A team including health economists, epidemiologists and a biostatistician at Vanderbilt University Medical Center and Vanderbilt University are amassing and processing data to develop a complex predictive model of the spread of COVID-19 within Tennessee, with region-specific projections, as well as a model of projected resource use during response to the pandemic.
“We’ve got a modeling team at Vanderbilt that’s been working together for six or seven years on precision medicine topics, so creating simulation models of disease progression and resource use within the U.S. health system is not anything foreign to us,” said John Graves, PhD, associate professor of Health Policy. “But doing this so fast, and with such a novel and fast-moving disease, has been a new challenge for us.
“Our goal, now that we have a model up and running, is to, in short order, provide policymakers across the state regular modeling estimates they can use to make decisions. This model can predict the trajectory of infections, and we can use that information, along with data on the effects of policies, to estimate what we need to do to keep the spread and consequences of COVID-19 in check. The ultimate goal is to know when it is possible to start to return to something more like a normal life.”
The Health Policy and Public Health COVID-19 Advisory Panel began their work in mid-March, and have produced five documents on policy-relevant topics ranging from public health strategies for limiting the spread of the virus to the need for regional planning to guide ventilator allocation. All of their advisory memos are available on the Department of Health Policy website.
The modeling efforts have benefited from existing data resources the group has used for past health care-related modeling for the state of Tennessee. The VUMC Department of Health Policy has a close working relationship with the Tennessee Department of Health, and its faculty are often resources for topics such as flu prediction and other precision health topics. Graves is working with Shawn Garbett, MS, a VUMC biostatistician, in the COVID-19 model development.
“Our team has access to Medicare data related to the specific geographic locations of health care providers and patient flows from ZIP codes to hospitals,” Graves said. “Really all kinds of data that we’ve been working on for years that we are bringing to bear on this model. We’ve been able to pivot and quickly take that data to this new COVID-19 model.”
The team is also diving deep into emerging scientific literature on the biology of the virus, especially research emerging from China and other areas hit hard by COVID-19.
“One of the unique things about our model is that it is tailored to Tennessee, and each sub-state region even has its own model we can use to project out where things are heading,” Graves said. “The fact that it is a Tennessee-specific model allows us to do more refinement based on our own local experience, and we don’t have to rely on a national model.”
The team also has to measure whether lessons being learned from COVID-19 responses and transmission patterns abroad are applicable to Tennessee. For example, how transmission rates are affected by population density and a variety of social distancing policies in other countries might not directly translate to a model for Tennessee.
And factors impacting the pandemic are evolving daily, which adds more difficulty, Graves said.
“There’s just a lot of moving pieces that you have to collect together into one place, and there’s a lot of uncertainty around this situation,” he said. “We’re making sure that we appreciate the uncertainty and have confidence in whatever we’re telling policymakers. It’s really important to us that, no matter how we cut it, the model is pointing in the same direction when it comes to concrete policy decision making.”
Moving forward, the team is working to tap into rapidly developing data resources from the Tennessee Department of Health to better inform the models they provide to policymakers at the state level.
In addition to Graves, members of the Health Policy and Public Health Covid-19 Advisory Panel include:
- Muktar Aliyu, MD, DrPH, MPH, professor of Health Policy and associate director for research, Vanderbilt University Institute for Global Health
- Shari Barkin, MD, MSHS, William K. Warren Foundation Chair in Medicine; Marian Wright Edelman Professor of Pediatrics; director, Division of General Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt
- Melinda Buntin, PhD, Mike Curb Professor of Health Policy and chair, Department of Health Policy
- Ellen Clayton, MD, JD Craig-Weaver Professor of Pediatrics, professor of law, professor of Health Policy
- Kathy Edwards, MD, Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics and professor of Pediatrics
- Marie Griffin, MD, MPH, professor of Health Policy, director of the Vanderbilt University Master of Public Health program
- Carlos Grijalva, MD, MPH, associate professor of Health Policy
- Melissa McPheeters, PhD, research professor, Health Policy, co-director of the Center for Improving the Public’s Health through Informatics
- Keith Meador, MD, ThM, MPH, professor of Psychiatry and Health Policy, co-director of the Center for Biomedical Ethics and Society