Spencer J. Fox | Searcharxiv

arXiv2026

Collaborative estimation and evaluation of SARS-CoV-2 variant nowcasting in the United States

The ability to estimate and predict pathogen variant dynamics can inform public health responses, including planning for increased transmission or severity, shifts in population immunity, or changes to vaccine or therapeutic effectiveness. The COVID-19 pandemic demonstrated the importance of monitoring SARS-CoV-2 variant evolution through viral genome sequencing, enabling predictive models to estimate variant frequencies in the recent past, present, and short-term future. Collaborative forecasting Hubs provided a valuable way to centralize predictive modeling of epidemiological indicators such as cases, hospitalizations, and deaths during the pandemic; however, none existed for variant dynamics. Here, we discuss the creation of the United States SARS-CoV-2 Variant Nowcast Hub, designed to solicit estimates of the relative abundance of a specified set of SARS-CoV-2 variants at the U.S. state level. We discuss the design decisions and challenges in building the Hub and its scoring procedures. Using submissions from the Hub's first respiratory virus season (nowcast dates October 9th, 2024 to June 4th, 2025), we evaluate five individual models and a baseline model. We found that the baseline model, which pools sequences across the U.S., performs well overall, with most individual models performing similarly or slightly worse. Locations with lower sequencing volumes exhibited greater variability in model performance. Models submitted for a single location outperformed those submitted for all locations, potentially due to greater timeliness and magnitude of local data. Much remains to be investigated regarding relative model performance across different phases of variant emergence, and we conclude by proposing future directions within and beyond this Hub.

stat.AP↗

arXiv2025

Improving Outbreak Forecasts Through Model Augmentation

Accurate forecasts of disease outbreaks are critical for effective public health responses, management of healthcare surge capacity, and communication of public risk. There are a growing number of powerful forecasting methods that fall into two broad categories -- empirical models that extrapolate from historical data, and mechanistic models based on fixed epidemiological assumptions. However, these methods often underperform precisely when reliable predictions are most urgently needed -- during periods of rapid epidemic escalation. Here, we introduce epimodulation, a hybrid approach that integrates fundamental epidemiological principles into existing predictive models to enhance forecasting accuracy, especially around epidemic peaks. When applied to simple empirical forecasting methods (ARIMA, Holt--Winters, and spline models), epimodulation improved overall prediction accuracy by an average of 9.1\% (range: 8.2--12.5\%) for COVID-19 hospital admissions and by 19.5\% (range: 17.6--23.2\%) for influenza hospital admissions; accuracy during epidemic peaks improved even further, by an average of 20.7\% and 25.4\%, respectively. Epimodulation also substantially enhanced the performance of complex forecasting methods, including the COVID-19 Forecast Hub ensemble model, demonstrating its broad utility in improving forecast reliability at critical moments in disease outbreaks.

stat.AP↗