EpiBeds: Data informed modelling of the COVID-19 hospital burden in England.
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Abstract
The first year of the COVID-19 pandemic put considerable strain on healthcare systems worldwide. In order to predict the effect of the local epidemic on hospital capacity in England, we used a variety of data streams to inform the construction and parameterisation of a hospital progression model, EpiBeds, which was coupled to a model of the generalised epidemic. In this model, individuals progress through different pathways (e.g. may recover, die, or progress to intensive care and recover or die) and data from a partially complete patient-pathway line-list was used to provide initial estimates of the mean duration that individuals spend in the different hospital compartments. We then fitted EpiBeds using complete data on hospital occupancy and hospital deaths, enabling estimation of the proportion of individuals that follow the different clinical pathways, the reproduction number of the generalised epidemic, and to make short-term predictions of hospital bed demand. The construction of EpiBeds makes it straightforward to adapt to different patient pathways and settings beyond England. As part of the UK response to the pandemic, EpiBeds provided weekly forecasts to the NHS for hospital bed occupancy and admissions in England, Wales, Scotland, and Northern Ireland at national and regional scales.
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Acknowledgements: The authors would like to thank colleagues in SPI-M-O and JUNIPER consortium for various discussions around hospital modelling and forecasting.
Funder: National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response
Funder: Li Ka Shing Foundation; funder-id: http://dx.doi.org/10.13039/100007421
Funder: National Institute for Health Research Policy Research Programme in Operational Research (OPERA)
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1553-7358
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Wellcome Trust (219992/Z/19/Z)
Medical Research Council (MR/V038613/1)
Engineering and Physical Sciences Research Council (EP/W011840/1)
Engineering and Physical Sciences Research Council (EP/R018561/1)
Wellcome Trust (UNS73114)
Royal Society (INF\R2\180067)
UKRI (MR/V038613/1)
Wellcome Trust and the Royal Society (107652/Z/15/Z)