EpiFlow: A framework for improving the utility of wastewater signals for disease forecasting

Wastewater-based surveillance is an effective tool for disease monitoring and can provide early warning of outbreaks. Although wastewater viral loads (WVL) correlate with disease burden, their utility for improving real-time forecasting remains under investigation. During the early phases of an epidemic, many indicators can effectively monitor disease spread, but their reliability may decline because of reporting fatigue and low prevalence. Hospital burden can vary substantially even during low-prevalence periods, making accurate forecasting of burden indicators essential for minimizing disease impacts. In this paper, we present principled approaches for processing wastewater data, characterizing its relationship with burden indicators, and generating real-time forecasts. We assess the predictability of WVL using entropy measures. We analyze the relationship between WVL and burden indicators using causality tests that capture temporal dynamics and the leading-indicator behavior of WVL. We incorporate these insights into a time-varying forecasting model that accounts for the evolving relationship between the signals. We also evaluate the effects of delays in WVL reporting through simulations. We test the utility of our methods by forecasting COVID-19 hospital admissions across Virginia and its health regions during periods of varying disease prevalence. Incorporating WVL improves forecast accuracy relative to baseline models, particularly during critical epidemic phases, and results in a 20 percentage point improvement in forecast coverage. Our results demonstrate that WVL signals can improve infectious disease forecasting even under conditions of low prevalence or delayed reporting.

Understanding Key Features of Time Series Foundation Models from Epidemic Forecasting

Seasonal influenza infects millions of people and causes substantial morbidity and mortality in the United States each year, making accurate short-term forecasting a core public-health need. Reliable forecasts of epidemic time series can inform vaccination timing, hospital staffing, and resource allocation, yet the comparative behavior of modern forecasting architectures on infectious-disease surveillance data remains insufficiently characterized. We address this gap through a systematic evaluation of regional influenza forecasting using influenza-like illness surveillance and influenza-associated hospitalization time series under both temporal and spatial generalization settings for 1-4-week-ahead prediction. We compare classical neural network architectures, numerical transformer-based models, pretrained time series foundation models, and LLM-based forecasting approaches. Across tasks, we demonstrate that a mixture-of-experts model that fuses multiple pretrained forecasters achieves the strongest overall performance, indicating that heterogeneous pretrained representations provide complementary predictive information. Our results further show that numerical transformer-based models produce reliable forecasts, while pretraining provides the largest gains at longer horizons, particularly when the pretraining domain is mechanistically aligned with influenza dynamics. In contrast, LLM-based time series methods underperform relative to numerical forecasters in this setting. Finally, we examine hospitalization information as both an auxiliary covariate and a pretraining source. Hospitalization signals provide complementary improvements in selected settings and clarify when additional surveillance streams enhance the robustness of multi-horizon forecasting. These findings provide actionable guidance on model selection, pretraining strategy, and auxiliary-signal use for influenza preparedness.

IDOBE: Infectious Disease Outbreak forecasting Benchmark Ecosystem

Epidemic forecasting has become an integral part of real-time infectious disease outbreak response. While collaborative ensembles composed of statistical and machine learning models have become the norm for real-time forecasting, standardized benchmark datasets for evaluating such methods are lacking. Further, there is limited understanding on performance of these methods for novel outbreaks with limited historical data. In this paper, we propose IDOBE, a curated collection of epidemiological time series focused on outbreak forecasting. IDOBE compiles from multiple data repositories spanning over a century of surveillance and across U.S. states and global locations. We perform derivative-based segmentation to generate over 10,000 outbreaks covering multiple outcomes such as cases and hospitalizations for 13 diseases. We consider a variety of information-theoretic and distributional measures to quantify the epidemiological diversity of the dataset. Finally, we perform multi-horizon short-term forecasting (1- to 4-week-ahead) through the progression of the outbreak using 11 baseline models and report on their performance. In addition to standard metrics such as NMSE and MAPE for point forecasts, we include probabilistic scoring rules such as Normalized Weighted Interval Score (NWIS) to quantify the performance. We find that MLP-based methods have the most robust performance, with statistical methods having a slight edge during the pre-peak phase. IDOBE dataset along with baselines are released publicly on https://github.com/NSSAC/IDOBE to enable standardized, reproducible benchmarking of outbreak forecasting methods.

IGraSS: Learning to Identify Infrastructure Networks from Satellite Imagery by Iterative Graph-constrained Semantic Segmentation

Accurate canal network mapping is essential for water management, including irrigation planning and infrastructure maintenance. State-of-the-art semantic segmentation models for infrastructure mapping, such as roads, rely on large, well-annotated remote sensing datasets. However, incomplete or inadequate ground truth can hinder these learning approaches. Many infrastructure networks have graph-level properties such as reachability to a source (like canals) or connectivity (roads) that can be leveraged to improve these existing ground truth. This paper develops a novel iterative framework IGraSS, combining a semantic segmentation module-incorporating RGB and additional modalities (NDWI, DEM)-with a graph-based ground-truth refinement module. The segmentation module processes satellite imagery patches, while the refinement module operates on the entire data viewing the infrastructure network as a graph. Experiments show that IGraSS reduces unreachable canal segments from around 18% to 3%, and training with refined ground truth significantly improves canal identification. IGraSS serves as a robust framework for both refining noisy ground truth and mapping canal networks from remote sensing imagery. We also demonstrate the effectiveness and generalizability of IGraSS using road networks as an example, applying a different graph-theoretic constraint to complete road networks.

Examining Deep Learning Models with Multiple Data Sources for COVID-19 Forecasting

The COVID-19 pandemic represents the most significant public health disaster since the 1918 influenza pandemic. During pandemics such as COVID-19, timely and reliable spatio-temporal forecasting of epidemic dynamics is crucial. Deep learning-based time series models for forecasting have recently gained popularity and have been successfully used for epidemic forecasting. Here we focus on the design and analysis of deep learning-based models for COVID-19 forecasting. We implement multiple recurrent neural network-based deep learning models and combine them using the stacking ensemble technique. In order to incorporate the effects of multiple factors in COVID-19 spread, we consider multiple sources such as COVID-19 testing data and human mobility data for better predictions. To overcome the sparsity of training data and to address the dynamic correlation of the disease, we propose clustering-based training for high-resolution forecasting. The methods help us to identify the similar trends of certain groups of regions due to various spatio-temporal effects. We examine the proposed method for forecasting weekly COVID-19 new confirmed cases at county-, state-, and country-level. A comprehensive comparison between different time series models in COVID-19 context is conducted and analyzed. The results show that simple deep learning models can achieve comparable or better performance when compared with more complicated models. We are currently integrating our methods as a part of our weekly forecasts that we provide state and federal authorities.

Models for COVID-19 Pandemic: A Comparative Analysis

COVID-19 pandemic represents an unprecedented global health crisis in the last 100 years. Its economic, social and health impact continues to grow and is likely to end up as one of the worst global disasters since the 1918 pandemic and the World Wars. Mathematical models have played an important role in the ongoing crisis; they have been used to inform public policies and have been instrumental in many of the social distancing measures that were instituted worldwide. In this article we review some of the important mathematical models used to support the ongoing planning and response efforts. These models differ in their use, their mathematical form and their scope.