Development of Bayesian segmented Poisson regression model to forecast COVID-19 dynamics based on wastewater data: a...

COVID-19 has caused tremendous hardships and challenges around the globe. Due to the prevalence of asymptomatic and pre-symptomatic carriers, relying solely on disease testing to screen for infections is not entirely reliable, which may affect the accuracy of predictions about the pandemic trends. This study is dedicated to developing a predictive model aimed at estimating of the dynamics of COVID-19 at an early stage based on wastewater data, to assist in establishing an effective early warning system for disease control.

Viral load in wastewater and the number of daily reported COVID-19 cases were collected from Nanning CDC and the Chinese Disease Prevention and Control Information System, respectively. We used the viral load to estimate daily reported cases by a Bayesian linear regression model. Subsequently, a Bayesian (segmented) Poisson regression model was developed, using data from the first wave of the epidemic as prior information, to predict the COVID-19 epidemic trend of the second wave. Finally, in order to explore the optimal training data for predicting outbreak dynamics during the pandemic, we fitted the model using various training sets.

The results revealed the estimated cases, using the viral load with a 3-day lag, were consistent with the actual reported cases, with adjusted R² value of 0.935 (p < 0.001). Our model successfully predicted the epidemic peak time and provided early warnings on the third day after the outbreak began. Furthermore, after using data from the first 6 days of the outbreak, the model's MAPE rapidly decreasing to lower levels (MAPE = 29.34%) and eventually stabilized at approximately 20%. Compared to using non-informative priors, this result allows for an advance warning of approximately two weeks. Importantly, as the inclusion of data from early outbreak increased, the predictive results of the model became more stable and accurate.

This study demonstrates the potential of wastewater-based epidemiology combined with Bayesian methods as a monitoring and predictive tool during infectious disease outbreaks.