key: cord-0713350-5k10we81 authors: Amusat, S. O. title: Forecasting the Epidemiological Impact of Coronavirus Disease (COVID-19): Pre-vaccination Era date: 2021-03-24 journal: nan DOI: 10.1101/2021.03.17.21253791 sha: 10371eee4b5dde22afdd3f5f1156ae3e1a93b6d3 doc_id: 713350 cord_uid: 5k10we81 Background: During this pandemic, many studies have been published on the virology, diagnosis, prevention, and control of the novel coronavirus. However, fewer studies are currently available on the quantitative future epidemiological impacts. Therefore, the purpose of this study is to forecast the COVID-19 morbidities and associated-mortalities among the top 20 countries with the highest number of confirmed COVID-19 cases globally prior to vaccination intervention. Method: We conducted a secondary data analysis of the prospective geographic distribution of COVID-19 cases data worldwide as of 10 April 2020. The historical data was forecasted using Exponential-Smoothing to detect seasonality patterns and confidence intervals surrounding each predicted value in which 95 percent of the future points are expected to fall based on the forecast. Results: The total mean forecasted cases and deaths were 99,823 and 8,801. Interestingly, the US has the highest forecasted cases, deaths, and percentage cases-deaths ratio of 45,338, 2 358, and 5.20% respectively. China has the lowest cases, deaths, and percentage cases-deaths ratio -267, -2, and 0.75% respectively. In addition, France has the highest forecasted percentage cases-deaths ratio of 26.40% with forecasted cases, and deaths of 6,246, and 1,649 respectively. Conclusion Our study revealed the possibility of higher COVID-19 morbidities and associated-mortalities worldwide. The COVID-19 pandemic is the most impromptu global health emergency of the 21 st century. Coronavirus disease (COVID-19) represents a potentially fatal disease that is of great global public health concern (1). Coronaviruses may cause various symptoms ranges from acute pneumonia, fever, difficulty breathing, and acute pulmonary infection (2). These viruses are common in animals worldwide, but very few cases have been known to affect humans (3) . The World Health Organization (WHO) adopted the term 2019-novel coronavirus (2019-nCOV) to refer to a specie of coronaviruses that affected the lower respiratory tract of pneumonia patients in Wuhan, Hubei province, China on 29 December 2019 (4, 5, 6) . The WHO officially renamed the 2019 novel coronavirus has coronavirus disease (COVID-19) which is now universally being used (WHO, 2020). In the same vein, the current reference name for the virus is Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). It was reported that a cluster of patients with pneumonia of unknown etiology was linked to a local Huanan South China wet-Market in Wuhan, in December 2019 (7) . According to ECDC (2020), over 1 316 988 cases of COVID-19 have been reported worldwide, with more than 74,066 deaths since 31 December 2019, and as of 7 April 2020, approximately 0.5% of these cases (608 500) have been reported from the European Union, European Economic Area (EEA) countries and the UK and approximately 0.1% (51 059) of them have died (8) . Also, and recently, the European all-cause mortality monitoring system showed all-cause excess mortality above the expected rate in Belgium, France, Italy, Malta, Spain, Switzerland, and the United Kingdom, mainly in the age group of 65 years and above (9) . Based on the Center for Disease Control (2020), community transmission of COVID-19 was first reported in the United States in February 2020. By the middle of March, all the 52 states and four U.S. territories had reported cases of COVID-19. As of April 7, 2020, a total of 395,926 COVID-19 cases, . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted March 24, 2021. ; including 12,757 deaths, were reported in the United States. In place of these developments, advanced countries are experiencing a dramatic impact on the epidemic. Thus, this study aims to forecast the future impact of COVID-19 on the 20 countries with the highest number of confirmed cases in the ongoing pandemic. We conducted a secondary data analysis of the prospective geographic distribution of COVID-19 cases data worldwide as of 10 April 2020. The data was sourced from the European Centre for Disease Prevention and Control, which was collected by the ECDC's Intelligence team based on reports from global healthcare authority. According to ECDC, there are regular updates from European Union and EEA countries through the Early Warning and Response System (EWRS), The European Surveillance System (TESSy), the World Health Organization (WHO), and email exchanges with other international stakeholders. The historical data was forecasted using Exponential Smoothing to detect seasonality patterns and confidence intervals surrounding each predicted value in which 95 percent of the future points are expected to fall based on the forecast. For convenient interpretation, the mean forecast, the confidence intervals of cases, and deaths for each country were recorded (Table 1) . Furthermore, the percentage death-case ratio was reported to determine the degree of mortality in each country ( Figure 3 ) by determining the forecasted mean to deaths multiplied by 100. . