COVID 19 Pandemic: A Real-time Forecasts & Prediction of Confirmed Cases, Active Cases using the ARIMA model &Public Health in West Bengal, India.

DOI: https://doi.org/10.21203/rs.3.rs-33982/v1

Abstract

Background: COVID-19 is an emerging infectious disease which has been declared a Pandemic by the World Health Organization (WHO) on March 11 2020. This pandemic has spread over the world in more than 200 countries. India is also adversely affected by this pandemic, and there are no signs of slowing down of the virus in coming time. The absence of a vaccine for COVID-19 is making the situation worse for the already overstretched Indian public health care system. As economic burden makes it increasingly difficult for our country to continue imposing control measures, it is vital for states like West Bengal to make predictions using time series forecasting for the upcoming cases , test kits , health care and estimated the requirement of Quarantine centers, isolation beds, ICU beds and ventilators for COVID-19 patients .

Objective: This study is forecasting the confirmed and active cases for COVID-19 until August, using time series ARIMA model & Public Health in West Bengal, India.

Methods: We used ARIMA model, and Auto ARIMA model for forecasting confirmed and active cases till the end of August month using time series data of COVID-19 cases in West Bengal, India from March 1, 2020, to June 4, 2020.

Discussion and Conclusion: This forecasts show a very crucial situation for West Bengal in coming days and, the actual numbers can go higher than our estimates of confirmed case as Lockdown 5.0 & Unlock 1.0 will be implemented from 1st June 2020 in India, West Bengal will be observing a partial lift of the lockdown and in that case, there will be a surge in the number of daily confirmed and active cases. The requirement of Health care sector needs to be further improved isolation beds, ICUs and ventilators will also be needed to increase in that scenario. Inter State & Intra State Movement restrictions are lifted. Hence, Migrants returning to their homes due to loss of livelihood and income in the lockdown period may lead to a rise in the number of cases, which could not be accounted for in our projections. We suggest more of Public-Private Partnership (PPP) model in the health sector to accommodate COVID-19 patients adequately and reduce the burden of the already overstretched Indian public health care system, which will directly or indirectly affect the States in the time of crisis.

Introduction

Coronavirus disease (COVID–19) is one of the greatest challenges the world has encountered in recent times. Since the initial reports of outbreak in late December, 2019, It is caused by severe acute respiratory syndrome Corona Virus 2 (SARS-CoV–2). The origin of the virus is yet to be confirmed, but the first person tested positive is from Wuhan, China. It is spreading very quickly throughout the world & the numbers have been consistently rising with the disease affecting 6.54 million people in 181 countries worldwide as of 6th June, 2020. In India, the first positive case of COVID–19 was detected on January 30th 2020, in Kerala. The frailty of a multitude of health care systems across the globe has been exposed by COVID–19. With the surfacing negative socioeconomic consequences of community mitigation strategies like lockdown affecting the vulnerable, especially in developing countries like India, Governments are eyeing at easing the restrictions that have long been in place by recent Lockdown 5.0. It is imperative to understand that lifting the control measures for economic salvage, without thoroughly preparing for the possible consequences, may only result in further economic decline and health crisis.

WHO in its strategic advice for countries looking to life the control measures illustrated six criteria in a sequential manner to be considered: control of transmission; preparation of health systems for active contact tracing and optimum care provision; careful management of health facilities to prevent outbreaks; adherence to preventive measures as the essential services resume; management of importation risks; indoctrination of the ‘new norm’ among communities by active engagement. According to the report of World Population prospects (2019), India has a population of more than 1.36 billion and most of the population of urban areas and cities are under the risk of contracting the virus. So, it is important to forecast numbers of confirmed and active cases. In this scenario, it is vital for every state to make predictions using time series forecasting, the study aims to draw comparative account of the progression of COVID–19 in near future in the state of West Bengal.

