Nowcasting for Real-Time COVID-19 Tracking in New York City: An Evaluation Using Reportable Disease Data From Early in the Pandemic

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Abstract

Nowcasting approaches enhance the utility of reportable disease data for trend monitoring by correcting for delays, but implementation details affect accuracy.

Objective

To support real-time COVID-19 situational awareness, the New York City Department of Health and Mental Hygiene used nowcasting to account for testing and reporting delays. We conducted an evaluation to determine which implementation details would yield the most accurate estimated case counts.

Methods

A time-correlated Bayesian approach called Nowcasting by Bayesian Smoothing (NobBS) was applied in real time to line lists of reportable disease surveillance data, accounting for the delay from diagnosis to reporting and the shape of the epidemic curve. We retrospectively evaluated nowcasting performance for confirmed case counts among residents diagnosed during the period from March to May 2020, a period when the median reporting delay was 2 days.

Results

Nowcasts with a 2-week moving window and a negative binomial distribution had lower mean absolute error, lower relative root mean square error, and higher 95% prediction interval coverage than nowcasts conducted with a 3-week moving window or with a Poisson distribution. Nowcasts conducted toward the end of the week outperformed nowcasts performed earlier in the week, given fewer patients diagnosed on weekends and lack of day-of-week adjustments. When estimating case counts for weekdays only, metrics were similar across days when the nowcasts were conducted, with Mondays having the lowest mean absolute error of 183 cases in the context of an average daily weekday case count of 2914.

Conclusions

Nowcasting using NobBS can effectively support COVID-19 trend monitoring. Accounting for overdispersion, shortening the moving window, and suppressing diagnoses on weekends—when fewer patients submitted specimens for testing—improved the accuracy of estimated case counts. Nowcasting ensured that recent decreases in observed case counts were not overinterpreted as true declines and supported officials in anticipating the magnitude and timing of hospitalizations and deaths and allocating resources geographically.

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  1. SciScore for 10.1101/2020.10.18.20209189: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This work was reviewed and deemed public health surveillance that is non-research by the DOHMH Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    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:
    Despite a mature electronic laboratory reporting system and strong informatics infrastructure and data cleaning procedures at NYC DOHMH, input data available for nowcasting had several limitations. First, for records with long lags between specimen collection and report, as long as the specimen was reported to have been collected during the pandemic period, it was not possible to distinguish long lags attributable to true delays in testing or reporting — and thus informative to the delay distribution — from long lags attributable to laboratory data entry errors in specimen collection dates. Second, nowcasting by patient modZCTA of residence relied on accurate laboratory reporting of patient address. For example, one week of real-time nowcasting results were biased when, for a batch of reports, one commercial laboratory misreported its own address as the residential address of all patients tested. Third, a large proportion of records had missing onset date. NobBS is designed for use with complete linelists with no missing onset or report dates. Given the complexities of imputing onset date from diagnosis date, nowcasts were instead conducted by specimen collection or diagnosis date. Fourth, patient hospitalization status was largely ascertained by matching administrative records. To allow time for record matching, hospitalization nowcasts were conducted at a 3-day lag, limiting the real time availability of results. Furthermore, records from certain facilities were unavailable...

    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.

    About SciScore

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