Real-time projections of epidemic transmission and estimation of vaccination impact during an Ebola virus disease outbreak in Northeastern Democratic Republic of Congo

Lee Worden; Rae Wannier; Nicole A. Hoff; Kamy Musene; Bernice Selo; Mathias Mossoko; Emile Okitolonda-Wemakoy; Jean Jacques Muyembe-Tamfum; George W. Rutherford; Thomas M. Lietman; Anne W. Rimoin; Travis C. Porco; J. Daniel Kelly

The copyright holder for this preprint (which was not peer-reviewed) is the author/funder. . https://doi.org/10.1101/461285 doi: bioRxiv preprint expect this to happen rarely, so we limit the tolerance of matching to only at most 15 157 cases below the reported count regardless of the tolerance of counts above the reported 158 count. This limit on underestimates was applied only to analysis of data sets from later 159 than October 13, to preserve unaltered the projection methods we reported in a 160 preprint of this paper [34] . Filtering tolerances were as follows: when using the August 161 20 data set, we allowed a tolerance of 4 cases more or less than each target count; for 162 August 27 and September 5, 6 cases; for September 15, 10 cases; for October 7, 12 cases; 163 for October 13, 17 cases; for November 1, 41 cases; for November 20, 55 cases; for The ring vaccination study found the vaccine to be effective against cases with onset 177 dates 10 days or more from the date of vaccine administration, so we modeled the 178 vaccination program as a proportionate reduction in the number of new cases with 179 onsets 10 days or more after the program start date. 180 We used past estimates of the proportion of unreported cases to estimate the 181 proportion of exposed individuals not covered by the vaccination process. Based on a 182 Sierra Leonean study from the 2013-2016 outbreak [37], we estimated the proportion of 183 reported cases (out of all known cases) in DRC to range from a low of 68% to a high of 184 96%, as extremes of the best known range of estimates, to be evaluated on their fit to 185 data. Given these low and high estimates of reported cases and the estimate of vaccine 186 effectiveness, a low estimate of vaccination program coverage was 44% (68% × 64.6%) 187 and a high estimate of vaccination program coverage was 62% (96% × 64.6%).