Data And Methodology

Data:

For our study, the required data of daily total confirmed cases and total active cases of COVID–19 infection collected for India as well as its state West Bengal from the (https://www.covid19india.org/), and excel of the patient database is used to build a time-series database for confirmed and active cases Using the Data Science Software called R. In this study, forecasting is done based on the data from March 1, 2020, to June 4 2020. This data is being used to build Forecast which includes all the Statistics and Graphs for mentioned model.

Methodology:

In the past few months, an increasing number of research related to forecasting the trend of pandemic COVID–19 cases are being published using different approaches in various part of the world. (Gupta and Pal 2020; Fanelli and Piazza 2020; Giordano et al. 2020; Tandon et al., 2020; Kumar et al. 2020; Benvenuto et al. 2020; Batista, 2020). The ARIMA model is one of them and nowadays used for forecasting case count for the prediction of epidemic diseases based on the time series modeling (Rios et al. 2000; Li et al. 2012; Zhang et al. 2014; Benvenuto et al., 2020).

In this study, the well-known Autoregressive Integrated Moving Average (ARIMA) time-series model used for the further forecasting purpose. ARIMA model is one of the generalized forms of an autoregressive moving average (ARMA) model among the time series forecasting. We fit both models to understand the data better or to predict future points in the series (Forecasting). ARIMA model depends or always represented with the help of some parameters, and the model has expressed as ARIMA (p, d, q): p, d and q are non-negative integers.

The parameters have their usual meaning, here, p stands for the order of auto-regression, d represents the degree of trend difference (the number of times the data have had past values subtracted) for the stationary of the trend and q signifies the order of moving average. This model combines auto regression lags under the stationary trend and moving average and predict better future values based on past and recent data. For this model, the degree of parameters p, d and q determine based on the partial Auto- correlation function (PACF) graph, The Augmented Dickey-Fuller Test to test the stationary of the time series observations and Complete Auto-Correlation Function (ACF) graph respectively (Forecasting COVID–19 cases in India)

We have applied the ARIMA model and Auto ARIMA model using R, to our considered time series data of COVID–19 cases in West Bengal for the forecasting the total confirmed and active cases for West Bengal and its majorly affected Districts. We selected Districts based on the criterion that chosen Districts should have at least 2 confirmed cases till June 2nd 2020. By using this selection criterion, West Bengal and its 24 Districts Alipurduar, Bankura, Birbhum, Cooch Behar,

Dakshin Dinajpur (South Dinajpur), Darjeeling, Hooghly, Howrah, Jalpaiguri, Jhargram, Kalimpong, Kolkata,Malda, Murshidabad, Nadia, North 24 Parganas, Paschim Medinipur (West Medinipur), Paschim (West) Burdwan (Bardhaman), Purba Burdwan (Bardhaman),

Purba Medinipur (East Medinipur), Purulia, South 24 Parganas, Uttar Dinajpur (North Dinajpur),

The cases are forecasted under the assumption that people will be maintaining condition similar to the partial lockdown situation and maintain physical distancing with self quarantine. After fitting the model, the built model is used to forecast confirmed and active cases COVID–19 cases for the next 80 days, i.e. from June 6rd, 2020, to August 3rd 2020.

The model for forecasting future confirmed and active cases of COVID–19 cases is represented as,

𝐴𝑅𝐼𝑀A (𝑝, d, q): 𝑋𝑡 = 𝛼1 𝑋𝑡 −1+𝛼2 𝑋𝑡 −2+𝛽1𝑍𝑡−1+𝛽2 𝑍𝑡 −2+ 𝑍t(i)

Where, 𝑍𝑡 = 𝑋𝑡−𝑋𝑡−1(ii)

Here, Xt is the predicted number of confirmed and active COVID–19 cases at tth day; α1, α2, β1 and β2 are parameters whereas Zt is the residual term for tth day.

The trend of forthcoming incidences can be estimated from the previous cases, and a time series analysis is performed for this purpose

(Tandon et. al., 2020).

