Estimating the COVID-19 epidemic trajectory and hospital capacity requirements in South West England: a mathematical modelling framework

Ross D Booton, Louis MacGregor, Lucy Vass, Katharine J Looker, Catherine Hyams, Philip D Bright, Irasha Harding, Rajeka Lazarus, Fergus Hamilton, Daniel Lawson, Leon Danon, Adrian Pratt, Richard Wood, Ellen Brooks-Pollock, Katherine M E Turner*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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OBJECTIVES: To develop a regional model of COVID-19 dynamics for use in estimating the number of infections, deaths and required acute and intensive care (IC) beds using the South West England (SW) as an example case.

DESIGN: Open-source age-structured variant of a susceptible-exposed-infectious-recovered compartmental mathematical model. Latin hypercube sampling and maximum likelihood estimation were used to calibrate to cumulative cases and cumulative deaths.

SETTING: SW at a time considered early in the pandemic, where National Health Service authorities required evidence to guide localised planning and support decision-making.

PARTICIPANTS: Publicly available data on patients with COVID-19.

PRIMARY AND SECONDARY OUTCOME MEASURES: The expected numbers of infected cases, deaths due to COVID-19 infection, patient occupancy of acute and IC beds and the reproduction ('R') number over time.

RESULTS: SW model projections indicate that, as of 11 May 2020 (when 'lockdown' measures were eased), 5793 (95% credible interval (CrI) 2003 to 12 051) individuals were still infectious (0.10% of the total SW population, 95% CrI 0.04% to 0.22%), and a total of 189 048 (95% CrI 141 580 to 277 955) had been infected with the virus (either asymptomatically or symptomatically), but recovered, which is 3.4% (95% CrI 2.5% to 5.0%) of the SW population. The total number of patients in acute and IC beds in the SW on 11 May 2020 was predicted to be 701 (95% CrI 169 to 1543) and 110 (95% CrI 8 to 464), respectively. The R value in SW was predicted to be 2.6 (95% CrI 2.0 to 3.2) prior to any interventions, with social distancing reducing this to 2.3 (95% CrI 1.8 to 2.9) and lockdown/school closures further reducing the R value to 0.6 (95% CrI 0.5 to 0.7).

CONCLUSIONS: The developed model has proved a valuable asset for regional healthcare services. The model will be used further in the SW as the pandemic evolves, and-as open-source software-is portable to healthcare systems in other geographies.

Original languageEnglish
Article numbere041536
Number of pages10
JournalBMJ Open
Publication statusPublished - 7 Jan 2021


  • Adolescent
  • Adult
  • Aged
  • COVID-19/epidemiology
  • Child
  • Child, Preschool
  • Critical Care/statistics & numerical data
  • Decision Making
  • England/epidemiology
  • Female
  • Hospital Bed Capacity/statistics & numerical data
  • Hospitalization/statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units
  • Male
  • Middle Aged
  • Models, Theoretical
  • Regional Health Planning
  • SARS-CoV-2
  • State Medicine
  • Surge Capacity
  • Young Adult

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