Supporting Real-Time COVID-19 Medical Management Decisions: The Transition Matrix Model Approach

Chen, Jian; Fu, Michael C.; Zhang, Wenhong; Zheng, Junhua

Since the onset of the COVID-19 outbreak in Wuhan, China, numerous forecasting models have been proposed to project the trajectory of coronavirus infection cases. We propose a new discrete-time Markov chain transition matrix model that directly incorporates stochastic behavior and for which parameter estimation is straightforward from available data. Using such data from China's Hubei province (for which Wuhan is the provincial capital city), the model is shown to be flexible, robust, and accurate. As a result, it has been adopted by the first Shanghai assistance medical team in Wuhan's Jinyintan Hospital, which was the first designated hospital to take COVID-19 patients in the world. The forecast has been used for preparing medical staff, intensive care unit (ICU) beds, ventilators, and other critical care medical resources and for supporting real-time medical management decisions. Empirical data from China's first two months (January/February) of fighting COVID-19 was collected and used to enhance the model by embedding NPI efficiency into the model. We applied the model to forecast Italy, South Korea, and Iran on March 9. Later we made forecasts for Spain, Germany, France, US on March 24. Again, the model has performed very well, proven to be flexible, robust, and accurate for most of these countries/regions outside China.