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1.
Front Public Health ; 11: 1111641, 2023.
Article in English | MEDLINE | ID: covidwho-2293758

ABSTRACT

Background: One of the main lessons of the COVID-19 pandemic is that we must prepare to face another pandemic like it. Consequently, this article aims to develop a general framework consisting of epidemiological modeling and a practical identifiability approach to assess combined vaccination and non-pharmaceutical intervention (NPI) strategies for the dynamics of any transmissible disease. Materials and methods: Epidemiological modeling of the present work relies on delay differential equations describing time variation and transitions between suitable compartments. The practical identifiability approach relies on parameter optimization, a parametric bootstrap technique, and data processing. We implemented a careful parameter optimization algorithm by searching for suitable initialization according to each processed dataset. In addition, we implemented a parametric bootstrap technique to accurately predict the ICU curve trend in the medium term and assess vaccination. Results: We show the framework's calibration capabilities for several processed COVID-19 datasets of different regions of Chile. We found a unique range of parameters that works well for every dataset and provides overall numerical stability and convergence for parameter optimization. Consequently, the framework produces outstanding results concerning quantitative tracking of COVID-19 dynamics. In addition, it allows us to accurately predict the ICU curve trend in the medium term and assess vaccination. Finally, it is reproducible since we provide open-source codes that consider parameter initialization standardized for every dataset. Conclusion: This work attempts to implement a holistic and general modeling framework for quantitative tracking of the dynamics of any transmissible disease, focusing on accurately predicting the ICU curve trend in the medium term and assessing vaccination. The scientific community could adapt it to evaluate the impact of combined vaccination and NPIs strategies for COVID-19 or any transmissible disease in any country and help visualize the potential effects of implemented plans by policymakers. In future work, we want to improve the computational cost of the parametric bootstrap technique or use another more efficient technique. The aim would be to reconstruct epidemiological curves to predict the combined NPIs and vaccination policies' impact on the ICU curve trend in real-time, providing scientific evidence to help anticipate policymakers' decisions.


Subject(s)
COVID-19 , Communicable Diseases , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , Chile/epidemiology , Intensive Care Units
2.
Health Care Manag Sci ; 24(2): 375-401, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1144370

ABSTRACT

Hospitals commonly project demand for their services by combining their historical share of regional demand with forecasts of total regional demand. Hospital-specific forecasts of demand that provide prediction intervals, rather than point estimates, may facilitate better managerial decisions, especially when demand overage and underage are associated with high, asymmetric costs. Regional point forecasts of patient demand are commonly available, e.g., for the number of people requiring hospitalization due to an epidemic such as COVID-19. However, even in this common setting, no probabilistic, consistent, computationally tractable forecast is available for the fraction of patients in a region that a particular institution should expect. We introduce such a forecast, DICE (Demand Intervals from Consistent Estimators). We describe its development and deployment at an academic medical center in California during the 'second wave' of COVID-19 in the Unite States. We show that DICE is consistent under mild assumptions and suitable for use with perfect, biased and unbiased regional forecasts. We evaluate its performance on empirical data from a large academic medical center as well as on synthetic data.


Subject(s)
COVID-19 , Health Services Needs and Demand/trends , Hospitalization/trends , Algorithms , Forecasting/methods , Humans , Intensive Care Units , Models, Statistical , SARS-CoV-2
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