In our study, the forecasted cases are mainly used for preparing the government of West Bengal for the health infrastructure such as the number of isolation beds, ICU beds and ventilators, Quarantine centers etc. across the State. In further analysis, based on predicted active cases, we estimated the hike in number of cases by COVID–19 patients in the coming days. Based on this theory we can maximize the requirement of Quarantine centers, Alcohol based Sanitizers, Public sanitizing materials, ICUs and ventilators as the infection hit its peak, which the state may get in the month of July-August according to the forecast.

Our health infrastructure requirement is estimated based on the active cases as our projections are made on the basis on data till June 2nd when our country was observing the complete lockdown and starting of Lookdown 5.0. However, India is observing partial lockdown in Containment Zones currently and has removed lockdown in the Red, Yellow & Green Zones, so for being prudent, we will estimate the amount of active cases which are to be increased and also look into the Public Health Infrastructure of West Bengal.

Results

Allegations against West Bengal Government: A Case Study

Chief Minister of West Bengal Mamata Banerjee and her government was widely criticized of the handling of the coronavirus pandemic and was accused of concealing facts by the opposition and critics. The opposition accused Mamata of playing “appeasement politics” amid the COVID–19 crisis. On 1 April, Banerjee claimed that the West Bengal Government have already traced 54 people who attended the Tablighi Jamaat religious gathering during the COVID–19 Outbreak, and 44 of them are foreigners. Although according to a report by central security agencies, 232 people had attended the Delhi’s Tablighi Jamaat event from West Bengal.

Of this, 123 are Indian nationals and 109 are foreigners.

Sooner she clarified that her government has acted swiftly after the Nizamuddin area was declared as a hotspot where nearly 2,300 people were staying despite the lockdown.

She further added that the government has quarantined 177 people, including 108 foreigners, who attended the Tablighi Jamaat congregation at the Nizamuddin Markaz.

The West Bengal Government has been also criticized for not sending enough samples to the National Institute of Cholera and Enteric Diseases(NICED) for testing.

West Bengal test numbers saw some rise after talks between government and NICED. According to them, this will be scaled up further in coming days.

The West Bengal Government has also been recommended to ensure transparency, genuine and verifiable data of COVID–19 by the West Bengal Doctors Forum (WBDF), as doctors cannot afford to send wrong signals to the world.

The doctors also hit out at the idea of the bureaucratic system to identify the death of COVID–19 patients. Their spokesperson claimed that every doctor is qualified enough and does not need a committee for such certification. On April 25, 2020,

The WB Govt admitted that 57 COVID–19 patients died but also said that 39 from comorbidities, after Inter Ministerial Central Team (IMCT) seek report.

The IMCT also pointed out flaws of the Govt in their letter to the Chief Secretary Rajiva Sinha, in which the letter read:

There were a large number of patients in the isolation wards of Chittaranjan National Cancer Institute (CNCI) as well as MR Bangur hospitals awaiting COVID test results for five days or longer.

Specifically at CNCI, there were four patients awaiting test result since April 16, 2020, two patients awaiting test result since April 17, 2020, and three since April 18, 2020.

Some of the patients have tested negative. It is not clear why the test results should take such a long time and there is a danger of COVID–19 negative patient acquiring the infection in the hospital while awaiting test result

Discussion & Conclusion

The world is going through a pandemic, and almost every country is affected by it. A country as well as the States needs to know how much burden of active and confirmed cases it will have to bear in the coming time. It will help the states in taking pre-active measures to prepare adequate health infrastructure for the coming time based on future needs. We used ARIMA model and Auto ARIMA model on the time series data of COVID–19 cases in West Bengal for forecasting the total confirmed and active cases till August end.

