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Revista de la Facultad de Medicina Humana

versión impresa ISSN 1814-5469versión On-line ISSN 2308-0531

Rev. Fac. Med. Hum. vol.21 no.1 Lima ene-mar 2021

http://dx.doi.org/10.25176/rfmh.v21i1.3307 

Original article

Application of the autoregressive integrated moving average for the analysis of covid-19 case series in Peru

Daniel Angel Córdova Sotomayor1  , Dental surgeon, Magister in Education

Flor Benigna Santa Maria Carlos2  , Dental surgeon, Magister in Health Services Management

1Facultad Integrada de Medicina, de Estomatología y de Enfermería, Universidad Peruana Cayetano Heredia. Lima, Perú

2Ministerio de Salud. Lambayeque, Perú

ABSTRACT:

Introduction:

In recent months, researchers have been using mathematical methods to forecast the number of COVID-19 cases worldwide.

Objective:

To estimate an Autoregressive integrated moving average (ARIMA) to analyze a series of COVID-19 cases in Peru.

Methods:

The present study was based on a univariate time series analysis; The data used refers to the number of new accumulated cases of COVID-19 from March 6 to June 11, 2020. For the analysis of the fit of the model, the autocorrelation coefficients (ACF), the unit root test of Augmented Dickey-Fuller (ADF), the Normalized Bayesian Information Criterion (Normalized BIC), the mean absolute percentage error (MAPE), and the Box-Ljung test.

Results:

The prognosis for COVID-19 cases, between June 12 and July 11, 2020, ranges from 220 596 to 429 790.

Conclusions:

The results obtained with the ARIMA model, compared with the observed data, show an adequate adjustment of the values. Although this model is easy to apply and interpret, it does not simulate the exact behavior over time. It can be considered a simple and immediate tool to approximate the number of cases.

Keywords: Forecasting; Pandemics; Coronavirus (Source: MeSH MLN)

INTRODUCTION

The new coronavirus (severe acute respiratory syndrome coronavirus 2-SARS) was reported in December 2019 in Wuhan-China, with the appearance of several cases of pneumonia of unknown etiology which caused severe acute respiratory problems1-7. This infection is transmitted by inhalation of respiratory droplets, close contact with the infected individual, and contact with contaminated surfaces or objects1,8.

On March 11, 2020, the World Health Organization (WHO) declared COVID19 a pandemic9. Cases are increasing worldwide, including Peru, where the first case was announced on March 6; As of July 12, the total number of confirmed cases was 326,32610.

There is great concern about the Peruvian health system’s response capacity to effectively meet the needs of people with COVID-19 as the number of cases increases. Despite all the measures taken by the government, it does not stop. The outcome is worst now that the government “opened the doors” for the population to a “new normal.”

Mathematical models are used to understand critical epidemiological transitions11-14, and in recent months, researchers have been using mathematical methods to forecast the number of COVID-19 cases worldwide. The Autoregressive Integrated Method of Moving Averages (ARIMA) is the one that has been used the most to make forecasts, such is the case of those proposed by Singh RK et al.11, for the United States, Spain, Italy, France, Germany, the United Kingdom, Turkey, Iran, China, Russia, Brazil, Canada, Belgium, the Netherlands, and Switzerland; by Ceylan Z15, for Italy, Spain, and France; by Moftakhar L and Seif M1, for Iran; by Benvenuto D et al.16, for Italy; by Yousaf M et al.17, for Pakistan; by Hiteshi Tandon18and Rishabh Tyagi et al.19, for India and by Perone G20, for Italy

Time series constitute data collections in a period in which trends or patterns are observed to forecast some future values21. The ARIMA model has three main parameters; the parameter p: associated with the autoregressive process (AR), the number of differences that must be taken from the series to be stationary. The parameter d: associated with the integrated part (I) y; the parameter q: related to the part of the moving average (MA), which is the current value of a series, which is defined as a linear combination of past errors11,12,18.

To estimate an ARIMA model, the Box-Jenkins methodology11,22-23, is used, which consists of 4 stages. Identification: which consists of identifying the model that can tentatively be considered. Estimation: which consists of estimating the parameters of the model tentatively considered; validation: which consists in performing diagnostic tests to check if the model fits the data. Finally, prediction, which consists of obtaining forecasts in probabilistic terms of future values and the model’s predictive capacity, is evaluated(24). One of the concerns in Peru and any other country, is to know how many people will be infected with COVID-19 in time; and this could be answered with predictive models25; Therefore, the present study aimed to estimate an Autoregressive Integrated Moving Average model (ARIMA) for the analysis of series of COVID-19 cases, in Peru, t seek an approximation between the results obtained with the model and observed data.

