A Bayesian Spatio-Temporal Extension to Poisson Auto-Regression: Modeling the Disease Infection Rate of COVID-19 in England (preprint)

The COVID-19 pandemic provided many modeling challenges to investigate the evolution of an epidemic process over areal units. A suitable encompassing model must describe the spatio-temporal variations of the disease infection rate of multiple areal processes while adjusting for local and global inputs. We develop an extension to Poisson Auto-Regression that incorporates spatio-temporal dependence to characterize the local dynamics while borrowing information among adjacent areas. The specification includes up to two sets of space-time random effects to capture the spatio-temporal dependence and a linear predictor depending on an arbitrary set of covariates. The proposed model, adopted in a fully Bayesian framework and implemented through a novel sparse-matrix representation in Stan, provides a framework for evaluating local policy changes over the whole spatial and temporal domain of the study. It has been validated through a substantial simulation study and applied to the weekly COVID-19 cases observed in the English local authority districts between May 2020 and March 2021. The model detects substantial spatial and temporal heterogeneity and allows a full evaluation of the impact of two alternative sets of covariates: the level of local restrictions in place and the value of the Google Mobility Indices. The paper also formalizes various novel model-based investigation methods for assessing additional aspects of disease epidemiology.

Predictive performance of multi-model ensemble forecasts of COVID-19 across European nations (preprint)

Background: Short-term forecasts of infectious disease burden can contribute to situational awareness and aid capacity planning. Based on best practice in other fields and recent insights in infectious disease epidemiology, one can maximise the predictive performance of such forecasts if multiple models are combined into an ensemble. Here we report on the performance of ensembles in predicting COVID-19 cases and deaths across Europe between 08 March 2021 and 07 March 2022. Methods: We used open-source tools to develop a public European COVID-19 Forecast Hub. We invited groups globally to contribute weekly forecasts for COVID-19 cases and deaths reported from a standardised source over the next one to four weeks. Teams submitted forecasts from March 2021 using standardised quantiles of the predictive distribution. Each week we created an ensemble forecast, where each predictive quantile was calculated as the equally-weighted average (initially the mean and then from 26th July the median) of all individual models predictive quantiles. We measured the performance of each model using the relative Weighted Interval Score (WIS), comparing models forecast accuracy relative to all other models. We retrospectively explored alternative methods for ensemble forecasts, including weighted averages based on models past predictive performance. Results: Over 52 weeks we collected and combined up to 28 forecast models for 32 countries. We found a weekly ensemble had a consistently strong performance across countries over time. Across all horizons and locations, the ensemble performed better on relative WIS than 84% of participating models forecasts of incident cases (with a total N=862), and 92% of participating models forecasts of deaths (N=746). Across a one to four week time horizon, ensemble performance declined with longer forecast periods when forecasting cases, but remained stable over four weeks for incident death forecasts. In every forecast across 32 countries, the ensemble outperformed most contributing models when forecasting either cases or deaths, frequently outperforming all of its individual component models. Among several choices of ensemble methods we found that the most influential and best choice was to use a median average of models instead of using the mean, regardless of methods of weighting component forecast models. Conclusions: Our results support the use of combining forecasts from individual models into an ensemble in order to improve predictive performance across epidemiological targets and populations during infectious disease epidemics. Our findings further suggest that median ensemble methods yield better predictive performance more than ones based on means. Our findings also highlight that forecast consumers should place more weight on incident death forecasts than incident case forecasts at forecast horizons greater than two weeks.

Spatial modelling of COVID-19 incident cases using Richards' curve: an application to the Italian regions (preprint)

We introduce an extended generalised logistic growth model for discrete outcomes, in which a network structure can be specified to deal with spatial dependence and time dependence is dealt with using an Auto-Regressive approach. A major challenge concerns the specification of the network structure, crucial to consistently estimate the canonical parameters of the generalised logistic curve, e.g. peak time and height. Parameters are estimated under the Bayesian framework, using the {\texttt{ Stan}} probabilistic programming language. The proposed approach is motivated by the analysis of the first and second wave of COVID-19 in Italy, i.e. from February 2020 to July 2020 and from July 2020 to December 2020, respectively. We analyse data at the regional level and, interestingly enough, prove that substantial spatial and temporal dependence occurred in both waves, although strong restrictive measures were implemented during the first wave. Accurate predictions are obtained, improving those of the model where independence across regions is assumed.

Nowcasting COVID-19 incidence indicators during the Italian first outbreak (preprint)

A novel parametric regression model is proposed to fit incidence data typically collected during epidemics. The proposal is motivated by real-time monitoring and short-term forecasting of the main epidemiological indicators within the first outbreak of COVID-19 in Italy. Accurate short-term predictions, including the potential effect of exogenous or external variables are provided; this ensures to accurately predict important characteristics of the epidemic (e.g., peak time and height), allowing for a better allocation of health resources over time. Parameters estimation is carried out in a maximum likelihood framework. All computational details required to reproduce the approach and replicate the results are provided.