Search

During the SARS-CoV-2 pandemic, governments and public health authorities collected massive amounts of data on daily confirmed positive cases and incidence rates. These data sets provide relevant information to develop a scientific understanding of the pandemic's spatiotemporal dynamics. At the same time, there is a lack of comprehensive approaches to describe and classify patterns underlying the dynamics of COVID-19 incidence across regions over time. This seriously constrains the potential benefits for public health authorities to understand spatiotemporal patterns of disease incidence that would allow for better risk communication strategies and improved assessment of mitigation policies efficacy. Within this context, we propose an exploratory statistical tool that combines functional data analysis with unsupervised learning algorithms to extract meaningful information about the main spatiotemporal patterns underlying COVID-19 incidence on mainland Portugal. We focus on the timeframe spanning from August 2020 to March 2022, considering data at the municipality level. First, we describe the temporal evolution of confirmed daily COVID-19 cases by municipality as a function of time, and outline the main temporal patterns of variability using a functional principal component analysis. Then, municipalities are classified according to their spatiotemporal similarities through hierarchical clustering adapted to spatially correlated functional data. Our findings reveal disparities in disease dynamics between northern and coastal municipalities versus those in the southern and hinterland. We also distinguish effects occurring during the 2020-2021 period from those in the 2021-2022 autumn-winter seasons. The results provide proof-of-concept that the proposed approach can be used to detect the main spatiotemporal patterns of disease incidence. The novel approach expands and enhances existing exploratory tools for spatiotemporal analysis of public health data., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ribeiro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...

Background: Self-Organizing Maps (SOM) are an unsupervised learning clustering and dimensionality reduction algorithm capable of mapping an initial complex high-dimensional data set into a low-dimensional domain, such as a two-dimensional grid of neurons. In the reduced space, the original complex patterns and their interactions can be better visualized, interpreted and understood., Methods: We use SOM to simultaneously couple the spatial and temporal domains of the COVID-19 evolution in the 278 municipalities of mainland Portugal during the first year of the pandemic. Temporal 14-days cumulative incidence time series along with socio-economic and demographic indicators per municipality were analyzed with SOM to identify regions of the country with similar behavior and infer the possible common origins of the incidence evolution., Results: The results show how neighbor municipalities tend to share a similar behavior of the disease, revealing the strong spatiotemporal relationship of the COVID-19 spreading beyond the administrative borders of each municipality. Additionally, we demonstrate how local socio-economic and demographic characteristics evolved as determinants of COVID-19 transmission, during the 1st wave school density per municipality was more relevant, where during 2nd wave jobs in the secondary sector and the deprivation score were more relevant., Conclusions: The results show that SOM can be an effective tool to analysing the spatiotemporal behavior of COVID-19 and synthetize the history of the disease in mainland Portugal during the period in analysis. While SOM have been applied to diverse scientific fields, the application of SOM to study the spatiotemporal evolution of COVID-19 is still limited. This work illustrates how SOM can be used to describe the spatiotemporal behavior of epidemic events. While the example shown herein uses 14-days cumulative incidence curves, the same analysis can be performed using other relevant data such as mortality data, vaccination rates or even infection rates of other disease of infectious nature., (© 2023. The Author(s).) more...

Since the beginning of the COVID-19 pandemic, bats are being pointed as responsible for its origin, even without solid scientific evidence. In this opinion piece, we discuss the most updated information on bats and COVID-19 and argue that bats should not be blamed for a disease they are not responsible for. Bats should be seen not as dangerous animals but, instead, as sources of several scientific insights useful for human health. [ABSTRACT FROM AUTHOR] more...

With the emergence of the coronavirus disease 2019 (COVID-19) pandemic in Portugal, a geostatistical tool was developed to model the spatial distribution of COVID-19 risk to support decision-making and policymakers. Based on a block direct sequential simulation algorithm, the model provides detailed disease risk estimates and associated spatial uncertainty. However, uncertainty is difficult to visualize with the estimated risk, and is usually overlooked as a tool to support decision-making. Ignoring uncertainty can be misleading in evaluating risk, since the amount of uncertainty varies throughout the spatial domain. The EpiGeostats R package was developed to solve this problem, since it integrates the geostatistical model and visualization tools to deliver a single map summarizing disease risk and spatial uncertainty. This paper briefly describes the methodology and package functions implemented for interfacing with the tools in question. The use of EpiGeostats is illustrated by applying it to real data from COVID-19 incidence rates on mainland Portugal. EpiGeostats is a powerful tool for supporting decision-making in the context of epidemics, since it combines a well-established geostatistical model for disease risk mapping with simple and intuitive ways of visualizing results, which prevent fine-scale inference in regions with high-risk uncertainty. The package may be used for similar problems such as mortality risk, or applied to other fields such as ecology or environmental epidemiology. [ABSTRACT FROM AUTHOR] more...