METHODS

Design and study area

This study was based on a univariate, descriptive, cross-sectional, retrospective time series analysis, carried out in Peru, with the number of new daily confirmed cases of COVID-19, between March 6 and March 11. June 2020.

Population and sample

The data used refers to the total number of new daily confirmed cases of COVID-19 between March 06 and June 11, 2020.

Variables and instruments

The data comes from the COVID-19 Situation Room -Peru, from Instituto Nacional de Salud y Centro Nacional de Epidemiologia, Prevención y Control de Enfermedades del Ministerio de Salud10; which serve to obtain the accuracy of the forecast of the spread of COVID-19.

Procedures

The data was used to obtain the forecasts of the number of cases for the next 30 days, from June 12 to July 11, 2020, creating a projected trajectory of these cases, to later compare them with the cases observed in the indicated period.

Statistical analysis

The time series method used for the forecast of COVID-19 cases was the Integrated Autoregressive Moving Averages of order (p, d, q) or ARIMA (p, d, q). The construction of the model was carried out iteratively following the 4 stages of the Box-Jenkins methodology11,22-24 1-Identification: in which the stationary transformation of the series was determined to obtain the appropriate model, through the analysis of autocorrelation coefficients (ACF), and the Augmented Dickey-Fuller unit root test (ADF); 2-Estimation: in which, by choosing the appropriate orders p, d, q, the model was adjusted to the time series, obtaining the ARIMA model(0,2,9); 3-Validation: in which it was analyzed if the model was appropriate, and it was valued with the Normalized Bayesian Information Criterion (Normalized BIC), the mean absolute percentage error (MAPE) and the white noise test or Box-Ljung test; 4-Prediction: in which the forecasts of the number of cases for the next 30 days were generated; and then compare the observed cases. The statistical program used for the time series analysis was the SPSS version 22, and the STATA version 15 program was used to determine the increased Dickey-Fuller unit root contrast.

Ethical aspects

The data is public, open, and has anonymous access. Therefore, the approval of an institutional ethics committee was not required.

RESULTS

Table 1shows the daily count of COVID 19 cases between March 6, 2020, and June 11, 2020. InFigure 1, it is shown that the autocorrelation coefficients (ACF) slowly decrease as linear, so they correspond to a non-stationary time series, this being corroborated by the Augmented Dickey-Fuller unit root contrast (p> 0.01). InFigure 2, the second-order stationary transformation is shown. The time series was stabilized by eliminating trends and obtaining the appropriate model with the orders p, d, q, which was ARIMA (0.2, 9).Table 2shows the parameters (p, d, q) obtained in the modeling process; the Normalized Bayesian Information Criterion (BIC) which indicates that 13,475 was the lowest value obtained indicating the best ARIMA model; the mean absolute percentage error (MAPE) that indicates that the forecast of the model is wrong by 7.775%; and the Ljung-Box test that suggests that the model is capable of reproducing the systematic behavior pattern of the time series. Figure 3andTable 3show the prognosis of the number of cases with 95% confidence intervals and the observed cases, from June 12 to July 11, 2020, with data from March 6, 2020, to June 11, 2020. The observed cases’ values are lower than the predicted cases’ values, with those observed within the minimum and maximum values of the estimates.

Table 1. Number of cases with COVID 19 per day, from March 6 to June 11, 2020. Peru 