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. ; https://doi.org/10.1101/2021.03.17.21253791 doi: medRxiv preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. . It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. The historical COVID-19 data of the top 20 countries with the highest number of confirmed COVID-19 cases from 31 December 2019 to 10 April 2020 was forecasted for 103 days starting from 10 April to 21 July 2020. As can be seen in table 1, the US has the highest number of confirmed cases 466,033 while Norway has the lowest number of confirmed cases 6,160 among the countries studied as of 10 April 2020. The US has the highest forecasted mean daily confirmed cases, and deaths of 45,338; CI (30,723-59,952) and 2,538; CI (1,596-3,119) respectively (Table 1 and Figure 1 ). The mean deaths-cases ratio was 3.58% as of 10 April 2020 while the forecasted mean deaths-cases ratio was 5.20%. This implies that the US could experience more morbidities and associated-mortalities taking into account the onset of community transmission, and time of the study. Interestingly, China has the lowest forecasted mean daily cases and deaths of -267; CI (-6286-5762), and -2; CI (-136-131) respectively (Table 1) . Although, the deaths-cases ratio was 4.03% as of 10 April 2020, and the forecasted deaths-cases ratio was 0.75%. Similarly, the mean deaths-cases ratio in, Ireland, and Iran were predicted to be 2.59%, and 6.01% compared to their actual deaths-cases as of 10 April 2020 (Figure 2 and Table 1 ). This implies that there Table 1 ). The mean deaths-cases ratio showed that France had the highest of 14.14% while Russia had the lowest mean death-case ratio of 0.75% as of 10 April 2020. Followed after France is Italy, UK, Netherlands, Belgium, Spain, and Sweden have the highest . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. ; incidences with mean death-case ratio of 12.73%, 12.26%, 11.01%, 10.10%, 10.0%, and 8.68% respectively ( Figure 3 ) as of 10 April 2020. Also, the forecasted death-case ratio showed that France, the UK, Belgium, Italy, Spain, Netherlands and Sweden could be more vulnerable to COVID-19 associatedmortality during the forecasted period with the mean forecasted deaths-cases ratio of 26.40%, 18.31%, 16.04%, 14.88%, 11.33%, 12.11% and 13.52% respectively. Lastly, the overall results showed that increase COVID-19 cases and associated-death were very much likely to occur in the countries. The study employed a systematic and rigorous approach to source for the information relevant to these research objectives. This research summarizes global distributions and quantitative impacts of COVID-19 on global health. This will stimulate the research community, stakeholders in the government and non-governmental organizations, and healthcare professionals to optimize strategies to mitigate the impact of the ongoing pandemic and strengthening preparedness for any future outbreaks. Also, it will inform the entire public to emulate compliance towards personal protective measures against the future outbreak. Our study only focuses on the top 20 countries with the highest confirmed cases in the COVID-19 global timeline. Although, it failed to reflect the entire COVID-19 cases worldwide due to redundancy in some countries' figures. Our study showed a holistic view of the current research in response to the outbreak of COVID-19. During this pandemic, many studies have been published on the virology, causes, clinical manifestation and diagnosis, and prevention and control of the novel coronavirus. However, fewer studies are currently available on the quantitative impact of COVID-19 both in the present-term and long term. Research in this aspect is urgently needed to inform stakeholders at local, regional, national, and global levels to devise strategies towards containment of SARS-COV-2 and mitigation of the impact of the outbreak on . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted March 24, 2021. ; global health and economy. We e c o n d u c t e d a t l o c a l , r e g i o n a l , a n d g l o b a l l e v e l s to provide valid and reliable ways to manage this kind of public health emergency in both the short-term and long-term. Also, accurate and timely infectious disease forecasts could inform stakeholders and authorities' responses to both future epidemics and pandemics by providing strategic policies for preparedness towards prevention and mitigation. Despite current limitations, forecasting remained a powerful tool to aid public health decision-making. We thank the European Centre for Disease Prevention and Control for making the geographic distribution of COVID-19 cases data available and accessible through https://www.ecdc.europa.eu/en/novel-coronavirus-china. This research did not receive any specific grant from funding agencies in the public, commercial, or notfor-profit sectors. Journal of autoimmunity, p.102433. 2. WMHC. 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