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Modelling the Second Covid-19 Wave in Mumbai

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 Added by Sandeep Juneja
 Publication date 2021
  fields Biology
and research's language is English




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India has been hit by a huge second wave of Covid-19 that started in mid-February 2021. Mumbai was amongst the first cities to see the increase. In this report, we use our agent based simulator to computationally study the second wave in Mumbai. We build upon our earlier analysis, where projections were made from November 2020 onwards. We use our simulator to conduct an extensive scenario analysis - we play out many plausible scenarios through varying economic activity, reinfection levels, population compliance, infectiveness, prevalence and lethality of the possible variant strains, and infection spread via local trains to arrive at those that may better explain the second wave fatality numbers. We observe and highlight that timings of peak and valley of the fatalities in the second wave are robust to many plausible scenarios, suggesting that they are likely to be accurate projections for Mumbai. During the second wave, the observed fatalities were low in February and mid-March and saw a phase change or a steep increase in the growth rate after around late March. We conduct extensive experiments to replicate this observed sharp convexity. This is not an easy phenomena to replicate, and we find that explanations such as increased laxity in the population, increased reinfections, increased intensity of infections in Mumbai transportation, increased lethality in the virus, or a combination amongst them, generally do a poor job of matching this pattern. We find that the most likely explanation is presence of small amount of extremely infective variant on February 1 that grows rapidly thereafter and becomes a dominant strain by Mid-March. From a prescriptive view, this points to an urgent need for extensive and continuous genome sequencing to establish existence and prevalence of different virus strains in Mumbai and in India, as they evolve over time.



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The second wave of Covid-19 that started in mid-February 2021 in Mumbai is now subsiding. Increasingly the focus amongst the policy makers and general public is on the potential third wave. Due to uncertainties regarding emergence of new variants and reinfections, instead of projecting our best guess scenario, in this report we conduct an extensive scenario analysis for Mumbai and track peak fatalities in the coming months in each of these scenarios. Our key conclusions are - As per our model, about 80% of Mumbai population has been exposed to Covid-19 by June 1, 2021. Under the assumption that all who are exposed have immunity against further infection, it is unlikely that Mumbai would see a large third wave. It is the reinfections that may lead to a large wave. Reinfections could occur because of declining antibodies amongst the infected as well as by variants that can break through the immunity provided by prior infections. Even under a reasonably pessimistic scenario we observe the resulting peak to be no larger than that under the second wave. We further observe that under the scenario where the reinfections are mild so that they affect the fatality figures negligibly, where the new variants (beyond the existing delta variant) have a mild impact, as the city opens up, we observe a small wave in the coming months. However, if by then the vaccine coverage is extensive, this wave will be barely noticeable. We also plot $R_t$, the infection growth rate at time $t$, and highlight some interesting observations.
COVID-19 has forced quarantine measures in several countries across the world. These measures have proven to be effective in significantly reducing the prevalence of the virus. To date, no effective treatment or vaccine is available. In the effort of preserving both public health as well as the economical and social textures, France and Italy governments have partially released lockdown measures. Here we extrapolate the long-term behavior of the epidemics in both countries using a Susceptible-Exposed-Infected-Recovered (SEIR) model where parameters are stochastically perturbed to handle the uncertainty in the estimates of COVID-19 prevalence. Our results suggest that uncertainties in both parameters and initial conditions rapidly propagate in the model and can result in different outcomes of the epidemics leading or not to a second wave of infections. Using actual knowledge, asymptotic estimates of COVID-19 prevalence can fluctuate of order of ten millions units in both countries.
The nation-wide lockdown starting 25 March 2020, aimed at suppressing the spread of the COVID-19 disease, was extended until 31 May 2020 in three subsequent orders by the Government of India. The extended lockdown has had significant social and economic consequences and `lockdown fatigue has likely set in. Phased reopening began from 01 June 2020 onwards. Mumbai, one of the most crowded cities in the world, has witnessed both the largest number of cases and deaths among all the cities in India (41986 positive cases and 1368 deaths as of 02 June 2020). Many tough decisions are going to be made on re-opening in the next few days. In an earlier IISc-TIFR Report, we presented an agent-based city-scale simulator(ABCS) to model the progression and spread of the infection in large metropolises like Mumbai and Bengaluru. As discussed in IISc-TIFR Report 1, ABCS is a useful tool to model interactions of city residents at an individual level and to capture the impact of non-pharmaceutical interventions on the infection spread. In this report we focus on Mumbai. Using our simulator, we consider some plausible scenarios for phased emergence of Mumbai from the lockdown, 01 June 2020 onwards. These include phased and gradual opening of the industry, partial opening of public transportation (modelling of infection spread in suburban trains), impact of containment zones on controlling infections, and the role of compliance with respect to various intervention measures including use of masks, case isolation, home quarantine, etc. The main takeaway of our simulation results is that a phased opening of workplaces, say at a conservative attendance level of 20 to 33%, is a good way to restart economic activity while ensuring that the citys medical care capacity remains adequate to handle the possible rise in the number of COVID-19 patients in June and July.
In late 2019, a novel coronavirus, the SARS-CoV-2 outbreak was identified in Wuhan, China and later spread to every corner of the globe. Whilst the number of infection-induced deaths in Ghana, West Africa are minimal when compared with the rest of the world, the impact on the local health service is still significant. Compartmental models are a useful framework for investigating transmission of diseases in societies. To understand how the infection will spread and how to limit the outbreak. We have developed a modified SEIR compartmental model with nine compartments (CoVCom9) to describe the dynamics of SARS-CoV-2 transmission in Ghana. We have carried out a detailed mathematical analysis of the CoVCom9, including the derivation of the basic reproduction number, $mathcal{R}_{0}$. In particular, we have shown that the disease-free equilibrium is globally asymptotically stable when $mathcal{R}_{0}<1$ via a candidate Lyapunov function. Using the SARS-CoV-2 reported data for confirmed-positive cases and deaths from March 13 to August 10, 2020, we have parametrised the CoVCom9 model. The results of this fit show good agreement with data. We used Latin hypercube sampling-rank correlation coefficient (LHS-PRCC) to investigate the uncertainty and sensitivity of $mathcal{R}_{0}$ since the results derived are significant in controlling the spread of SARS-CoV-2. We estimate that over this five month period, the basic reproduction number is given by $mathcal{R}_{0} = 3.110$, with the 95% confidence interval being $2.042 leq mathcal{R}_0 leq 3.240$, and the mean value being $mathcal{R}_{0}=2.623$. Of the 32 parameters in the model, we find that just six have a significant influence on $mathcal{R}_{0}$, these include the rate of testing, where an increasing testing rate contributes to the reduction of $mathcal{R}_{0}$.
By characterising the time evolution of COVID-19 in term of its velocity (log of the new cases per day) and its rate of variation, or acceleration, we show that in many countries there has been a deceleration even before lockdowns were issued. This feature, possibly due to the increase of social awareness, can be rationalised by a susceptible-hidden-infected-recovered (SHIR) model introduced by Barnes, in which a hidden (isolated from the virus) compartment $H$ is gradually populated by susceptible people, thus reducing the effectiveness of the virus spreading. By introducing a partial hiding mechanism, for instance due to the impossibility for a fraction of the population to enter the hidden state, we obtain a model that, although still sufficiently simple, faithfully reproduces the different deceleration trends observed in several major countries.
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