Based on the forecasts, confirmed cases for West Bengal at the end of June are expected to be 17838- 18724 (95% CI: 128806, 227968). West Bengal will be having 27147–30616 confirmed cases (95% CI: 173917, 415800) in the mid of July from the estimates, Even West Bengal will be having 50588–55617 confirmed cases (95% CI: 198917, 525800) in the mid of August from the estimates & we expect that India will be having

Estimated Cases—62279 ± 5000 at the end of August.

These results also show that daily confirmed cases are increasing at a faster pace even at the end of June with around 400–500 daily confirmed cases, so it is likely that peak will be attained afterwards.

According to our forecasts, it is a very alarming situation for India & West Bengal in coming days. However, the actual numbers can go higher than our estimates of confirmed cases, active cases & trends we made based on the data till June 3rd in this forecast, when West Bengal observed complete lockdown. Currently,

West Bengal has a partial lockdown or Following Unlock 1.0 with restrictions varying for three zones (red, orange and green zone) based on the current assessment of the situation in there.

Lockdown is getting lifted, and in this case, there will be a surge in the number of daily confirmed and active cases.

The requirement of isolation beds, ICUs and ventilators will also be increased in that scenario. The migrants are returning to their homes due to loss of livelihood and income in the lockdown period, which may lead to a rise in the number of cases, and could not be accounted for, in our projections.

So, India and its majorly affected states like Maharashtra, Gujarat, Tamil Nadu and Delhi & West Bengal need to be well prepared for the pandemic challenge in coming time and focus on increasing their healthcare infrastructure, and other states should also remain alert till the pandemic completely recedes. We suggest a Public-Private Partnership (PPP) model in the health sector to accommodate COVID–19 patients adequately and reduce the burden of the already overstretched Indian public health care system.

Limitations or Errors that may occur:

The forecasting of COVID–19 cases is done based on the data under the lockdown duration and few in Unlock 1.0. So, the forecasted cases in future will be showing the same trend as India would have observed, had it been observing complete lockdown.

Since May 4, India is observing Unlock 1.0, and for that actual cases will/can/may be more than the forecasted cases. For our state it is showing hike in COVID–19 infection and increased trend in future, but the situation may not occur in future because of the nature of the previous trend-pattern is different from now.

Forecasted cases based on ARIMA model in our study for some states having lower bound for the 95% CI comes negative values which we have considered zero cases in that situation. In our study, the seasonality factor was considered but it may vary now due to Unlock 1.0, and it may affect our Forecast,

Therefore the is a Plus—Minus in the forecasted cases to avoid any Big Error, & make the Data more Reliable.

Tables

Table : Date wise number confirmed and active cases in West Bengal , Trend , Predicted 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yt

 

Yt/CMA

Average (respective quature)

De- Seasonalized Value

Intersept +Slope*Time Code

No.

Months

Date

Cases

Moving Average

(5) MA

St * It

St

Yt/St

Trend

Predicted (Yp)

1

March

01/03/2020

0

 

0.00

0.00

0.00

-0.59

0

2

 

02/03/2020

0

0.00

0.00

0.00

0.00

0.06

0

3

 

03/03/2020

0

0.00

0.00

0.00

0.00

0.71

0

4

 

04/03/2020

0

0.00

0.00

0.00

0.00

1.35

1

5

 

05/03/2020

0

0.00

0.00

0.00

0.00

2.00

1

6

 

06/03/2020

0

0.00

0.00

0.00

0.00

2.65

2

7

 

07/03/2020

0

0.00

0.00

0.00

0.00

3.30

3

8

 

08/03/2020

0

0.00

0.00

0.00

0.00

3.95

4

9

 

09/03/2020

0

0.00

0.00

0.00

0.00

4.59

5

10

 

10/03/2020

0

0.00

0.00

0.00

0.00

5.24

6

11

 

11/03/2020

0

0.00

0.00

0.00

0.00

5.89

7

12

 

12/03/2020

0

0.00

0.00

0.00

0.00

6.54

9


13

 

