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Paul Birrell

Publications and source records attributed to Paul Birrell.

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A computationally efficient framework for realistic epidemic modelling through Gaussian Markov random fields

We tackle limitations of ordinary differential equation-driven Susceptible-Infections-Removed (SIR) models and their extensions that have recently be employed for epidemic nowcasting and forecasting. In particular, we deal with challenges related to the extension of SIR-type models to account for the so-called \textit{environmental stochasticity}, i.e., external factors, such as seasonal forcing, social cycles and vaccinations that can dramatically affect outbreaks of infectious diseases. Typically, in SIR-type models environmental stochasticity is modelled through stochastic processes. However, this stochastic extension of epidemic models leads to models with large dimension that increases over time. Here we propose a Bayesian approach to build an efficient modelling and inferential framework for epidemic nowcasting and forecasting by using Gaussian Markov random fields to model the evolution of these stochastic processes over time and across population strata. Importantly, we also develop a bespoke and computationally efficient Markov chain Monte Carlo algorithm to estimate the large number of parameters and latent states of the proposed model. We test our approach on simulated data and we apply it to real data from the Covid-19 pandemic in the United Kingdom.

stat.CO

Estimating the duration of RT-PCR positivity for SARS-CoV-2 from doubly interval censored data with undetected infections

Monitoring the incidence of new infections during a pandemic is critical for an effective public health response. General population prevalence surveys for SARS-CoV-2 can provide high-quality data to estimate incidence. However, estimation relies on understanding the distribution of the duration that infections remain detectable. This study addresses this need using data from the Coronavirus Infection Survey (CIS), a long-term, longitudinal, general population survey conducted in the UK. Analyzing these data presents unique challenges, such as doubly interval censoring, undetected infections, and false negatives. We propose a Bayesian nonparametric survival analysis approach, estimating a discrete-time distribution of durations and integrating prior information derived from a complementary study. Our methodology is validated through a simulation study, including its resilience to model misspecification, and then applied to the CIS dataset. This results in the first estimate of the full duration distribution in a general population, as well as methodology that could be transferred to new contexts.

stat.ME

Trends in COVID-19 hospital outcomes in England before and after vaccine introduction, a cohort study

Widespread vaccination campaigns have changed the landscape for COVID-19, vastly altering symptoms and reducing morbidity and mortality. We estimate trends in mortality by month of admission and vaccination status among those hospitalised with COVID-19 in England between March 2020 to September 2021, controlling for demographic factors and hospital load. Among 259,727 hospitalised COVID-19 cases, 51,948 (20.0%) experienced mortality in hospital. Hospitalised fatality risk ranged from 40.3% (95% confidence interval 39.4-41.3%) in March 2020 to 8.1% (7.2-9.0%) in June 2021. Older individuals and those with multiple co-morbidities were more likely to die or else experienced longer stays prior to discharge. Compared to unvaccinated people, the hazard of hospitalised mortality was 0.71 (0.67-0.77) with a first vaccine dose, and 0.56 (0.52-0.61) with a second vaccine dose. Compared to hospital load at 0-20% of the busiest week, the hazard of hospitalised mortality during periods of peak load (90-100%), was 1.23 (1.12-1.34). The prognosis for people hospitalised with COVID-19 in England has varied substantially throughout the pandemic and according to case-mix, vaccination, and hospital load. Our estimates provide an indication for demands on hospital resources, and the relationship between hospital burden and outcomes.

stat.AP