Policy-driven mathematical modeling for COVID-19 pandemic response in the Philippines.

Around the world, disease surveillance and mathematical modeling have been vital tools for government responses to the COVID-19 pandemic. In the face of a volatile crisis, modeling efforts have had to evolve over time in proposing policies for pandemic interventions. In this paper, we document how mathematical modeling contributed to guiding the trajectory of pandemic policies in the Philippines. We present the mathematical specifications of the FASSSTER COVID-19 compartmental model at the core of the FASSSTER platform, the scenario-based disease modeling and analytics toolkit used in the Philippines. We trace how evolving epidemiological analysis at the national, regional, and provincial levels guided government actions; and conversely, how emergent policy questions prompted subsequent model development and analysis. At various stages of the pandemic, simulated outputs of the FASSSTER model strongly correlated with empirically observed case trajectories (r=94%-99%, p<.001). Model simulations were subsequently utilized to predict the outcomes of proposed interventions, including the calibration of community quarantine levels alongside improvements to healthcare system capacity. This study shows how the FASSSTER model enabled the implementation of a phased approach toward gradually expanding economic activity while limiting the spread of COVID-19. This work points to the importance of locally contextualized, flexible, and responsive mathematical modeling, as applied to pandemic intelligence and for data-driven policy-making in general.

Understanding COVID-19 dynamics and the effects of interventions in the Philippines: A mathematical modelling study.

BACKGROUND: COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries, possibly because of differing demographics, socioeconomics, surveillance, and policy responses. Here, we investigate the role of multiple factors on COVID-19 dynamics in the Philippines, a LMIC that has had a relatively severe COVID-19 outbreak. METHODS: We applied an age-structured compartmental model that incorporated time-varying mobility, testing, and personal protective behaviors (through a "Minimum Health Standards" policy, MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon, Central Visayas, and the National Capital Region). We estimated effects of control measures, key epidemiological parameters, and interventions. FINDINGS: Population age structure, contact rates, mobility, testing, and MHS were sufficient to explain the Philippines epidemic based on the good fit between modelled and reported cases, hospitalisations, and deaths. The model indicated that MHS reduced the probability of transmission per contact by 13-27%. The February 2021 case detection rate was estimated at ~8%, population recovered at ~9%, and scenario projections indicated high sensitivity to MHS adherence. INTERPRETATION: COVID-19 dynamics in the Philippines are driven by age, contact structure, mobility, and MHS adherence. Continued compliance with low-cost MHS should help the Philippines control the epidemic until vaccines are widely distributed, but disease resurgence may be occurring due to a combination of low population immunity and detection rates and new variants of concern.