During the COVID-19 crisis, the Chilean Ministry of Health and the Ministry of Sciences, Technology, Knowledge and Innovation partnered with the Instituto Sistemas Complejos de Ingeniería (ISCI) and the telecommunications company ENTEL to develop innovative methodologies and tools that placed operations research and analytics at the forefront of the battle against the pandemic. These innovations have been used in key decision aspects that helped shape a comprehensive strategy against the virus, including tools that: (1) shed light on the actual effects of lockdowns in different municipalities and over time; (2) helped allocate limited intensive care capacity; (3) significantly increased the testing capacity and provided on-the-ground strategies for active screening of asymptomatic cases; and (4) implemented a nationwide serology surveillance program that significantly influenced Chile’s decision regarding vaccine booster doses that also provided information of global relevance.
This fruitful partnership between the public and the private sector and academia was supported by the collection, processing, and analysis of massive amounts of critical data, which was used to feed various models and develop decision-support tools that informed the most critical decision-making. Early in the pandemic, the team started using massive cell phone data to solve the big data challenge of identifying mobility patterns, which enabled quantifying the impact of lockdowns and voluntary shelter-at-home decisions across the country. The use of advanced econometric models showed that said impact was highly heterogeneous and dependent on socioeconomic levels, and that infections positively correlated with mobility. The different dashboards and reports produced provided the Chilean government with critical insights regarding the lockdown strategy throughout the country and its plan to support lower income populations with additional measures to increase compliance.
In the context of testing and tracing, the team combined the aforementioned mobility patterns with granular epidemiological data to developed index-based nationwide heat maps to guide active screening efforts to detect asymptomatic cases in public spaces, which were adopted and continue to be an integral component of the national testing strategy. In addition to this essential planning tool, the team developed and piloted testing monitoring programs based on group testing, which helped to dramatically increase the testing capacity by more than 50%. Despite all prevention efforts, many people were nevertheless infected, and a fraction of them became severely ill, thus requiring hospitalization. To support the centralized management of critical beds, the team used an ensemble of stochastic and machine learning models to produce short-term demand forecasts of intensive care beds at the regional level throughout the country. These forecasts were reported by the Minister of Science to the president and his crisis advisory committee, and were key inputs to inform the coordinated efforts for adapting and augmenting the supply of this scarce resource and reallocating patients across regions. The intensive care capacity was never once surpassed during the pandemic.
Regarding vaccination rollout, Chile followed a multiplatform approach, favoring vaccine availability over choice of a specific technology. While this strategy put Chile among the leaders in inoculations worldwide, it created the need to monitor vaccine effectiveness, because such information was not available elsewhere. With this in mind, the team designed and implemented a centralized surveillance system that monitored the presence of Immunoglobulin G antibodies (IgG) in the population. The information provided by this system, which used mobility data and integer programming to design the sampling mechanism in the general population and was fed to a statistical model of IgG waning dynamics, was instrumental to the government’s decision of implementing heterologous first and second booster shots. Chile became one of the world pioneers in booster shots.
By providing scientific evidence supporting the decision-making behind the Chilean strategy against the pandemic, the project helped provide transparency and objectivity to decision-makers and the general population. According to conservative estimates, the number of lives saved by all of the initiatives together is over 2,000, equivalent to around 5% of the total death toll in Chile during the pandemic. The saved resources associated with testing, ICU beds, and working days amounts to $200 million USD.
The project faced a large number of difficulties, including the fact that it was carried out in possibly one of the most complicated situations faced by any country in the last decades, and solutions were urgently needed. Additionally, the only way the project had any chance to succeed was by the joint work of a quite heterogeneous group of people, from engineers and researchers, to political authorities, to healthcare workers on the ground, all whom were facing huge amounts of stress. Building trust among these groups was fundamental for the efforts of one group to be followed by the next group in the line of work. This project required an enormous amount of coordination between institutions and its officials. And finally, as it dealt with very delicate information, the results had to be communicated with care – something that required further interaction between authorities and scientists, with the results carefully explained to the national media.