Estimating the effects of lockdown timing on COVID-19 cases and deaths in England: A counterfactual modelling study.

BACKGROUND: During the first wave of the COVID-19 pandemic, the United Kingdom experienced one of the highest per-capita death tolls worldwide. It is debated whether this may partly be explained by the relatively late initiation of voluntary social distancing and mandatory lockdown measures. In this study, we used simulations to estimate the number of cases and deaths that would have occurred in England by 1 June 2020 if these interventions had been implemented one or two weeks earlier, and the impact on the required duration of lockdown. METHODS: Using official reported data on the number of Pillar 1 lab-confirmed cases of COVID-19 and associated deaths occurring in England from 3 March to 1 June, we modelled: the natural (i.e. observed) growth of cases, and the counterfactual (i.e. hypothetical) growth of cases that would have occurred had measures been implemented one or two weeks earlier. Under each counterfactual condition, we estimated the expected number of deaths and the time required to reach the incidence observed under natural growth on 1 June. RESULTS: Introducing measures one week earlier would have reduced by 74% the number of confirmed COVID-19 cases in England by 1 June, resulting in approximately 21,000 fewer hospital deaths and 34,000 fewer total deaths; the required time spent in full lockdown could also have been halved, from 69 to 35 days. Acting two weeks earlier would have reduced cases by 93%, resulting in between 26,000 and 43,000 fewer deaths. CONCLUSIONS: Our modelling supports the claim that the relatively late introduction of social distancing and lockdown measures likely increased the scale, severity, and duration of the first wave of COVID-19 in England. Our results highlight the importance of acting swiftly to minimise the spread of an infectious disease when case numbers are increasing exponentially.

Analysing trajectories of a longitudinal exposure: A causal perspective on common methods in lifecourse research.

Longitudinal data is commonly analysed to inform prevention policies for diseases that may develop throughout life. Commonly methods interpret the longitudinal data as a series of discrete measurements or as continuous patterns. Some of the latter methods condition on the outcome, aiming to capture 'average' patterns within outcome groups, while others capture individual-level pattern features before relating these to the outcome. Conditioning on the outcome may prevent meaningful interpretation. Repeated measurements of a longitudinal exposure (weight) and later outcome (glycated haemoglobin levels) were simulated to match three scenarios: one with no causal relationship between growth rate and glycated haemoglobin; two with a positive causal effect of growth rate on glycated haemoglobin. Two methods that condition on the outcome and one that did not were applied to the data in 1000 simulations. The interpretation of the two-step method matched the simulation in all causal scenarios, but that of the methods conditioning on the outcome did not. Methods that condition on the outcome do not accurately represent a causal relationship between a longitudinal pattern and outcome. Researchers considering longitudinal data should carefully determine if they wish to analyse longitudinal data as a series of discrete time points or by extracting pattern features.

DAG-informed regression modelling, agent-based modelling and microsimulation modelling: a critical comparison of methods for causal inference.

The current paradigm for causal inference in epidemiology relies primarily on the evaluation of counterfactual contrasts via statistical regression models informed by graphical causal models (often in the form of directed acyclic graphs, or DAGs) and their underlying mathematical theory. However, there have been growing calls for supplementary methods, and one such method that has been proposed is agent-based modelling due to its potential for simulating counterfactuals. However, within the epidemiological literature, there currently exists a general lack of clarity regarding what exactly agent-based modelling is (and is not) and, importantly, how it differs from microsimulation modelling-perhaps its closest methodological comparator. We clarify this distinction by briefly reviewing the history of each method, which provides a context for their similarities and differences, and casts light on the types of research questions that they have evolved (and thus are well suited) to answering; we do the same for DAG-informed regression methods. The distinct historical evolutions of DAG-informed regression modelling, microsimulation modelling and agent-based modelling have given rise to distinct features of the methods themselves, and provide a foundation for critical comparison. Not only are the three methods well suited to addressing different types of causal questions, but, in doing so, they place differing levels of emphasis on fixed and random effects, and also tend to operate on different timescales and in different timeframes.

Symbiotic adaptive neuro-evolution applied to rainfall-runoff modelling in northern England.

This paper uses a symbiotic adaptive neuro-evolutionary algorithm to breed neural network models for the River Ouse catchment. It advances on traditional evolutionary approaches by evolving and optimising individual neurons. Furthermore, it is ideal for experimentation with alternative objective functions. Recent research suggests that sum squared error may not result in the most appropriate models from a hydrological perspective. Models are bred for lead times of 6 and 24 hours and compared with conventional neural network models trained using backpropagation. The algorithm is also modified to use different objective functions in the optimisation process: mean squared error, relative error and the Nash-Sutcliffe coefficient of efficiency. The results show that at longer lead times the evolved neural networks outperform the conventional ones in terms of overall performance. It is also shown that the sum squared error objective function does not result in the best performing model from a hydrological perspective.