Development and application of a dynamic transmission model of health systems' preparedness and response to COVID-19 in twenty-six Latin American and Caribbean countries.

Adrián Santoro,Maisa Havela,Ivan Williams,Andrés Pichón Riviere,Ariel Bardach,Analía López,Federico Augustovski,Alejandro López Osornio,Adolfo Rubinstein,Cintia Cejas,Martín Wachs,Nnodimele Onuigbo Atulomah

doi:10.1371/journal.pgph.0000186

Abstract

The global impact of COVID-19 has challenged health systems across the world. This situation highlighted the need to develop policies based on scientific evidence to prepare the health systems and mitigate the pandemic. In this scenario, governments were urged to predict the impact of the measures they were implementing, how they related to the population's behavior, and the capacity of health systems to respond to the pandemic. The overarching aim of this research was to develop a customizable and open-source tool to predict the impact of the expansion of COVID-19 on the level of preparedness of the health systems of different Latin American and the Caribbean countries, with two main objectives. Firstly, to estimate the transmission dynamics of COVID-19 and the preparedness and response capacity of health systems in those countries, based on different scenarios and public policies implemented to control, mitigate, or suppress the spread of the epidemic. Secondly, to facilitate policy makers' decisions by allowing the model to adjust its parameters according to the specific pandemic trajectory and policy context. How many infections and deaths are estimated per day?; When are the peaks of cases and deaths expected, according to the different scenarios?; Which occupancy rate will ICU services have along the epidemiological curve?; When is the optimal time increase restrictions in order to prevent saturation of ICU beds?, are some of the key questions that the model can respond, and is publicly accessible through the following link: http://shinyapps.iecs.org.ar/modelo-covid19/. This open-access and open code tool is based on a SEIR model (Susceptible, Exposed, Infected and Recovered). Using a deterministic epidemiological model, it allows to frame potential scenarios for long periods, providing valuable information on the dynamics of transmission and how it could impact on health systems through multiple customized configurations adapted to specific characteristics of each country.

Highlights

The global impact of COVID-19 has challenged health systems across the world
Since the beginning of the COVID-19 epidemic in China, warnings have been made about the ability of the SARS-CoV-2 virus to spread and its possible impact in different countries [1–3].This situation showed the necessity to develop policies based on scientific evidence to prepare the health systems to mitigate the pandemic
The infectious fatality rate (IFR) is the key parameter to derive the number of infected subjects and the percentage of patients requiring admission to a critical care unit as well as the length of stay in days in the critical care unit per patient

Summary

Introduction

The global impact of COVID-19 has challenged health systems across the world. The public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Since the beginning of the COVID-19 epidemic in China, warnings have been made about the ability of the SARS-CoV-2 virus to spread and its possible impact in different countries [1–3].This situation showed the necessity to develop policies based on scientific evidence to prepare the health systems to mitigate the pandemic. As different countries are taking different public health measures to face the pandemic, it is necessary to predict the extent to which their healthcare systems are prepared to respond to this challenge, since they have become hotspots of the COVID-19 pandemic, exacerbated by weak social protection, fragmented health systems, and profound inequalities

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