The role of modelling and analytics in South African COVID-19 planning and budgeting

PLOS Glob Public Health. 2023 Jul 3;3(7):e0001063. doi: 10.1371/journal.pgph.0001063. eCollection 2023.

Abstract

Background: The South African COVID-19 Modelling Consortium (SACMC) was established in late March 2020 to support planning and budgeting for COVID-19 related healthcare in South Africa. We developed several tools in response to the needs of decision makers in the different stages of the epidemic, allowing the South African government to plan several months ahead.

Methods: Our tools included epidemic projection models, several cost and budget impact models, and online dashboards to help government and the public visualise our projections, track case development and forecast hospital admissions. Information on new variants, including Delta and Omicron, were incorporated in real time to allow the shifting of scarce resources when necessary.

Results: Given the rapidly changing nature of the outbreak globally and in South Africa, the model projections were updated regularly. The updates reflected 1) the changing policy priorities over the course of the epidemic; 2) the availability of new data from South African data systems; and 3) the evolving response to COVID-19 in South Africa, such as changes in lockdown levels and ensuing mobility and contact rates, testing and contact tracing strategies and hospitalisation criteria. Insights into population behaviour required updates by incorporating notions of behavioural heterogeneity and behavioural responses to observed changes in mortality. We incorporated these aspects into developing scenarios for the third wave and developed additional methodology that allowed us to forecast required inpatient capacity. Finally, real-time analyses of the most important characteristics of the Omicron variant first identified in South Africa in November 2021 allowed us to advise policymakers early in the fourth wave that a relatively lower admission rate was likely.

Conclusion: The SACMC's models, developed rapidly in an emergency setting and regularly updated with local data, supported national and provincial government to plan several months ahead, expand hospital capacity when needed, allocate budgets and procure additional resources where possible. Across four waves of COVID-19 cases, the SACMC continued to serve the planning needs of the government, tracking waves and supporting the national vaccine rollout.

Grants and funding

The work of GMR and LJ on the SACMC has been made possible by the generous support of the American People and the President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) under the terms of Cooperative Agreement 72067419CA00004 to HE2RO. The contents are the responsibility of the authors and do not necessarily reflect the views of PEPFAR, USAID or the United States Government. SPS, RAH and the development of the SACMC dashboards are funded by the Wellcome Trust (GN: 2114236/Z/18Z) and the Clinton Health Access Initiative. JRCP is supported by the Department of Science and Innovation and the National Research Foundation. Any opinion, finding, and conclusion or recommendation expressed in this material is that of the authors, and the NRF does not accept any liability in this regard. The SACMC’s work is also supported by the Bill & Melinda Gates Foundation under Investment INV-035464. The views and opinions expressed in this report do however not necessarily reflect the positions or policies of the Bill & Melinda Gates Foundation.