The Role of Modelling and Analytics in South African COVID-19 Planning and Budgeting

Abstract

Background The South African COVID-19 Modelling Consortium (SACMC) was established in late March 2020 to support planning and budgeting for COVID-19 related healthcare in South Africa. We developed several tools in response to the needs of decision makers in the different stages of the epidemic, allowing the South African government to plan several months ahead of time. Methods Our tools included epidemic projection models, several cost and budget impact models, and online dashboards to help government and the public visualise our projections, track case development and forecast hospital admissions. Information on new variants, including Delta and Omicron, were incorporated in real time to allow the shifting of scarce resources when necessary. Results Given the rapidly changing nature of the outbreak globally and in South Africa, the model projections were updated regularly. The updates reflected 1) the changing policy priorities over the course of the epidemic; 2) the availability of new data from South African data systems; and 3) the evolving response to COVID-19 in South Africa such as changes in lockdown levels and ensuing mobility and contact rates, testing and contact tracing strategies, and hospitalisation criteria. Insights into population behaviour required updates by incorporating notions of behavioural heterogeneity and behavioural responses to observed changes in mortality. We incorporated these aspects into developing scenarios for the third wave and developed additional methodology that allowed us to forecast required inpatient capacity. Finally, real-time analyses of the most important characteristics of the Omicron variant first identified in South Africa in November 2021 allowed us to advise policymakers early in the fourth wave that a relatively lower admission rate was likely. 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 when needed, allocate budgets, and procure additional resources where possible. Across four waves of COVID-19 cases, the SACMC continued to serve the planning needs of the government, tracking waves and supporting the national vaccine rollout.

The National COVID-19 Epi Model (NCEM): Estimating cases, admissions and deaths in South Africa

“…The model presented here has been developed using data that is subject to a high degree of uncertainty. As all models are simplifications of reality that are designed to describe and predict system behaviour and are a product of the assumptions and data with which they are developed, the model used to support planning in South Africa was refined regularly throughout the South African COVID-19 epidemic 14 .…”

“…In this period from March 2020 to October 2020, the primary use of the NCEM was for projection of the timecourse of case numbers and hospitalisations, as well as cumulative indicators such as the number of expected COVID-19-associated deaths. The modelling process, model evolution and a reflection on modelling for this purpose and in this context that could highlight best practices and lessons learned to assist LMIC with modelling for pandemic preparedness is presented in Meyer-Rath, Hounsell (14). This paper presents the technical modelling framework used for projection, the consideration of behavioural factors in updating the framework and its application at a district level for the first wave of COVID-19 in South Africa.…”