Prediction of influenza outbreaks in Fuzhou, China: comparative analysis of forecasting models.

BACKGROUND: Influenza is a highly contagious respiratory disease that presents a significant challenge to public health globally. Therefore, effective influenza prediction and prevention are crucial for the timely allocation of resources, the development of vaccine strategies, and the implementation of targeted public health interventions. METHOD: In this study, we utilized historical influenza case data from January 2013 to December 2021 in Fuzhou to develop four regression prediction models: SARIMA, Prophet, Holt-Winters, and XGBoost models. Their predicted performance was assessed by using influenza data from the period from January 2022 to December 2022 in Fuzhou. These models were used for fitting and prediction analysis. The evaluation metrics, including Mean Squared Error (MSE), Root Mean Squared Error (RMSE), and Mean Absolute Error (MAE), were employed to compare the performance of these models. RESULTS: The results indicate that the epidemic of influenza in Fuzhou exhibits a distinct seasonal and cyclical pattern. The influenza cases data displayed a noticeable upward trend and significant fluctuations. In our study, we employed SARIMA, Prophet, Holt-Winters, and XGBoost models to predict influenza outbreaks in Fuzhou. Among these models, the XGBoost model demonstrated the best performance on both the training and test sets, yielding the lowest values for MSE, RMSE, and MAE among the four models. CONCLUSION: The utilization of the XGBoost model significantly enhances the prediction accuracy of influenza in Fuzhou. This study makes a valuable contribution to the field of influenza prediction and provides substantial support for future influenza response efforts.

Predicting ambient PM2.5 concentrations via time series models in Anhui Province, China.

Due to rapid expansion in the global economy and industrialization, PM2.5 (particles smaller than 2.5 µm in aerodynamic diameter) pollution has become a key environmental issue. The public health and social development directly affected by high PM2.5 levels. In this paper, ambient PM2.5 concentrations along with meteorological data are forecasted using time series models, including random forest (RF), prophet forecasting model (PFM), and autoregressive integrated moving average (ARIMA) in Anhui province, China. The results indicate that the RF model outperformed the PFM and ARIMA in the prediction of PM2.5 concentrations, with cross-validation coefficients of determination R2, RMSE, and MAE values of 0.83, 10.39 µg/m3, and 6.83 µg/m3, respectively. PFM achieved the average results (R2 = 0.71, RMSE = 13.90 µg/m3, and MAE = 9.05 µg/m3), while the predicted results by ARIMA are comparatively poorer (R2 = 0.64, RMSE = 15.85 µg/m3, and MAE = 10.59 µg/m3) than RF and PFM. These findings reveal that the RF model is the most effective method for predicting PM2.5 and can be applied to other regions for new findings.

Integrating Bio-Electrochemical Sensors and Machine Learning to Predict the Efficacy of Biological Nutrient Removal Processes at Water Resource Recovery Facilities.

Monitoring biological nutrient removal (BNR) processes at water resource recovery facilities (WRRFs) with data-driven models is currently limited by the data limitations associated with the variability of bioavailable carbon (C) in wastewater. This study focuses on leveraging the amperometric response of a bio-electrochemical sensor (BES) to wastewater C variability, to predict influent shock loading events and NO3- removal in the first-stage anoxic zone (ANX1) of a five-stage Bardenpho BNR process using machine learning (ML) methods. Shock loading prediction with BES signal processing successfully detected 86.9% of the influent industrial slug and rain events of the plant during the study period. Extreme gradient boosting (XGBoost) and artificial neural network (ANN) models developed using the BES signal and other recorded variables provided a good prediction performance for NO3- removal in the ANX1, particularly within the normal operating range of WRRFs. A sensitivity analysis of the XGBoost model using SHapley Additive exPlanations indicated that the BES signal had the strongest impact on the model output and current approaches to methanol dosing that neglect C availability can negatively impact nitrogen (N) removal due to cascading impacts of overdosing on nitrification efficacy.

Pedestrian Flow Identification and Occupancy Prediction for Indoor Areas.

