Combining digital data streams and epidemic networks for real time outbreak detection

Responding to disease outbreaks requires close surveillance of their trajectories, but outbreak detection is hindered by the high noise in epidemic time series. Aggregating information across data sources has shown great denoising ability in other fields, but remains underexplored in epidemiology. Here, we present LRTrend, an interpretable machine learning framework to identify outbreaks in real time. LRTrend effectively aggregates diverse health and behavioral data streams within one region and learns disease-specific epidemic networks to aggregate information across regions. We reveal diverse epidemic clusters and connections across the United States that are not well explained by commonly used human mobility networks and may be informative for future public health coordination. We apply LRTrend to 2 years of COVID-19 data in 305 hospital referral regions and frequently detect regional Delta and Omicron waves within 2 weeks of the outbreak's start, when case counts are a small fraction of the wave's resulting peak.