Surveillance and modelling tools to understand & evidence the COVID-19 outbreak

Published: 24 May 2021

By supporting Venezuelan scientists to undertake disease surveillance and modelling in the absence of state infrastructure, the main objective of this project was to mitigate the health consequences of Venezuela’s rapid economic decline in the midst of the COVID-19 pandemic.

Venezuelan research team carrying out solid-phase peptide synthesis (SPPS), to produce COVID peptides

The University of Glasgow made use of an established and embedded Global Challenges Research Fund network – Vector Borne Disease Control Network - Venezuela – to gain a deeper understanding of how COVID-19 was spreading in Venezuela and provide evidence to support COVID-19 control measures. It is estimated that 90% of Venezuelans live in extreme poverty, since 2015 five million have fled the country, with almost two million ending up in Colombia. Intense urbanisation, high population density, poor living standards, and a dilapidated healthcare infrastructure make Venezuela acutely sensitive to the COVID-19 pandemic.

By supporting Venezuelan scientists to undertake disease surveillance and modelling in the absence of state infrastructure, the main objective of this project was to mitigate the health consequences of Venezuela’s rapid economic decline in the midst of the COVID-19 pandemic.

Data – understanding the pandemic in Venezuela

It is widely accepted that the number of cases and deaths has been underreported by the Venezuelan government. A focus for this project was to gather COVID-19 incidence and morbidity data via formal and informal channels, and data mining; providing key stakeholders with data on the extent of the pandemic.

The research team established new connections and developed existing informal links to hospitals to obtain data, develop a model and create open-source databases. These databases are updated live and provide information such as ventilator occupancy, respiratory disease mortality and other key indicators. These data are fed forward via live access to key stakeholders to help inform healthcare decisions.

Extensive modelling has been undertaken to predict the potential growth of the outbreak and, to date, two monthly reports issued, funded by this project. The two reports have been widely reported in local and international news media. Also, they have been the main alternative and accurate source of the true epidemic size and level of transmission of COVID-19 in Venezuela during the first epidemiological wave.

Dr. Maria Grillet, co-investigator says “modelling scenarios with indirect indicators of transmission is a great challenge, but the best current alternative in Venezuela, where epidemiological information is very limited. The grant was really beneficial, it allowed us to develop  a set of models that generated potential epidemiological scenarios that informed health authorities and community about how was the epidemic unwrapping in Venezuela during the first COVID-19 wave”.

Population – changing behaviours

Preventing the transmission of the virus requires people to change their behaviour and adopt new habits to help prevent the spread. Modifying human behaviour is challenging and requires a level of understanding knowledge, attitudes, and practices (KAPs) regarding health threats.

This study explored KAPs among people in Ecuador. An internet-based questionnaire was used to assess knowledge about COVID-19, attitudes toward ability to control COVID-19, self-reported practices related to COVID-19, and demographics. A total of 2399 individuals participated.

Participants had moderate to high levels of knowledge and expressed mixed attitudes about the eventual control of COVID-19 in Ecuador. Participants reported high levels of adoption of preventive practices. The study found that the greatest area for improvement is regarding pessimistic attitudes on the eventual control of COVID-19. The research team would recommend that suggests health education and outreach should not only focus on knowledge and prevention practices but should also promote optimistic attitudes.

Transmission between Venezuela and Colombia

Given the scale of the mass migration between Venezuela and Colombia gaining some understanding of how the virus may be acquired could help inform estimates of the growth of the pandemic and undetected transmission.

Data collection has been ongoing at two Venezuelan hospitals in Caracas and Carabobo. Testing in Colombia, coordinated by our partner Universidad del Rosario, has been ongoing for several months. The project is still to report on the outcomes of this study.

The research team also undertook a study of the genetic similarities of COVID-19 in Venezuela and Colombia. Genomic sequencing demonstrated similarity between SARS-CoV-2 lineages from Venezuela and viruses collected from patients in bordering areas in Colombia and from Brazil, this is consistent with cross-border transit despite preventive measures including lockdowns.  

The study also found the presence of mutations at sites may potentially be associated with increased infectivity. A more transmissible mutation of the virus may pose additional challenges for the control of the virus in Latin American countries. The report advised that public health authorities should carefully follow the progress of the pandemic and its impact on displaced populations within the region.

Key facts

  • The project established surveillance and modelling tools which helped scientists and stakeholders understand the COVID-19 outbreak in Venezuela; providing much needed scientific evidence to support COVID-19 control measures.
  • The project has resulted in reports modelling the potential path of the outbreak. These represent the only accurate account of the pandemic in Venezuela.
  • Results from genomic sequencing suggest that cross-border transmission is taking place highlighting the overall risk to the Latin America region and the need for public health authorities to monitor the pandemic and its impact on displaced populations.

First published: 24 May 2021