Indoor localization is used to locate objects and people within buildings where outdoor tracking tools and technologies cannot provide precise results. This paper aims to improve analytics research, focusing on data collected through indoor localization methods. Smart devices recurrently broadcast automatic connectivity requests. These packets are known as Wi-Fi probe requests and can encapsulate various types of spatiotemporal information from the device carrier. In addition, in this paper, we perform a comparison between the Prophet model and our implementation of the autoregressive moving average (ARMA) model. The Prophet model is an additive model that requires no manual effort and can easily detect and handle outliers or missing data. In contrast, the ARMA model may require more effort and deep statistical analysis but allows the user to tune it and reach a more personalized result. Second, we attempted to understand human behaviour. We used historical data from a live store in Dubai to forecast the use of two different models, which we conclude by comparing. Subsequently, we mapped each probe request to the section of our place of interest where it was captured. Finally, we performed pedestrian flow analysis by identifying the most common paths followed inside our place of interest.

Prediction and analysis of COVID-19 daily new cases and cumulative cases: times series forecasting and machine learning models.

BACKGROUND: COVID-19 poses a severe threat to global human health, especially the USA, Brazil, and India cases continue to increase dynamically, which has a far-reaching impact on people's health, social activities, and the local economic situation. METHODS: The study proposed the ARIMA, SARIMA and Prophet models to predict daily new cases and cumulative confirmed cases in the USA, Brazil and India over the next 30 days based on the COVID-19 new confirmed cases and cumulative confirmed cases data set(May 1, 2020, and November 30, 2021) published by the official WHO, Three models were implemented in the R 4.1.1 software with forecast and prophet package. The performance of different models was evaluated by using root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). RESULTS: Through the fitting and prediction of daily new case data, we reveal that the Prophet model has more advantages in the prediction of the COVID-19 of the USA, which could compose data components and capture periodic characteristics when the data changes significantly, while SARIMA is more likely to appear over-fitting in the USA. And the SARIMA model captured a seven-day period hidden in daily COVID-19 new cases from 3 countries. While in the prediction of new cumulative cases, the ARIMA model has a better ability to fit and predict the data with a positive growth trend in different countries(Brazil and India). CONCLUSIONS: This study can shed light on understanding the outbreak trends and give an insight into the epidemiological control of these regions. Further, the prediction of the Prophet model showed sufficient accuracy in the daily COVID-19 new cases of the USA. The ARIMA model is suitable for predicting Brazil and India, which can help take precautions and policy formulation for this epidemic in other countries.

A RUL Estimation System from Clustered Run-to-Failure Degradation Signals.

The prognostics and health management disciplines provide an efficient solution to improve a system's durability, taking advantage of its lifespan in functionality before a failure appears. Prognostics are performed to estimate the system or subsystem's remaining useful life (RUL). This estimation can be used as a supply in decision-making within maintenance plans and procedures. This work focuses on prognostics by developing a recurrent neural network and a forecasting method called Prophet to measure the performance quality in RUL estimation. We apply this approach to degradation signals, which do not need to be monotonical. Finally, we test our system using data from new generation telescopes in real-world applications.

An infodemiological framework for tracking the spread of SARS-CoV-2 using integrated public data.

The outbreak of the SARS-CoV-2 novel coronavirus has caused a health crisis of immeasurable magnitude. Signals from heterogeneous public data sources could serve as early predictors for infection waves of the pandemic, particularly in its early phases, when infection data was scarce. In this article, we characterize temporal pandemic indicators by leveraging an integrated set of public data and apply them to a Prophet model to predict COVID-19 trends. An effective natural language processing pipeline was first built to extract time-series signals of specific articles from a news corpus. Bursts of these temporal signals were further identified with Kleinberg's burst detection algorithm. Across different US states, correlations for Google Trends of COVID-19 related terms, COVID-19 news volume, and publicly available wastewater SARS-CoV-2 measurements with weekly COVID-19 case numbers were generally high with lags ranging from 0 to 3 weeks, indicating them as strong predictors of viral spread. Incorporating time-series signals of these effective predictors significantly improved the performance of the Prophet model, which was able to predict the COVID-19 case numbers between one and two weeks with average mean absolute error rates of 0.38 and 0.46 respectively across different states.

Short term Markov corrector for building load forecasting system - Concept and case study of day-ahead load forecasting under the impact of the COVID-19 pandemic.

