Estimating number of cases and spread of coronavirus disease (COVID-19) using critical care admissions, United Kingdom, February to March 2020

Jit, Mark; Jombart, Thibaut; Nightingale, Emily; Endo, Akira; Abbott, Sam; Edmunds, W. John

doi:10.2807/1560-7917.es.2020.25.18.2000632

Cited by 45 publications

(39 citation statements)

References 7 publications

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“…The COVID-19 transmission scenarios explored in this study are speculative and reflect uncertainty about the potential size and timing of a second COVID-19 wave. However, they present a range of reasonable scenarios based on previous modelling predictions [19] that are consistent with the expectation that a second wave will have a lower peak incidence and flatter epidemic curve than the first wave in March -July 2020 in the UK [20]. Our results show that total testing demand is relatively insensitive to COVID-19 transmission and that, even in more severe scenarios, testing demand due to baseline cough or fever cases will outweigh demand due to symptomatic COVID-19 cases.…”

Section: Discussionsupporting

confidence: 81%

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study

Eyre

Burns

Kirkby

et al. 2020

Preprint

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Background: Diagnostic testing forms a major part of the UK's response to the current COVID-19 pandemic with tests offered to people with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK. Methods: In this analysis of the Bug Watch prospective community cohort study, we estimated the incidence of cough or fever in England in 2018-2019. We then estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests and four second wave scenarios and then compared to current national capacity. Results: The baseline incidence of cough or fever in the UK is expected to rise rapidly from 154,554 (95%CI 103,083 - 231,725) cases per day in August 2020 to 250,708 (95%CI 181,095 - 347,080) in September, peaking at 444,660 (95%CI 353,084 - 559,988) in December. If 80% of baseline cough or fever cases request tests, average daily UK testing demand would exceed current capacity for five consecutive months (October 2020 to February 2021), with a peak demand of 147,240 (95%CI 73,978 - 239,502) tests per day above capacity in December 2020. Conclusions: Our results show that current national COVID-19 testing capacity is likely to be exceeded by demand due to baseline cough and fever alone. This study highlights that the UK's response to the COVID-19 pandemic must ensure that a high proportion of people with symptoms request tests, and that testing capacity is immediately scaled up to meet this high predicted demand.

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Section: Discussionsupporting

confidence: 81%

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study

Eyre

Burns

Kirkby

et al. 2020

Preprint

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“…The model includes data on pre-pandemic mobility and mixing, and is calibrated on hospital admissions and seroprevalence data. The initial phase of the COVID-19 epidemic in Belgium is characterized by a fast spread of the disease, with a doubling time of 3.09 days (95% CI [3.05 : 3.14]), in line with values from other countries [5,2,37,38,39]. Combined with our parameter choices, this results in R 0 = 3.40 (95% CI [3.36 : 3.44]), which lies within the interval estimated in recent meta-analysis (mean = 2.6, standard deviation = 0.54 [40] and mean = 3.28 [39]).…”

Section: Discussionmentioning

confidence: 52%

A data-driven metapopulation model for the Belgian COVID-19 epidemic: assessing the impact of lockdown and exit strategies

Coletti

Libin

Petrof

et al. 2020

Preprint

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In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and serological data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Community contacts are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment is crucial to adjust to evolving behavioral changes that can affect epidemic diffusion. In addition to social distancing, sufficient capacity for extensive testing and contact tracing is essential for successful mitigation.

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“…2 The UK national government adopted similar measures in March 2020 following a rapid rise in cases of coronavirus disease 2019 (COVID-19) and the prospect of the healthcare system becoming overwhelmed. 3 The mandatory measures of physical distancing were implemented in the early stages of the pandemic on the basis of the high transmissibility of SARS-CoV-2 and burden of COVID-19, uncertainties about the COVID-19 epidemiology, 1 the absence of effective pharmaceutical interventions against COVID-19, and the imperative to save lives under the rule of rescue. 4 Nonetheless, the pandemic response has led to large contractions of the global economy, and the largest contraction in the UK economy since monthly records began in 1997, with gross domestic product (GDP) falling by 5.8% in March 2020 and by 20.4% in April 2020.…”

Section: Introductionmentioning

confidence: 99%

The potential health and economic value of SARS-CoV-2 vaccination alongside physical distancing in the UK: transmission model-based future scenario analysis and economic evaluation

Sandmann

Davies

Vassall

et al. 2020

Preprint

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Background In response to the coronavirus disease 2019 (COVID-19), the UK adopted mandatory physical distancing measures in March 2020. Vaccines against the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may become available as early as late 2020. We explored the health and economic value of introducing SARS-CoV-2 immunisation alongside physical distancing scenarios in the UK. Methods We used an age-structured dynamic-transmission and economic model to explore different scenarios of immunisation programmes over ten years. Assuming vaccines are effective in 5-64 year olds, we compared vaccinating 90% of individuals in this age group to no vaccination. We assumed either vaccine effectiveness of 25% and 1-year protection and 90% re-vaccinated annually, or 75% vaccine effectiveness and 10-year protection and 10% re-vaccinated annually. Natural immunity was assumed to last 45 weeks in the base case. We also explored the additional impact of physical distancing. We considered benefits from disease prevented in terms of quality-adjusted life-years (QALYs), and costs to the healthcare payer versus the national economy. We discounted at 3.5% annually and monetised health impact at 20,000 per QALY to obtain the net monetary value, which we explored in sensitivity analyses. Findings Without vaccination and physical distancing, we estimated 147.9 million COVID-19 cases (95% uncertainty interval: 48.5 million, 198.7 million) and 2.8 million (770,000, 4.2 million) deaths in the UK over ten years. Vaccination with 75% vaccine effectiveness and 10-year protection may stop community transmission entirely for several years, whereas SARS-CoV-2 becomes endemic without highly effective vaccines. Introducing vaccination compared to no vaccination leads to economic gains (positive net monetary value) of 0.37 billion to +1.33 billion across all physical distancing and vaccine effectiveness scenarios from the healthcare perspective, but net monetary values of physical distancing scenarios may be negative from societal perspective if the daily national economy losses are persistent and large. Interpretation Our model findings highlight the substantial health and economic value of introducing SARS-CoV-2 vaccination. Given uncertainty around both characteristics of the eventually licensed vaccines and long-term COVID-19 epidemiology, our study provides early insights about possible future scenarios in a post-vaccination era from an economic and epidemiological perspective.

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Estimating number of cases and spread of coronavirus disease (COVID-19) using critical care admissions, United Kingdom, February to March 2020

Cited by 45 publications

References 7 publications

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study

A data-driven metapopulation model for the Belgian COVID-19 epidemic: assessing the impact of lockdown and exit strategies

The potential health and economic value of SARS-CoV-2 vaccination alongside physical distancing in the UK: transmission model-based future scenario analysis and economic evaluation

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