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Record W4408584779 · doi:10.1214/24-aoas1964

A three-state coupled Markov switching model for COVID-19 outbreaks across Quebec based on hospital admissions

2025· article· en· W4408584779 on OpenAlexaffabout
Dirk Douwes‐Schultz, Alexandra M. Schmidt, Yan Shen, David L. Buckeridge

Bibliographic record

VenueThe Annals of Applied Statistics · 2025
Typearticle
Languageen
FieldMathematics
TopicCOVID-19 epidemiological studies
Canadian institutionsMcGill University
Fundersnot available
KeywordsCoronavirus disease 2019 (COVID-19)Outbreak2019-20 coronavirus outbreakSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Markov chainMarkov modelStatisticsState (computer science)GeographyComputer scienceEconometricsVirologyMedicineMathematicsAlgorithmInfectious disease (medical specialty)

Abstract

fetched live from OpenAlex

Recurrent COVID-19 outbreaks have placed immense strain on the hospital system in Quebec. We develop a Bayesian three-state coupled Markov switching model to analyze COVID-19 outbreaks across Quebec based on admissions in the 30 largest hospitals. Within each catchment area, we assume the existence of three states for the disease: absence, a new state meant to account for many zeroes in some of the smaller areas; endemic and outbreak. Then we assume the disease switches between the three states in each area through a series of coupled nonhomogeneous hidden Markov chains. Unlike previous approaches, the transition probabilities may depend on covariates and the occurrence of outbreaks in neighboring areas to account for geographical outbreak spread. Additionally, to prevent rapid switching between endemic and outbreak periods we introduce clone states into the model which enforce minimum endemic and outbreak durations. We make some interesting findings, such as that mobility in retail and recreation venues had a positive association with the development and persistence of new COVID-19 outbreaks in Quebec. Based on model comparison, our contributions show promise in improving state estimation retrospectively and in real-time, especially when there are smaller areas and highly spatially synchronized outbreaks. Furthermore, our approach offers new and interesting epidemiological interpretations, such as being able to estimate the effect of covariates on disease extinction.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: Simulation or modeling
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.202
Threshold uncertainty score0.407

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0020.001
Open science0.0030.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0060.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.251
GPT teacher head0.476
Teacher spread0.226 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSimulation or modeling
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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