In this paper, we present the concept and formulation of a short-term Markov corrector to an underlying day-ahead building load forecasting model. The models and the correctors are then integrated to the building supervision, control and data acquisition system to automate the self-updating and retraining processes. The proposed Markov corrector is experimentally proven to significantly improve the reactivity of the forecasting models with respect to untaught variations. Developed in a discrete manner over a continuous forecasting model, the corrector also helps to capture better the consumption peaks during the activity days. A proof-of-concept is demonstrated via the case study of the GreenER building, where the impact of the Markov correctors to the performance of the existing day-ahead load forecasting system (based on Prophet model) was analyzed during the 2021/2022 winter, under the influences of the Omicron wave of the COVID-19 pandemic.

Time series forecasting of temperature and turbidity due to global warming in river Ganga at and around Varanasi, India.

The fluctuation in the river ecosystem network due to climate change-induced global warming affects aquatic organisms, water quality, and other ecological processes. Assessment of climate change-induced global warming impacts on regional hydrological processes is vital for effective water resource management and planning. The global warming effect on river water quality has been analyzed in this work. The river Ganga stretch near the Varanasi region has been chosen as the study area for this analysis. The air temperature has been predicted using the seasonal autoregressive integrated moving average (SARIMA) and the Prophet model. The Prophet model has shown better accuracy with a root mean square percent error (RMSPE) value of 3.2% compared to the SARIMA model, which has an RMPSE value of 7.54%. The river temperature, turbidity, and nighttime radiance values have been predicted for the years 2022 and 2025 using the long short-term memory (LSTM) algorithm. The anthropogenic effect on the river has been evaluated by using the nighttime radiance imageries. The predicted average river temperature shows an increment of 0.58 °C and 0.63 °C for the city and non-city river stretches, respectively, in 2025 compared to 2022. Similarly, the river turbidity shows an increment of 1.21 nephelometric turbidity units (NTU) and 1.17 NTU for the city and non-city stretch, respectively, in 2025 compared to 2022. For future predicted years, the nighttime radiance values for the region situated near the city river stretch show a significant rise compared to the region that lies nearby the non-city river stretch.

Intelligent computing on time-series data analysis and prediction of COVID-19 pandemics.

Covid-19 disease caused by novel coronavirus (SARS-CoV-2) is a highly contagious epidemic that originated in Wuhan, Hubei Province of China in late December 2019. World Health Organization (WHO) declared Covid-19 as a pandemic on 12th March 2020. Researchers and policy makers are designing strategies to control the pandemic in order to minimize its impact on human health and economy round the clock. The SARS-CoV-2 virus transmits mostly through respiratory droplets and through contaminated surfacesin human body.Securing an appropriate level of safety during the pandemic situation is a highly problematic issue which resulted from the transportation sector which has been hit hard by COVID-19. This paper focuses on developing an intelligent computing model for forecasting the outbreak of COVID-19. The Facebook Prophet model predicts 90 days future values including the peak date of the confirmed cases of COVID-19 for six worst hit countries of the world including India and six high incidence states of India. The model also identifies five significant changepoints in the growth curve of confirmed cases of India which indicate the impact of the interventions imposed by Government of India on the growth rate of the infection. The goodness-of-fit of the model measures 85% MAPE for all six countries and all six states of India. The above computational analysis may be able to throw some light on planning and management of healthcare system and infrastructure.

Did Prophet Mohammad (PBUH) have epilepsy? A neurological analysis.

INTRODUCTION: The Prophet of Islam is one of the several famous religious figures who allegedly suffered from epilepsy. Early Greek chronicler Theophanes was one of the first to mention that the revelations of The Prophet were episodes of epilepsy, sparking a debate that has continued to date. This argument, for the most part, was confined to historic literary writings only until it was quoted by some eminent neurologists of recent times. They suggested probable diagnosis of temporal lobe epilepsy, adding credibility to the historical claims. MATERIAL AND METHOD: Review of works of some prominent historians, orientalists, literati from previous twelve centuries, and recent neurologists who believed The Prophet to be epileptic was done. The resource material that influenced them to believe this was likewise examined. Other archived literature including Hadith, the primary resource material that provides detailed information about the day-to-day happenings in The Prophet's life with books on the life of The Prophet by orientalists and Muslim historians describing such features during revelations and other events, was scrutinized. Documentations of these events from all resources were compared and analyzed from a neurological perspective. RESULTS: The author on analysis found literature indicating faulty translations of the original Arabic text into Latin as one of the reason for misleading conclusions. Verbatim translations of Arabic phrases used symbolically have taken away the exact construal giving it a wrong perspective. Similarly, The Prophet's peri-revelation episodes as they appear in Hadith when evaluated from a neurological perspective suggest that The Prophet did not have epilepsy. CONCLUSION: A judicious analysis of the features on which the historians and literati based their suspicion to label The Prophet epileptic, provides little supportive evidence when analyzed from a neurological perspective. Without judicious analysis of clinical data chances of misdiagnosis tend to be fairly high.

