DAMTP, Centre for Mathematical Sciences, University of Cambridge, Cambridge, United Kingdom.
Quantitative Research, JPMorgan Chase & Co., London, United Kingdom.
PLoS One. 2021 Nov 24;16(11):e0258968. doi: 10.1371/journal.pone.0258968. eCollection 2021.
We apply Bayesian inference methods to a suite of distinct compartmental models of generalised SEIR type, in which diagnosis and quarantine are included via extra compartments. We investigate the evidence for a change in lethality of COVID-19 in late autumn 2020 in the UK, using age-structured, weekly national aggregate data for cases and mortalities. Models that allow a (step-like or graded) change in infection fatality rate (IFR) have consistently higher model evidence than those without. Moreover, they all infer a close to two-fold increase in IFR. This value lies well above most previously available estimates. However, the same models consistently infer that, most probably, the increase in IFR preceded the time window during which variant B.1.1.7 (alpha) became the dominant strain in the UK. Therefore, according to our models, the caseload and mortality data do not offer unequivocal evidence for higher lethality of a new variant. We compare these results for the UK with similar models for Germany and France, which also show increases in inferred IFR during the same period, despite the even later arrival of new variants in those countries. We argue that while the new variant(s) may be one contributing cause of a large increase in IFR in the UK in autumn 2020, other factors, such as seasonality, or pressure on health services, are likely to also have contributed.
我们应用贝叶斯推断方法对一系列广义 SEIR 型的分离模型进行了研究,这些模型通过额外的隔室纳入了诊断和隔离措施。我们使用基于年龄结构的每周全国综合病例和死亡数据,研究了 2020 年秋末英国 COVID-19 致死率变化的证据。允许(阶跃式或渐变式)改变感染病死率(IFR)的模型比没有改变的模型具有更高的模型证据。此外,它们都推断出 IFR 接近两倍的增加。这一数值远高于大多数之前可用的估计值。然而,同样的模型一致推断,最有可能的是,IFR 的增加先于 B.1.1.7(阿尔法)变异成为英国主要菌株的时间窗口。因此,根据我们的模型,病例数和死亡率数据并没有提供新变异更高致死率的明确证据。我们将英国的这些结果与德国和法国的类似模型进行了比较,尽管这些国家的新变异出现得更晚,但它们在同一时期也显示出推断出的 IFR 增加。我们认为,尽管新变异(s)可能是 2020 年秋季英国 IFR 大幅增加的一个原因,但其他因素,如季节性或对卫生服务的压力,也可能起到了作用。