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Estimating Undocumented Infections By Data Driven Approach

Forecasting the spread of an epidemic relies on the incidence series of reported cases to generate the essential epidemiological characteristics of a specific infection. The unknown percentages of unreported instances and levels of nonpharmacological treatments, which vary significantly across various locations and periods, are two significant limitations for projections. It's simple to use data to determine how many undocumented infections there are and the adequate reproductive number. A compartmental model includes asymptomatic and presymptomatic contagions, which can be used to figure out how many unreported infections there are and the proper reproductive number.

A research team led by Guilherme S. Costa, Wesley Cota, and Silvio C. Ferreira from Brazil's Departamento de Fsica, Universidade Federal de Viçosa, and National Institute of Science and Technology for Complex Systems applied this method to the COVID-19 epidemic series across different municipalities, allowing them to estimate the heterogeneity level of under-reporting across other places. The reproductive number calculated using the existing approach is insensitive to both diagnostic and infection rates during asymptomatic phases. If there is enough data, the procedures can be expanded to more general examples and used with different epidemiological methods and data.

Data-Driven Approach

The SARS-CoV-2 pandemic prompted unprecedented efforts by the scientific community, epidemic surveillance, public authorities, and communication systems to provide nearly real-time updated and publicly available counts for diagnosed infections, deaths, and other vital statistics for COVID-19 spread around the world. However, available epidemic series are still not perfect due to the limited ability to record all diseases quickly. Furthermore, these constraints vary significantly across various locations and times. This, however, offers new options for the development and refinement of tools for extracting information that is not clear in the data. An exciting opportunity is a data-driven approach, which uses data to feed mathematical and mechanical models, allowing for estimating variables that are not explicitly accessible. In the case of SARS-CoV-2 infections, the fundamental class of asymptomatic or pre-symptomatic infections, in which people transmit the disease even while they are asymptomatic, is critical.

Red and bleck screen with red dots
Red and bleck screen with red dots

Compartmental Model

The researchers developed a compartmental model to estimate the number of unreported cases in epidemic compartments inaccessible through surveillance systems. The approach estimates the proportion of unrecorded infections by utilizing the case fatality ratio (CFR) and biological characteristics calculated in controlled experiments, namely the infection fatality ratio (IFR). The approach was used in an epidemic series of confirmed cases and fatalities in two Brazilian states where the dates of the start of symptoms were known. They chose the first semester of 2021, when Brazil was hit by a second epidemic wave of COVID-19, caused mainly by the Gamma variety. An underreporting coefficient was developed, which gives the ratio of diagnosed infections versus those that are not. The data revealed significant variance in your time and across various regions over the same period. The technique can assess the initial status of undocumented compartments, mainly asymptomatic and exposed cases. While the reported data should not be construed as precise estimates of actual epidemic prevalence, they clearly show that infected people who may seek medical care constitute a modest portion of total cases. Surprisingly, the effective reproduction rate doesn't seem to be affected by the test speed of asymptomatic patients. This shows that infections that aren't reported have little impact on this critical epidemic indicator.


The technique may be expanded by using age-specific contact matrices or metapopulation methods. However, the important takeaway is that the beginning conditions for undocumented infections may be inferred using a basic mechanical system based on compartmental models and fed by an epidemiological sequence of identified deaths and cases. Nonetheless, technique accuracy is dependent on reasonable estimations of biological factors, particularly the infection fatality ratio, which fluctuates as the epidemic situation evolves. Vaccination, for example, is likely to lower the infection fatality ratio, but the introduction of more aggressive varieties may raise it. A simple data-driven method was devised to estimate the evolution of the infection fatality ratio in time series with vaccination rates. Following this study, we could look at other time distributions for epidemic transitions, just like real-life epidemiology.

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