An Optimized Probabilistic Delay Tolerant Network (DTN) Routing Protocol Based on Scheduling Mechanism for Internet of Things (IoT).

Many applications of Internet of Things (IoT) have been implemented based on unreliable wireless or mobile networks like the delay tolerant network (DTN). Therefore, it is an important issue for IoT applications to achieve efficient data transmission in DTN. In order to improve delivery rate and optimize delivery delay with low overhead in DTN for IoT applications, we propose a new routing protocol, called Scheduling-Probabilistic Routing Protocol using History of Encounters and Transitivity (PROPHET). In this protocol, we calculate the delivery predictability according to the encountering frequency among nodes. Two scheduling mechanisms are proposed to extend the traditional PROPHET protocol and improve performance in both storage and transmission in DTN. In order to evaluate the proposed routing protocol, we perform simulations and compare it with other routing protocols in an Opportunistic Network Environment (ONE) simulator. The results demonstrate that the proposed Scheduling-PROPHET can achieve better performances in several key aspects compared with the existing protocols.

Predictive healthcare modeling for early pandemic assessment leveraging deep auto regressor neural prophet.

In this paper, NeuralProphet (NP), an explainable hybrid modular framework, enhances the forecasting performance of pandemics by adding two neural network modules; auto-regressor (AR) and lagged-regressor (LR). An advanced deep auto-regressor neural network (Deep-AR-Net) model is employed to implement these two modules. The enhanced NP is optimized via AdamW and Huber loss function to perform multivariate multi-step forecasting contrast to Prophet. The models are validated with COVID-19 time-series datasets. The NP's efficiency is studied component-wise for a long-term forecast for India and an overall reduction of 60.36% and individually 34.7% by AR-module, 53.4% by LR-module in MASE compared to Prophet. The Deep-AR-Net model reduces the forecasting error of NP for all five countries, on average, by 49.21% and 46.07% for short-and-long-term, respectively. The visualizations confirm that forecasting curves are closer to the actual cases but significantly different from Prophet. Hence, it can develop a real-time decision-making system for highly infectious diseases.

Examining sea levels forecasting using autoregressive and prophet models.

Global climate change in recent years has resulted in significant changes in sea levels at both global and local scales. Various oceanic and climatic factors play direct and indirect roles in influencing sea level changes, such as temperature, ocean heat, and Greenhouse gases (GHG) emissions. This study examined time series analysis models, specifically Autoregressive Moving Average (ARIMA) and Facebook's prophet, in forecasting the Global Mean Sea Level (GMSL). Additionally, Vector Autoregressive (VAR) model was utilized to investigate the influence of selected oceanic and climatic factors contributing to sea level rise, including ocean heat, air temperature, and GHG emissions. Moreover, the models were applied to regional sea level data from the Arabian Gulf, which experienced higher fluctuations compared to GMSL. Results showed the capability of autoregressive models in long-term forecasting, while the Prophet model excelled in capturing trends and patterns in the time series over extended periods of time.

Mathematical analysis and prediction of future outbreak of dengue on time-varying contact rate using machine learning approach.

This article introduces a novel mathematical model analyzing the dynamics of Dengue in the recent past, specifically focusing on the 2023 outbreak of this disease. The model explores the patterns and behaviors of dengue fever in Bangladesh. Incorporating a sinusoidal function reveals significant mid-May to Late October outbreak predictions, aligning with the government's exposed data in our simulation. For different amplitudes (A) within a sequence of values (A = 0.1 to 0.5), the highest number of infected mosquitoes occurs in July. However, simulations project that when ßM = 0.5 and A = 0.1, the peak of human infections occurs in late September. Not only the next-generation matrix approach along with the stability of disease-free and endemic equilibrium points are observed, but also a cutting-edge Machine learning (ML) approach such as the Prophet model is explored for forecasting future Dengue outbreaks in Bangladesh. Remarkably, we have fitted our solution curve of infection with the reported data by the government of Bangladesh. We can predict the outcome of 2024 based on the ML Prophet model situation of Dengue will be detrimental and proliferate 25 % compared to 2023. Finally, the study marks a significant milestone in understanding and managing Dengue outbreaks in Bangladesh.

