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Actual US cases multiple hundreds of thousands at end of May, 2009

Models’ Projections for Flu Miss Mark by Wide Margin By DONALD G. McNEIL Jr. Published: June 1, 2009 http://www.nytimes.com/2009/06/02/health/02model.html?ref=science


In the waning days of April, as federal officials were declaring a public health emergency and the world seemed gripped by swine flu panic, two rival supercomputer teams made projections about the epidemic that were surprisingly similar — and surprisingly reassuring. By the end of May, they said, there would be only 2,000 to 2,500 cases in the United States.

May’s over. They were a bit off.

On May 15, the Centers for Disease Control and Prevention estimated that there were “upwards of 100,000” cases in the country, even though only 7,415 had been confirmed at that point.

The agency declines to update that estimate just yet. But Tim Germann, a computational scientist who worked on a 2006 flu forecast model at Los Alamos National Laboratory, said he imagined there were now “a few hundred thousand” cases. (At their peaks, epidemics are thought to double in as little as three days, which could drive the number into the millions, but Dr. Germann said he would not use such a rapid doubling rate unless it was a cold November and no countermeasures, like closing schools, were being taken.)

What went wrong?

The leaders of both the Northwestern University and Indiana University teams seemed a bit abashed when they were asked that last week.

Northwestern’s predictions got the most publicity because of the eye-catching metric for predicting spread: data from Where’s George?, a Web site that tracks millions of dollar bills as they move around the country.

Dirk Brockmann, the engineering professor who led the team, said the realization that his initial estimates had been far too low struck him on May 11, when British, Mexican and World Health Organization researchers published a study in the journal Science tracing the first days of the outbreak. They estimated that it had begun in rural La Gloria, Mexico, in mid-February and that by April 30 there were 6,000 to 32,000 infections throughout Mexico.

“The numbers of reported cases in Mexico that we plugged in at the beginning of our model were orders of magnitude lower,” Dr. Brockmann said.

He is still proud, he said, of how well his model predicted geographical spread in the United States. He had to adjust it for the unexpected infusion of cases stemming from students at St. Francis Preparatory School in New York City who brought the virus back from spring break in Cancún, but otherwise it was accurate in predicting that California, Texas, Illinois and Florida would be hot spots.

Alessandro Vespignani, the informatics professor who led Indiana’s team, was a little more defensive, suggesting that he was either misquoted or had misunderstood the question on May 2 when he was reported as estimating that there would be about 2,500 cases by month’s end. His first model predicted 9,500 cases by May 24, he said.

Dr. Vespignani said he felt the C.D.C. estimate of 100,000 or more was “a bit of an overshooting.”

However, he pointed out, his adjustment of his figures on May 17 had an upper estimate of 100,000 for the end of May, and if one assumed that the disease centers counted asymptomatic cases and he did not, then that could stretch to 150,000.

Decisions by the C.D.C. and state health departments to stop confirming most cases in laboratories “is making our life miserable,” he said, adding, “If you don’t have good data, you don’t make good predictions.”

Both professors said they would use the experience to refine their models for the future. Dr. Brockman has not updated his since May 9.

“For this disease, we won’t put out another projection,” he said. “Once it’s in the dispersal phase, exponential growth kicks in. You don’t need a sophisticated model anymore.”

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INEXACT SCIENCE Where’s George?, a Web site that tracks dollar bills, provided data for a flu projection. Related Times Topics: Swine Flu (AH1N1 Virus)

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