Retrospective methodology to estimate daily infections from deaths (REMEDID) in COVID-19: the Spain case study
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Abstract
The number of new daily infections is one of the main parameters to understand the dynamics of an epidemic. During the COVID-19 pandemic in 2020, however, such information has been underestimated. Here, we propose a retrospective methodology to estimate daily infections from daily deaths, because those are usually more accurately documented. Given the incubation period, the time from illness onset to death, and the case fatality ratio, the date of death can be estimated from the date of infection. We apply this idea conversely to estimate infections from deaths. This methodology is applied to Spain and its 19 administrative regions. Our results showed that probable daily infections during the first wave were between 35 and 42 times more than those officially documented on 14 March, when the national government decreed a national lockdown and 9 times more than those documented by the updated version of the official data. The national lockdown had a strong effect on the growth rate of virus transmission, which began to decrease immediately. Finally, the first inferred infection in Spain is about 43 days before the official data were available during the first wave. The current official data show delays of 15–30 days in the first infection relative to the inferred infections in 63% of the regions. In summary, we propose a methodology that allows reinterpretation of official daily infections, improving data accuracy in infection magnitude and dates because it assimilates valuable information from the National Seroprevalence Studies.
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SciScore for 10.1101/2020.06.22.20136960: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our main findings for Spain are: The REMEDID algorithm has strengths and limitations. First, it uses the number of deaths, which are more accurately recorded than infections. Second, it allows elucidation of the date of the infections estimated during the seroprevalence studies, which only determines the total number of infections. Thus, the REMEDID algorithm complements the seroprevalence studies. Third, the estimated daily infections indicate …
SciScore for 10.1101/2020.06.22.20136960: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our main findings for Spain are: The REMEDID algorithm has strengths and limitations. First, it uses the number of deaths, which are more accurately recorded than infections. Second, it allows elucidation of the date of the infections estimated during the seroprevalence studies, which only determines the total number of infections. Thus, the REMEDID algorithm complements the seroprevalence studies. Third, the estimated daily infections indicate the probable date of infection better than the official numbers. Note that official infections are delayed due to the inclusion of two periods, i.e., incubation period (from infection to illness onset) and illness onset (symptoms) to diagnosis. Therefore, although the maxima of infections theoretically should have coincided with the state of emergency and the national lockdown on 14 March, official infections in Spain were maximum 16 days later. Infections estimated from death data do not show such delay, however. Determination of the actual day of infection is very important for evaluation of the immediate effect of the implemented countermeasures. It must be said that in Madrid, the estimated infections reached their maxima on 11 March, when regional government warned the population to stay at home, and schools and universities were closed, forcing 1.2 million students to stay at home. Moreover, overall recommendations on disease control and social distancing were given by the Ministry of Health to the general public since de beginni...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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- No protocol registration statement was detected.
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