Time series models in prediction of severe fever with thrombocytopenia syndrome cases in Shandong province, China.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus (SFTSV). Predicting the incidence of this disease in advance is crucial for policymakers to develop prevention and control strategies. In this study, we utilized historical incidence data of SFTS (2013-2020) in Shandong Province, China to establish three univariate prediction models based on two time-series forecasting algorithms Autoregressive Integrated Moving Average (ARIMA) and Prophet, as well as a special type of recurrent neural network Long Short-Term Memory (LSTM) algorithm. We then evaluated and compared the performance of these models. All three models demonstrated good predictive capabilities for SFTS cases, with the predicted results closely aligning with the actual cases. Among the models, the LSTM model exhibited the best fitting and prediction performance. It achieved the lowest values for mean absolute error (MAE), mean square error (MSE), and root mean square error (RMSE). The number of SFTS cases in the subsequent 5 years in this area were also generated using this model. The LSTM model, being simple and practical, provides valuable information and data for assessing the potential risk of SFTS in advance. This information is crucial for the development of early warning systems and the formulation of effective prevention and control measures for SFTS.

Time series based road traffic accidents forecasting via SARIMA and Facebook Prophet model with potential changepoints.

Road traffic accident (RTA) is a critical global public health concern, particularly in developing countries. Analyzing past fatalities and predicting future trends is vital for the development of road safety policies and regulations. The main objective of this study is to assess the effectiveness of univariate Seasonal Autoregressive Integrated Moving Average (SARIMA) and Facebook (FB) Prophet models, with potential change points, in handling time-series road accident data involving seasonal patterns in contrast to other statistical methods employed by key governmental agencies such as Ghana's Motor Transport and Traffic Unit (MTTU). The aforementioned models underwent training with monthly RTA data spanning from 2013 to 2018. Their predictive accuracies were then evaluated using the test set, comprising monthly RTA data from 2019. The study employed the Box-Jenkins method on the training set, yielding the development of various tentative time series models to effectively capture the patterns in the monthly RTA data. SARIMA(0,1,1)×(1,0,0)12 was found to be the suitable model for forecasting RTAs with a log-likelihood value of -266.28, AIC value of 538.56, AICc value of 538.92, BIC value of 545.35. The findings disclosed that the SARIMA(0,1,1)×(1,0,0)12 model developed outperforms FB-Prophet with a forecast accuracy of 93.1025% as clearly depicted by the model's MAPE of 6.8975% and a Theil U1 statistic of 0.0376 compared to the FB-Prophet model's respective forecasted accuracy and Theil U1 statistic of 84.3569% and 0.1071. A Ljung-Box test on the residuals of the estimated SARIMA(0,1,1)×(1,0,0)12 model revealed that they are independent and free from auto/serial correlation. A Box-Pierce test for larger lags also revealed that the proposed model is adequate for forecasting. Due to the high forecast accuracy of the proposed SARIMA model, the study recommends the use of the proposed SARIMA model in the analysis of road traffic accidents in Ghana.

Epidemiological characteristics and prediction model construction of hemorrhagic fever with renal syndrome in Quzhou City, China, 2005-2022.

