How Modelling and Analytics Informed the South African Government's COVID-19 Planning and Budgeting

ABSTRACT

Introduction/ Background: The South African COVID-19 Modelling Consortium (SACMC) was established in March 2020 to support government planning and budgeting for COVID-19 related healthcare. We developed tools in response to changing decision maker needs in different stages of the epidemic, allowing the South African government to plan several months ahead of time. Methods: Our tools included generalised SEIR models, shortterm forecasts, cost and budget impact models, and online dashboards to help government and the public visualise our projections during the first wave and track the epidemic trajectory and forecast hospitalisation trends during the second and third wave. Given the rapidly changing nature of the pandemic, the model projections and methods were updated regularly. Projections, forecasts and monitoring metrics were regularly disseminated via dashboards. Results: The updates reflected 1) the changing policy priorities;2) the availability of new data, in particular from South African data systems whose coverage was improving continuously;and 3) the evolving response to COVID-19 in South Africa such as changes in lockdown levels and resulting mobility and contact rates, testing policy, contact tracing strategy, and hospitalisation criteria. Insights into population behaviour, for example in reaction to increases in cases and deaths during first wave in May to August 2020, required the incorporation of behavioural response. Impact We incorporated these aspects into projecting a third wave and developed additional methodology that allowed us to forecast short-term trends in hospital admissions as the third wave started rolling. The SACMC has further updated the models to incorporate the impact of the vaccines and advise on booster options. Conclusion: The SACMC's models, developed rapidly in an emergency setting and regularly updated with local data, supported national and provincial government to plan several months ahead of time, expand hospital capacity, allocate budgets, and procure additional resources where possible.