binomial model for the counts) and bootstrapping techniques, in order to estimate the variability in the model parameters.
Operations Research techniques are then used to simulate (using Monte Carlo methods) different scenarios regarding hospital and ICU bed occupancy. In addition to the incidence rate, other factors are considered, such as: the proportion observed in previous days of hospitalizations with respect to positive cases, the rate of ICU admissions for reasons other than COVID-19 in the same spring season of the previous years (2018 and 2019), or the duration of an admission (triangular probability distribution).”
As a result, they obtain estimated scenarios about the daily occupation of beds up to a horizon of 7 days, which are providing support and guidance to hospital management in the hospital resource planning.
3) Using a delay-adjusted case fatality ratio to estimate under-reporting
• Collaborators: Department of Health of the Basque Government and Osakidetza
Reports show that there is bias in the Case Fatality Ratio due to delay between confirmation of COVID-19 and death.
This last approach is based on the
work by Russell et al. from the Center for Mathematical Modelling of Infectious Disease (London School of Hygiene and Tropical Medicine) and it’s an attempt to estimate a corrected CFR (Case Fatality Ratio) to estimate under-reporting of COVID-19 cases in Spain, the autonomous regions and particularly to the Basque Country to evaluate the evolution of the CFR and the percentage of confirmed cases of COVID-19 along time.
For this purpose, BCAM researchers are using the accumulated deaths and daily accumulated confirmed cases provided by
Instituto de Salud Carlos III. Although the model is based on strong assumptions, this estimation serves to monitor the under-reporting and adapt it to new knowledge about COVID-19.
Evolution of the corrected fatality rate in the Basque Country based on data reported between 11-03-2020 and 16-04-2020 by the ISCIII
Future developments:
According to Dae-Jin Lee, leader of the Applied Statistics group at BCAM, this approach could be extended to consider age-group distribution or to model and forecast temporal evolution. “It could also be useful to support and contrast the result with the Bayesian SEIR model we are working on”.