# Forecasting the Spread of COVID-19 in Kuwait Using Compartmental and Logistic Regression Models
## 4 Discussion  
Different scenarios were investigated for the Kuwait COVID-19 outbreak to provide insights for policymakers to implement appropriate intervention actions. Compartmental and logistic models were used in this study to forecast the peak of daily cases, the total infected cases and the expected dates of the start and ending phase of the epidemic. Also, stochastic SIR ICM simulations were carried out to examine the impact of the simultaneous changes in the number of the susceptible and infected populations. Furthermore, stochastic SIR-ICM simulations assess the effectiveness of intervention measures such as social distancing and lockdown. Different control measures were taken by the Kuwait government as indicated in Table 2. The measures were increased gradually into more restricted measures in response to the spread of COVID-19. The first measure was the closure of schools and universities since the percentage of people in the age range of 5-24 years represent approximately 25% of the whole Kuwait population as of 1 January 2019 according to the Central Statistical Bureau [23]. The action is important despite the early report that indicated the low percentage of this age range [24] as they could transmit the virus to other age groups. In addition, a recent report from WHO indicated a steady-state increase over time in the proportion of cases aged 20-39 [25]. Such actions are believed to assist in the absence of any local transmission in the first two weeks as shown in Table 8. However, the number of local transmission cases increased drastically and have reached 274 cases during the 6 th week of the epidemic. Another increase of 635 and 665 cases in the 7 th and 8 th weeks respectively was observed. Therefore, additional controlling measures were implemented. Partial curfew was imposed all over Kuwait from Sunday evening, 22 March 2020, from 5 p.m. until 4 a.m. daily. On 6 April 2020, complete isolation and  
Figure 8: Stochastic simulation results of SIR model with various infection rates and contacts after the repartition plan. lockdown was imposed in selected areas that have had the highest local transmission. These areas are Jleeb Al-Shuyaukh and Al-mahaboula, with a lockdown period of two weeks. The results of the first scenario depicted in Figure 1 indicated that the ending phase is expected to start at 22 April 2020 and the estimated number of maximum cases as 4223. The expected date is based on the fitting of the logistics regression model of confirmed infected cases recorded in Kuwait. In addition, the scenario was simulated using the SIR model to estimate the reproduction number from the model and was found to be 2.2. The value \(R_{o}\) is in the lower band of the world range which was reported to be between 2.0 to 2.5 as provided by WHO estimation [17]. This can be used to indicate the positive impact of the implemented governmental measures to mitigate and slow down the outbreak of COVID-19. The measures emphasized and focused on social distancing to reduce the contact of people and thus reducing human-to-human transmission. In addition, the effect of the repatriation plan of approximately 40,000 citizens on the current COVID-19 spread was simulated and analyzed. Simulation results encourage strict intervention measures of Kuwait to contain the spread of COVID-19 and suggest that Kuwait will be able to contain the spread by extending the prevention measures period. Although there is an increase in the predicted cases due to the repatriation plan, Kuwait has kept the integrity of its citizens, and prevented possible failures in the health system by the proper arrangement of repatriating flights. The flights were arranged with an arrivals rate that is within the range of available quarantine locations. The maximum reproduction number value (\(R_{o}=2.5\)) was used to predict the worst scenario and was compared to the current forecasting as shown in Figures 3 and 4. There is a great difference between the two scenarios in the estimated cumulative cases.