Day Cases Day Cases Day Cases Day Cases
6/03/2020 1 31/03/2020 1065 25/04/2020 25331 20/05/2020 104020
7/03/2020 6 1/04/2020 1323 26/04/2020 27517 21/05/2020 108769
8/03/2020 6 2/04/2020 1414 27/04/2020 28699 22/05/2020 111698
9/03/2020 9 3/04/2020 1595 28/04/2020 31190 23/05/2020 115754
10/03/2020 11 4/04/2020 1746 29/04/2020 33931 24/05/2020 119959
11/03/2020 17 5/04/2020 2281 30/04/2020 36976 25/05/2020 123979
12/03/2020 22 6/04/2020 2561 1/05/2020 40459 26/05/2020 129751
13/03/2020 38 7/04/2020 2954 2/05/2020 42534 27/05/2020 135905
14/03/2020 43 8/04/2020 4342 3/05/2020 45928 28/05/2020 141779
15/03/2020 71 9/04/2020 5256 4/05/2020 47372 29/05/2020 148285
16/03/2020 86 10/04/2020 5897 5/05/2020 51189 30/05/2020 155671
17/03/2020 117 11/04/2020 6848 6/05/2020 54817 31/05/2020 164476
18/03/2020 145 12/04/2020 7519 7/05/2020 58526 1/06/2020 170039
19/03/2020 234 13/04/2020 9784 8/05/2020 61847 2/06/2020 174884
20/03/2020 263 14/04/2020 10303 9/05/2020 65015 3/06/2020 178914
21/03/2020 317 15/04/2020 11475 10/05/2020 67307 4/06/2020 183198
22/03/2020 360 16/04/2020 12491 11/05/2020 68822 5/06/2020 187400
23/03/2020 395 17/04/2020 13489 12/05/2020 72059 6/06/2020 191758
24/03/2020 416 18/04/2020 14420 13/05/2020 76306 7/06/2020 196515
25/03/2020 480 19/04/2020 15628 14/05/2020 80604 8/06/2020 199696
26/03/2020 580 20/04/2020 16325 15/05/2020 84495 9/06/2020 203736
27/03/2020 635 21/04/2020 17837 16/05/2020 88541 10/06/2020 208823
28/03/2020 671 22/04/2020 19250 17/05/2020 92273 11/06/2020 214788
29/03/2020 852 23/04/2020 20914 18/05/2020 94933 ………………… …………….
30/03/2020 950 24/04/2020 21648 19/05/2020 99483 ………………… …………….

Source: COVID 19-Peru Situation Room, of the National Institute of Health and National Center for Epidemiology, Prevention and Disease Control of the Ministry of Health

Figure 1. Autocorrelation correlogram (ACF) estimated for the time series 

Figure 2. Autocorrelation correlogram (ACF) estimated for the time series, with a second-order transformation 

Table 2 Optimal parameters for the model 

  parameters BIC Mean error test
  ARIMA normalized absolute Ljung-Box
Perú (0,2,9) 13,475 7,775 0,040*

Note: * p <0.01 Normalized BIC: Standardized Bayesian Information Criterion ARIMA: Autoregressive Integrated Method of Moving Averages

Figure 3. Forecast of the number of COVID 19 cases, with 95% confidence intervals and observed cases of COVID 19; from June 12 to July 11, 2020 

Table 3. Observed cases and forecast of the number of COVID 19 cases, with 95% confidence intervals from June 12 to July 11, 2020 

      Forecast
      Confidence Interval: 95%
Day Observed ARIMA Limit lower Limite upper
12/06/2020 220749 220596 216821 224394
13/06/2020 225132 226675 220300 233118
14/06/2020 229736 232952 223819 242221
15/06/2020 232992 239355 227227 251717
16/06/2020 237156 245776 230401 261518
17/06/2020 240908 252499 233612 271929
18/06/2020 244388 259233 236578 282653
19/06/2020 247925 265890 239218 293600
20/06/2020 251338 272444 241516 304743
21/06/2020 254936 279083 243973 315926
22/06/2020 257447 285805 246533 327204
23/06/2020 260810 292612 249163 338615
24/06/2020 264689 299503 251840 350183
25/06/2020 268602 306478 254548 361925
26/06/2020 272364 313539 257274 373857
27/06/2020 275989 320685 260010 385988
28/06/2020 279419 327916 262748 398327
29/06/2020 282365 335232 265483 410882
30/06/2020 285213 342635 268210 423660
1/07/2020 288477 350123 270926 436665
2/07/2020 292004 357698 273628 449903
3/07/2020 295599 365359 276313 463378
4/07/2020 299080 373107 278978 477094
5/07/2020 302718 380942 281622 491054
6/07/2020 305703 388864 284244 505263
7/07/2020 309278 396873 286842 519724
8/07/2020 312911 404970 289414 534438
9/07/2020 316448 413155 291960 549411
10/07/2020 319646 421428 294478 564643
11/07/2020 322710 429790 296969 580138

Note: The forecasts with their confidence intervals are obtained with the Autoregressive Integrated Method of Moving Averages-ARIMA (0,2,9)

DISCUSSION

This research was carried out to predict the number of cases with COVID-19 from June 12 to July 11, 2020, in Peru using the Autoregressive Integrated Method of Moving Averages (ARIMA), to later compare them with the cases observed in order to find an approximation between both results.

