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# Predictive Mathematical Models of the COVID-19 PandemicUnderlying Principles and Value of Projections

Educational Objective
To understand how predictive mathematical models can be used to understand the future transmission rates of COVID-19
1 Credit CME

Numerous mathematical models are being produced to forecast the future of coronavirus disease 2019 (COVID-19) epidemics in the US and worldwide. These predictions have far-reaching consequences regarding how quickly and how strongly governments move to curb an epidemic. However, the primary and most effective use of epidemiological models is to estimate the relative effect of various interventions in reducing disease burden rather than to produce precise quantitative predictions about extent or duration of disease burdens. For predictions, “models are not crystal balls,” as Ferguson noted in a recent overview of the role of modeling.1

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Article Information

Corresponding Author: Nicholas P. Jewell, PhD, Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, United Kingdom (nicholas.jewell@lshtm.ac.uk).

Published Online: April 16, 2020. doi:10.1001/jama.2020.6585

Conflict of Interest Disclosures: Drs Jewell, Lewnard, and Jewell reported currently having a paid contract with Kaiser Permanente to advise them regarding hospital demand associated with coronavirus disease 2019 cases. No other disclosures were reported.

References
1.
Adam  D﻿ .  Special report: the simulations driving the world’s response to COVID-19. ﻿  Nature. 2020;580(7803):316-318.PubMedGoogle ScholarCrossref
2.
Whitty  CJ﻿ .  What makes an academic paper useful for health policy? ﻿  BMC Med. 2015;13:301.PubMedGoogle ScholarCrossref
3.
@AdamJKucharski. Indeed, as this (aptly titled) piece suggests, complex models may be no more reliable than simple ones if they miss key aspects of the biology. Complex models can create the illusion of realism, and make it harder to spot crucial omissions https://www.pnas.org/content/103/33/12221. April 1, 2020. Accessed April 13, 2020. https://twitter.com/AdamJKucharski/status/1245336665691807744
4.
Lawler  J﻿ . What healthcare providers need to know: preparing for the COVID-19. American Hospital Association webinar. February 26, 2020. Accessed April 13, 2020.
5.
Murray  CJL﻿ ; IHME COVID-19 health service utilization forecasting team. Forecasting COVID-19 impact on hospital bed-days, ICU-days, ventilator-days and deaths by US state in the next 4 months. MedRxiv. Preprint posted March 30, 2020. doi:10.1101/2020.03.27.20043752
6.
Foresti  CCL﻿ . The real death toll for COVID-19 is at least 4 times the official numbers. Politico. March 26, 2020. Accessed March 31, 2020. https://www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130.shtml?refresh_ce-cp
7.
COVID-19 resources. Institute for Health Metrics and Evaluation website. Updated April 10, 2020. Accessed April 13, 2020. http://www.healthdata.org/covid
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