13/03/2020

0

0.00

0.00

0.00

0.00

7.18

11

14

 

14/03/2020

0

0.00

0.00

0.60

0.00

7.83

12

15

 

15/03/2020

0

0.00

0.00

1.00

0.00

8.48

14

16

 

16/03/2020

0

0.00

0.00

1.36

0.00

9.13

16

17

 

17/03/2020

0

0.00

0.00

1.70

0.00

9.78

18

18

 

18/03/2020

1

0.33

3.00

2.08

0.48

10.42

21

19

 

19/03/2020

2

1.00

2.00

1.82

1.10

11.07

23

20

 

20/03/2020

3

1.67

1.80

1.72

1.74

11.72

25

21

 

21/03/2020

4

2.33

1.71

1.68

2.38

12.37

28

22

 

22/03/2020

7

3.67

1.91

1.70

4.13

13.02

31

23

 

23/03/2020

9

5.33

1.69

1.63

5.51

13.66

34

24

 

24/03/2020

9

6.00

1.50

1.62

5.56

14.31

37

25

 

25/03/2020

10

6.33

1.58

1.63

6.12

14.96

40

26

 

26/03/2020

15

8.33

1.80

1.65

9.10

15.61

43

27

 

27/03/2020

17

10.67

1.59

1.63

10.40

16.26

47

28

 

28/03/2020

20

12.33

1.62

1.63

12.29

16.90

50

29

 

29/03/2020

22

14.00

1.57

1.62

13.54

17.55

54

30

 

30/03/2020

27

16.33

1.65

1.64

16.50

18.20

58

31

April

01/04/2020

37

21.33

1.73

1.62

22.85

18.85

62

32

 

02/04/2020

40

25.67

1.56

1.59

25.17

19.49

66

33

 

03/04/2020

46

28.67

1.60

1.60

28.78

20.14

70

34

 

04/04/2020

55

33.67

1.63

1.58

34.79

20.79

75

35

 

05/04/2020

60

38.33

1.57

1.57

38.21

21.44

79

36

 

06/04/2020

67

42.33

1.58

1.57

42.62

22.09

84

37

 

07/04/2020

77

48.00

1.60

1.56

49.22

22.73

88

38

 

08/04/2020

79

52.00

1.52

1.55

51.08

23.38

93

39

 

09/04/2020

88

55.67

1.58

1.56

56.31

24.03

98

40

 

10/04/2020

97

61.67

1.57

1.56

62.24

24.68

103

41

 

11/04/2020

103

66.67

1.55

1.56

66.15

25.33

109

42

 

12/04/2020

105

69.33

1.51

1.56

67.17

25.97

114

43

 

13/04/2020

120

75.00

1.60

1.61

74.30

26.62

120

44

 

14/04/2020

130

83.33

1.56

1.61

80.71

27.27

125

45

 

15/04/2020

142

90.67

1.57

1.61

88.07

27.92

131

46

 

16/04/2020

157

99.67

1.58

1.63

96.57

28.56

137

47

 

17/04/2020

227

128.00

1.77

1.62

139.73

29.21

243

48

 

18/04/2020

252

159.67

1.58

1.58

159.23

29.86

249

49

 

19/04/2020

276

176.00

1.57

1.59

173.86

30.51

298

50

 

20/04/2020

330

202.00

1.63

1.59

207.45

31.16

362

51

 

21/04/2020

362

230.67

1.57

1.58

229.77

31.80

416

52

 

22/04/2020

394

252.00

1.56

1.57

250.61

32.45

471

53

 

23/04/2020

452

282.00

1.60

1.57

287.71

33.10

518

54

 

24/04/2020

506

319.33

1.58

1.56

324.89

33.75

559

55

 

25/04/2020

546

350.67

1.56

1.55

352.76

34.40

596

56

 

26/04/2020

586

377.33

1.55

1.55

378.26

35.04

603


57

 