It must be taken into account that the forecasts obtained from a univariate time series model are extrapolations of the observed data until the time the series ends, being in many cases very effective providing a reference point to predict future values of confirmed cases. Most series are stochastic, in that their past values can partially determine the future, so accurate forecasts are impossible24.

Various authors1,11,15-20, worldwide, have developed models for the prognosis of COVID-19 cases based on the ARIMA method. They have used certain statistics to evaluate the goodness of fit of the model showing good results in short-term forecasts.

The modeling carried out in this study has followed all the stages of the Box-Jenkins methodology11,22-23, to obtain the best predictive model. Although, some researchers have applied these stages, they have only mentioned some statistical parameters used in their construction.

Moftakhar L and Seif M1, mention the use of the analysis of the autocorrelation coefficients (ACF), partial autocorrelation (PACF) and the Box-Ljung test; Singh RK et al11, mention the use of the Akaike information criterion (AIC); Ceylan Z15, mentions the use of the mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE); Benvenuto D16, mentions the use of the Augmented Dickey-Fuller unit root test (ADF) and the analysis of the autocorrelation coefficients (ACF) and partial autocorrelation (PACF); Yousaf M et al17, mention the use of the analysis of the autocorrelation coefficients (ACF) and partial autocorrelation (ACF and PACF) and the Akaike information criterion (AIC); Hiteshi Tandon18, mentions the use of the analysis of the autocorrelation coefficients (ACF) and partial autocorrelation (PACF) in addition to the variance, normality test, the mean absolute percentage error (MAPE), the Absolute Deviation of the Mean ( DAM) and mean squared deviation (MSD); Rishabh Tyagi et al19, mention the use of the analysis of the autocorrelation coefficients (ACF) and partial autocorrelation (PACF), the Augmented Dickey-Fuller unit root test (ADF), and provide the confidence intervals (CI ) 95% for point estimates; Finally, Perone G20) mentions the use of the Akaike information criterion (AIC), the analysis of the autocorrelation coefficients (ACF) and partial autocorrelation (PACF), the Augmented Dickey-Fuller unit root test (ADF ), the modified Elliott-Rothenberg-Stock (DF-GLS) unit root test, the mean absolute error (MAE), the normality test, the homoscedasticity, the Engle Lagrange multiplier test, and the Box test -Ljun, many of which coincide with those used in this investigation.

Although it is true that within the mathematical forecasting models, there are a variety of models, the ARIMA model has a higher fitting precision than the others26. It captures seasonal and non-seasonal forecast trends; This study focuses on a non-seasonal model to describe the growth pattern over time. On the other hand, if a model uses statistical approaches for its selection and evaluation, it must be recognized that the number of cases is not true. Since ARIMA is the only official source of information available in the country, it can lead to an inaccurate forecast. Even with this limitation, the results suggest that the method can help estimate the outbreak dynamics and provide guidelines to stop or better control the increase in infections in the country. It is also evident that any attempt to control depends on the public policies dictated by the authorities and above all. The awareness of each citizen about the spread of COVID-19 and the lethal effects that an irresponsible behavior or practice can have, as a consequence, the health of an individual, a family, and community.

Likewise, this model allows to analyze the possible evolution of the contagion curve and to be able to compare the results with those of other countries to evaluate the actions that are being taken.

It should be clarified that this estimate is strongly related to the trend of the original series data, and the result of the forecasts can help to understand any sudden change in the prognosis of COVID-19 cases.

Within the limitation of the study, it can be mentioned that the precision of the forecast depends on the precision of the applied data, this means that there is no other additional evidence that can estimate the exact number of patients with COVID-19 since only the number of official cases reported by the National Institute of Health and the National Center for Epidemiology, Prevention and Control of Diseases of the Ministry of Health was considered.

CONCLUSION

Compared with the observed data, the results obtained with the ARIMA model show an adequate adjustment of the values. This model is easy to apply and interpret, but does not simulate the exact behavior over time. It can be considered a simple and immediate tool to approximate the number of cases.

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Funding: Self-financed

Received: October 01, 2020; Accepted: December 12, 2020

Correspondence: Daniel Angel Córdova Sotomayor. Address: Av. Sosa Peláez N°1111. Block 8. Dpto. 104. Cercado de Lima Cell: 954682470 Email:cordova.sotomayor.d@upch.pe

Author’s contributions: Both authors have participated in the conception and design of the article, data collection, writing of the article, critical review of the article, approval of the final version. In addition, DACS performed the analysis and interpretation of the data.

Conflict of interest: The authors declare no conflict of interest in the publication of this article.

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