Background: Hemorrhagic fever with renal syndrome (HFRS) is one of the 10 major infectious diseases that jeopardize human health and is distributed in more than 30 countries around the world. China is the country with the highest number of reported HFRS cases worldwide, accounting for 90% of global cases. The incidence level of HFRS in Quzhou is at the forefront of Zhejiang Province, and there is no specific treatment for it yet. Therefore, it is crucial to grasp the epidemiological characteristics of HFRS in Quzhou and establish a prediction model for HFRS to lay the foundation for early warning of HFRS. Methods: Descriptive epidemiological methods were used to analyze the epidemic characteristics of HFRS, the incidence map was drawn by ArcGIS software, the Seasonal AutoRegressive Integrated Moving Average (SARIMA) and Prophet model were established by R software. Then, root mean square error (RMSE) and mean absolute error (MAE) were used to evaluate the fitting and prediction performances of the model. Results: A total of 843 HFRS cases were reported in Quzhou City from 2005 to 2022, with the highest annual incidence rate in 2007 (3.93/100,000) and the lowest in 2022 (1.05/100,000) (P trend<0.001). The incidence is distributed in a seasonal double-peak distribution, with the first peak from October to January and the second peak from May to July. The incidence rate in males (2.87/100,000) was significantly higher than in females (1.32/100,000). Farmers had the highest number of cases, accounting for 79.95% of the total number of cases. The incidence is high in the northwest of Quzhou City, with cases concentrated on cultivated land and artificial land. The RMSE and MAE values of the Prophet model are smaller than those of the SARIMA (1,0,1) (2,1,0)12 model. Conclusion: From 2005 to 2022, the incidence of HFRS in Quzhou City showed an overall downward trend, but the epidemic in high-incidence areas was still serious. In the future, the dynamics of HFRS outbreaks and host animal surveillance should be continuously strengthened in combination with the Prophet model. During the peak season, HFRS vaccination and health education are promoted with farmers as the key groups.

Forecasting the Spread of COVID-19 Using Deep Learning and Big Data Analytics Methods.

To contain the spread of the COVID-19 pandemic, there is a need for cutting-edge approaches that make use of existing technology capabilities. Forecasting its spread in a single or multiple countries ahead of time is a common strategy in most research. There is, however, a need for all-inclusive studies that capitalize on the entire regions on the African continent. This study closes this gap by conducting a wide-ranging investigation and analysis to forecast COVID-19 cases and identify the most critical countries in terms of the COVID-19 pandemic in all five major African regions. The proposed approach leveraged both statistical and deep learning models that included the autoregressive integrated moving average (ARIMA) model with a seasonal perspective, the long-term memory (LSTM), and Prophet models. In this approach, the forecasting problem was considered as a univariate time series problem using confirmed cumulative COVID-19 cases. The model performance was evaluated using seven performance metrics that included the mean-squared error, root mean-square error, mean absolute percentage error, symmetric mean absolute percentage error, peak signal-to-noise ratio, normalized root mean-square error, and the R2 score. The best-performing model was selected and used to make future predictions for the next 61 days. In this study, the long short-term memory model performed the best. Mali, Angola, Egypt, Somalia, and Gabon from the Western, Southern, Northern, Eastern, and Central African regions, with an expected increase of 22.77%, 18.97%, 11.83%, 10.72%, and 2.81%, respectively, were the most vulnerable countries with the highest expected increase in the number of cumulative positive cases.

Quantifying the impact of COVID-19 on essential health services: a comparison of interrupted time series analysis using Prophet and Poisson regression models.

BACKGROUND: Coronavirus disease 2019 (COVID-19) altered healthcare utilization patterns. However, there is a dearth of literature comparing methods for quantifying the extent to which the pandemic disrupted healthcare service provision in sub-Saharan African countries. OBJECTIVE: To compare interrupted time series analysis using Prophet and Poisson regression models in evaluating the impact of COVID-19 on essential health services. METHODS: We used reported data from Uganda's Health Management Information System from February 2018 to December 2020. We compared Prophet and Poisson models in evaluating the impact of COVID-19 on new clinic visits, diabetes clinic visits, and in-hospital deliveries between March 2020 to December 2020 and across the Central, Eastern, Northern, and Western regions of Uganda. RESULTS: The models generated similar estimates of the impact of COVID-19 in 10 of the 12 outcome-region pairs evaluated. Both models estimated declines in new clinic visits in the Central, Northern, and Western regions, and an increase in the Eastern Region. Both models estimated declines in diabetes clinic visits in the Central and Western regions, with no significant changes in the Eastern and Northern regions. For in-hospital deliveries, the models estimated a decline in the Western Region, no changes in the Central Region, and had different estimates in the Eastern and Northern regions. CONCLUSIONS: The Prophet and Poisson models are useful in quantifying the impact of interruptions on essential health services during pandemics but may result in different measures of effect. Rigor and multimethod triangulation are necessary to study the true effect of pandemics on essential health services.