Prediction of infectious disease epidemics via weighted density ensembles

Accurate and reliable predictions of infectious disease dynamics can be valuable to public health organizations that plan interventions to decrease or prevent disease transmission. A great variety of models have been developed for this task, using different model structures, covariates, and targets for prediction. Experience has shown that the performance of these models varies; some tend to do better or worse in different seasons or at different points within a season. Ensemble methods combine multiple models to obtain a single prediction that leverages the strengths of each model. We considered a range of ensemble methods that each form a predictive density for a target of interest as a weighted sum of the predictive densities from component models. In the simplest case, equal weight is assigned to each component model; in the most complex case, the weights vary with the region, prediction target, week of the season when the predictions are made, a measure of component model uncertainty, and recent observations of disease incidence. We applied these methods to predict measures of influenza season timing and severity in the United States, both at the national and regional levels, using three component models. We trained the models on retrospective predictions from 14 seasons (1997/1998 - 2010/2011) and evaluated each model's prospective, out-of-sample performance in the five subsequent influenza seasons. In this test phase, the ensemble methods showed overall performance that was similar to the best of the component models, but offered more consistent performance across seasons than the component models. Ensemble methods offer the potential to deliver more reliable predictions to public health decision makers.Comment: 20 pages, 6 figure

The Dynamics of Real-Time Online Information and Disease Progression: Understanding Spatial Heterogeneity in the Relationship

The re-emergence of infectious diseases such as measles and polio is creating logistics challenges for the state authorities to curb their spread and contain them. (CL, 2015) Real-time surveillance of infectious diseases is important to detect possible epidemics in advance to prevent shortages of medications (FDA, 2018). The outbreak of an infectious disease creates panic in the community and is accompanied by a sudden increase in the online interest in knowing more about the disease and its symptoms. Prior studies have found a strong relationship between web-based information and disease outbreak but the influence of dynamics of web-based information in real-time is often not considered (Zhang, 2017). The dynamics or rate of change of the online interest in a disease can inform or misinform about perspective cases of the disease in a region. Oftentimes, especially in this connected world individuals overreact to the situation which may send spurious online signals regarding the disease progression. Hence, we study the relationship between the dynamics of online information and the infectious disease outbreak. We also investigate if this relationship could be influenced by regional demographic factors. We analyze weekly online interest dynamics for five infectious diseases over a period of three years across 50 states of the United States. We control for several factors (including weather, demographics, and travelers) and utilize hierarchical functional data models to incorporate real-time dynamics and clustering at the regional level. Preliminary findings suggest that online interest dynamics have a significant relationship with disease outbreak and the effect is segregated at the regional level. These findings are important to develop a system for real-time surveillance and account for the influence of heterogonous online interest during an endemic outbreak

Stat Med

Seasonal influenza infects between 10 and 50 million people in the United States every year. Accurate forecasts of influenza and influenza-like illness (ILI) have been named by the CDC as an important tool to fight the damaging effects of these epidemics. Multi-model ensembles make accurate forecasts of seasonal influenza, but current operational ensemble forecasts are static: they require an abundance of past ILI data and assign fixed weights to component models at the beginning of a season, but do not update weights as new data on component model performance is collected. We propose an adaptive ensemble that (i) does not initially need data to combine forecasts and (ii) finds optimal weights which are updated week-by-week throughout the influenza season. We take a regularized likelihood approach and investigate this regularizer's ability to impact adaptive ensemble performance. After finding an optimal regularization value, we compare our adaptive ensemble to an equal-weighted and static ensemble. Applied to forecasts of short-term ILI incidence at the regional and national level, our adaptive model outperforms an equal-weighted ensemble and has similar performance to the static ensemble using only a fraction of the data available to the static ensemble. Needing no data at the beginning of an epidemic, an adaptive ensemble can quickly train and forecast an outbreak, providing a practical tool to public health officials looking for a forecast to conform to unique features of a specific season.R35 GM119582/GM/NIGMS NIH HHSUnited States/U01 IP001122/IP/NCIRD CDC HHSUnited States

Data-Centric Epidemic Forecasting: A Survey

The COVID-19 pandemic has brought forth the importance of epidemic forecasting for decision makers in multiple domains, ranging from public health to the economy as a whole. While forecasting epidemic progression is frequently conceptualized as being analogous to weather forecasting, however it has some key differences and remains a non-trivial task. The spread of diseases is subject to multiple confounding factors spanning human behavior, pathogen dynamics, weather and environmental conditions. Research interest has been fueled by the increased availability of rich data sources capturing previously unobservable facets and also due to initiatives from government public health and funding agencies. This has resulted, in particular, in a spate of work on 'data-centered' solutions which have shown potential in enhancing our forecasting capabilities by leveraging non-traditional data sources as well as recent innovations in AI and machine learning. This survey delves into various data-driven methodological and practical advancements and introduces a conceptual framework to navigate through them. First, we enumerate the large number of epidemiological datasets and novel data streams that are relevant to epidemic forecasting, capturing various factors like symptomatic online surveys, retail and commerce, mobility, genomics data and more. Next, we discuss methods and modeling paradigms focusing on the recent data-driven statistical and deep-learning based methods as well as on the novel class of hybrid models that combine domain knowledge of mechanistic models with the effectiveness and flexibility of statistical approaches. We also discuss experiences and challenges that arise in real-world deployment of these forecasting systems including decision-making informed by forecasts. Finally, we highlight some challenges and open problems found across the forecasting pipeline.Comment: 67 pages, 12 figure