Model Families for Multi-Criteria Decision Support: A COVID-19 Case Study (preprint)

Continued model-based decision support is associated with particular challenges, especially in long-term projects. Due to the regularly changing questions and the often changing understanding of the underlying system, the models used must be regularly re-evaluated, -modelled and -implemented with respect to changing modelling purpose, system boundaries and mapped causalities. Usually, this leads to models with continuously growing complexity and volume. In this work we aim to reevaluate the idea of the model family, dating back to the 1990s, and use it to promote this as a mindset in the creation of decision support frameworks in large research projects. The idea is to generally not develop and enhance a single standalone model, but to divide the research tasks into interacting smaller models which specifically correspond to the research question. This strategy comes with many advantages, which we explain using the example of a family of models for decision support in the COVID-19 crisis and corresponding success stories. We describe the individual models, explain their role within the family, and how they are used - individually and with each other.

National-scale surveillance of emerging SARS-CoV-2 variants in wastewater (preprint)

SARS-CoV-2 surveillance is crucial to identify variants with altered epidemiological properties. Wastewater-based epidemiology (WBE) provides an unbiased and complementary approach to sequencing individual cases. Yet, national WBE surveillance programs have not been widely implemented and data analyses remain challenging. We deep-sequenced 2,093 wastewater samples representing 95 municipal catchments, covering >57% of Austria's population, from December 2020 to September 2021. Our Variant Quantification in Sewage pipeline designed for Robustness (VaQuERo) enabled us to deduce variant abundance from complex wastewater samples and delineate the spatiotemporal dynamics of the dominant Alpha and Delta variants as well as regional clusters of other variants of concern. These results were cross validated by epidemiological records of >130,000 individual cases. Finally, we provide a framework to predict emerging variants de novo and infer variant-specific reproduction numbers from wastewater. This study demonstrates the power of national-scale WBE to support public health and promises particular value for countries without dense individual monitoring.

Model Based Estimation of the SARS-CoV-2 Immunization Level in Austria and Consequences for Herd Immunity Effects (preprint)

Several systemic factors indicate, that worldwide herd immunity against COVID-19 will probably not be achieved in 2021. Vaccination programs are limited by availability of doses, the number of people already infected is still too low to have a disease preventing impact and new emerging variants of the virus seem to partially neglect developed antibodies from previous infections. Nevertheless, after one year of COVID-19 observing high numbers of reported cases in most European countries, we might expect that the immunization level should have an impact on the spread of SARS-CoV-2. We used an agent-based simulation model to reproduce the COVID-19 pandemic in Austria to estimate the immunization level of the population as of February 2021. We ran several simulations of an uncontrolled epidemic wave with varying initial immunization scenarios to assess the effect on the effective reproduction number. We also used a classic differential equation SIR-model to cross-validate the simulation model. As of February 2021, 14.7% of the Austrian population has been affected by a SARS-CoV-2 infection which causes a 9% reduction of the effective reproduction number and a 24.7% reduction of the prevalence peak compared to a fully susceptible population. This estimation is now recomputed on a regular basis to publish model based analysis of immunization level in Austria also including the fast growing effects of vaccination programs. This provides substantial information for decision makers to evaluate the necessity of NPI-measures based on the estimated impact of natural and vaccinated immunization.

Synthetic Reproduction and Augmentation of COVID-19 Case Reporting Data by Agent-Based Simulation (preprint)

We generate synthetic data documenting COVID-19 cases in Austria by the means of an agent-based simulation model. The model simulates the transmission of the SARS-CoV-2 virus in a statistical replica of the population and reproduces typical patient pathways on an individual basis while simultaneously integrating historical data on the implementation and expiration of population-wide countermeasures. The resulting data semantically and statistically aligns with an official epidemiological case reporting data set and provides an easily accessible, consistent and augmented alternative. Our synthetic data set provides additional insight into the spread of the epidemic by synthesizing information that cannot be recorded in reality.