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. 2021 Jun 7;21(1):533.
doi: 10.1186/s12879-021-06077-9.

A comparison of five epidemiological models for transmission of SARS-CoV-2 in India

Affiliations

A comparison of five epidemiological models for transmission of SARS-CoV-2 in India

Soumik Purkayastha et al. BMC Infect Dis. .

Abstract

Background: Many popular disease transmission models have helped nations respond to the COVID-19 pandemic by informing decisions about pandemic planning, resource allocation, implementation of social distancing measures, lockdowns, and other non-pharmaceutical interventions. We study how five epidemiological models forecast and assess the course of the pandemic in India: a baseline curve-fitting model, an extended SIR (eSIR) model, two extended SEIR (SAPHIRE and SEIR-fansy) models, and a semi-mechanistic Bayesian hierarchical model (ICM).

Methods: Using COVID-19 case-recovery-death count data reported in India from March 15 to October 15 to train the models, we generate predictions from each of the five models from October 16 to December 31. To compare prediction accuracy with respect to reported cumulative and active case counts and reported cumulative death counts, we compute the symmetric mean absolute prediction error (SMAPE) for each of the five models. For reported cumulative cases and deaths, we compute Pearson's and Lin's correlation coefficients to investigate how well the projected and observed reported counts agree. We also present underreporting factors when available, and comment on uncertainty of projections from each model.

Results: For active case counts, SMAPE values are 35.14% (SEIR-fansy) and 37.96% (eSIR). For cumulative case counts, SMAPE values are 6.89% (baseline), 6.59% (eSIR), 2.25% (SAPHIRE) and 2.29% (SEIR-fansy). For cumulative death counts, the SMAPE values are 4.74% (SEIR-fansy), 8.94% (eSIR) and 0.77% (ICM). Three models (SAPHIRE, SEIR-fansy and ICM) return total (sum of reported and unreported) cumulative case counts as well. We compute underreporting factors as of October 31 and note that for cumulative cases, the SEIR-fansy model yields an underreporting factor of 7.25 and ICM model yields 4.54 for the same quantity. For total (sum of reported and unreported) cumulative deaths the SEIR-fansy model reports an underreporting factor of 2.97. On October 31, we observe 8.18 million cumulative reported cases, while the projections (in millions) from the baseline model are 8.71 (95% credible interval: 8.63-8.80), while eSIR yields 8.35 (7.19-9.60), SAPHIRE returns 8.17 (7.90-8.52) and SEIR-fansy projects 8.51 (8.18-8.85) million cases. Cumulative case projections from the eSIR model have the highest uncertainty in terms of width of 95% credible intervals, followed by those from SAPHIRE, the baseline model and finally SEIR-fansy.

Conclusions: In this comparative paper, we describe five different models used to study the transmission dynamics of the SARS-Cov-2 virus in India. While simulation studies are the only gold standard way to compare the accuracy of the models, here we were uniquely poised to compare the projected case-counts against observed data on a test period. The largest variability across models is observed in predicting the "total" number of infections including reported and unreported cases (on which we have no validation data). The degree of under-reporting has been a major concern in India and is characterized in this report. Overall, the SEIR-fansy model appeared to be a good choice with publicly available R-package and desired flexibility plus accuracy.

Keywords: Compartmental models; Low and middle income countries; Prediction uncertainty; Statistical models.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic overview of the baseline model
Fig. 2
Fig. 2
The eSIR model with a latent SIR model on the unobserved proportions. Reproduced from Wang et al., 2020 [10]
Fig. 3
Fig. 3
The SAPHIRE model includes seven compartments: susceptible (S), exposed (E), pre-symptomatic infectious (P), reported infectious (I), unreported infectious (A), isolation in hospital (H) and removed (R)
Fig. 4
Fig. 4
Schematic diagram for the SEIR-fansy model with imperfect testing and misclassification. The model has ten compartments: S (Susceptible), E (Exposed), T (Tested), U (Untested), P (Tested positive), F (Tested False Negative), RR (Reported Recovered), RU (Unreported Recovered), DR (Reported Deaths) and DU (Unreported Deaths). Reproduced from Bhaduri, Kundu et al., 2020 [18]
Fig. 5
Fig. 5
Schematic overview of ICM
Fig. 6
Fig. 6
Comparison of projected and observed reported active cases from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 7
Fig. 7
Comparison of projected and observed reported cumulative cases from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 8
Fig. 8
Comparison of projected and observed reported cumulative deaths from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 9
Fig. 9
Scatter plot and marginal densities of projected and observed reported active cases from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 10
Fig. 10
Scatter plot and marginal densities of projected and observed cumulative cases from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 11
Fig. 11
Scatter plot and marginal densities of projected and observed cumulative death from October 16 to December 31 for India, using training data from March 15 to October 15, 2020
Fig. 12
Fig. 12
Boxplots showing width of 95% credible interval associated with projected active cases, cumulative cases and cumulative deaths from October 16 to December 31 for India, using training data from March 15 to October 15, 2020

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