27/04/2020

633

406.33

1.56

1.55

409.51

35.69

659

58

 

28/04/2020

663

432.00

1.53

1.56

425.99

36.34

698

 

 

 

 

 

 

 

 

 

 

59

 

29/04/2020

696

453.00

1.54

1.59

438.16

36.99

708

60

 

30/04/2020

758

484.67

1.56

1.59

477.14

37.64

783

61

May

01/05/2020

795

517.67

1.54

1.59

501.38

38.28

841

62

 

02/05/2020

922

572.33

1.61

1.59

579.70

38.93

949

63

 

03/05/2020

1198

706.67

1.70

1.58

759.43

39.58

1257

64

 

04/05/2020

1259

819.00

1.54

1.55

811.98

40.23

1295

65

 

05/05/2020

1344

867.67

1.55

1.55

865.74

40.87

1374

66

 

06/05/2020

1456

933.33

1.56

1.55

936.36

41.52

1482

67

 

07/05/2020

1548

1001.33

1.55

1.55

997.26

42.17

1591

68

 

08/05/2020

1678

1075.33

1.56

1.55

1081.99

42.82

1699

69

 

09/05/2020

1786

1154.67

1.55

1.55

1154.77

43.47

1788

70

 

10/05/2020

1939

1241.67

1.56

1.54

1256.75

44.11

1887

71

 

11/05/2020

2063

1334.00

1.55

1.54

1343.32

44.76

2124

72

 

12/05/2020

2173

1412.00

1.54

1.53

1417.20

45.41

2362

73

 

13/05/2020

2290

1487.67

1.54

1.53

1495.48

46.06

2456

74

 

14/05/2020

2377

1555.67

1.53

1.53

1552.08

46.71

2552

75

 

15/05/2020

2461

1612.67

1.53

1.53

1605.40

47.35

2648

76

 

16/05/2020

2576

1679.00

1.53

1.53

1678.43

48.00

2746

77

 

17/05/2020

2677

1751.00

1.53

1.53

1746.94

48.65

2845

78

 

18/05/2020

2825

1834.00

1.54

1.53

1843.00

49.30

2946

79

 

19/05/2020

2961

1928.67

1.54

1.53

1934.83

49.95

3047

80

 

20/05/2020

3103

2021.33

1.54

1.53

2025.36

50.59

3151

81

 

21/05/2020

3197

2100.00

1.52

1.53

2088.15

51.24

3255

82

 

22/05/2020

3332

2176.33

1.53

1.53

2172.18

51.89

3361

83

 

23/05/2020

3459

2263.67

1.53

1.53

2254.25

52.54

3468

84

 

24/05/2020

3667

2375.33

1.54

1.54

2380.17

53.18

3576

85

 

25/05/2020

3816

2494.33

1.53

1.54

2476.67

53.83

3885

86

 

26/05/2020

4009

2608.33

1.54

1.54

2595.88

54.48

4096

87

 

27/05/2020

4192

2733.67

1.53

1.55

2696.45

55.13

4265

88

 

28/05/2020

4536

2909.33

1.56

1.56

2911.62

56.42

4637

89

 

29/05/2020

4813

3116.33

1.54

1.55

3096.94

57.72

4953

90

 

30/05/2020

5130

3314.33

1.55

1.55

3302.27

58.37

5247

91

June

01/06/2020

5772

3634.00

1.59

1.54

3738.56

60.96

5847

92

 

02/06/2020

6168

3980.00

1.55

1.53

4023.99

63.55

6332

93

 

03/06/2020

6508

4225.33

1.54

1.53

4261.51

68.09

6536

94

 

04/06/2020

6876

4461.33

1.54

1.52

4521.83

72.62

6938

95

 

05/06/2020

7303

4584.00

1.50

1.50

4584.00

75.38

7354

References

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Declarations

I Dibash Sarkar Declare No competing interests & The authors declare no competing interests