Robust estimation of diagnostic rate and real incidence of COVID-19 for European policymakers
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Abstract
Policymakers need clear, fast assessment of the real spread of the COVID-19 epidemic in each of their respective countries. Standard measures of the situation provided by the governments include reported positive cases and total deaths. While total deaths indicate immediately that countries like Italy and Spain had the worst situation as of mid-April, 2020, reported cases alone do not provide a complete picture of the situation. Different countries diagnose differently and present very distinctive reported case fatality ratios. Similar levels of reported incidence and mortality might hide a very different underlying pictures. Here we present a straightforward and robust estimation of the diagnostic rate in each European country. From that estimation we obtain a uniform, unbiased incidence of the epidemic. The method to obtain the diagnostic rate is transparent and empirical. The key assumption of the method is that the infection fatality ratio of COVID-19 in Europe is not strongly country-dependent. We show that this number is not expected to be biased due to demography nor to the way total deaths are reported. The estimation protocol is dynamic, and it has been yielding converging numbers for diagnostic rates in all European countries as from mid-April, 2020. Using this diagnostic rate, policy makers can obtain Effective Potential Growth updated every day, providing an unbiased assessment of the countries at greater risk of experiencing an uncontrolled situation. The method developed has been and will be used to track possible improvements in the diagnostic rate in European countries as the epidemic evolves.
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SciScore for 10.1101/2020.05.01.20087023: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The only real limitation is that the social and environmental issues could affect the prognosis of the infected. If living in a small house with other people infected could lead to worse prognosis than staying in a large house alone, a new analysis regarding the unbiased nature of the CFR would need to be done. It is important to …
SciScore for 10.1101/2020.05.01.20087023: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The only real limitation is that the social and environmental issues could affect the prognosis of the infected. If living in a small house with other people infected could lead to worse prognosis than staying in a large house alone, a new analysis regarding the unbiased nature of the CFR would need to be done. It is important to indicate that not only I14 is unbiased, as analysed in previous sections, but that is not biased as well. Even though absolute reported cases is biased, as we have shown, pt deals with ratios and its evolution. As long as the diagnosis and recording of the people with disease follows roughly the same criteria along time in each country, ρt is a good measure of the growth the epidemic. Indeed, if evaluated diagnosis percentage is more or less constant in time, we can assume that ρt correctly reveals tendencies in contagiousness. If a change in criteria in reporting the cases occurs (i. e., a large increase in the number of tests per day leading to an increase of cases due to more testing), ρt will be temporally affected but will go back to be a good measure once the new criteria is established. In this case, EPG will provide a wrong picture for a while as well, until stationary conditions in diagnosing and reporting are achieved again. There is another important point to address in order to guarantee that ρt is a robust measure. As soon as we are estimating real number of cases, we can determine the associated ρt. It is expected that both ρt behave si...
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.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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