Multi-model forecasting of respiratory disease activity in Germany during the 2024-2025 season

Respiratory diseases cause considerable morbidity in autumn and winter and are a priority in public health monitoring. In Germany, they are subject to a number of surveillance systems, including both pathogen-specific and syndromic indicators. In this paper we present a collaborative multi-target and multi-model real-time forecasting system rolled out during the 2024/25 season, and discuss differences to earlier efforts carried out during the COVID-19 pandemic. A total of nine models were run to generate forecasts of general practitioner consultations for acute respiratory infections (ARI), hospitalizations for severe acute respiratory infections (SARI) and confirmed cases of seasonal influenza and RSV. As all indicators were subject to retrospective revisions, forecasting models were combined with a nowcasting step. Whenever multiple models were available for the same indicator, we combined them into an ensemble. Nowcasts showed convincing performance, even though for some models Christmas break effects led to an upward bias in early January. Forecasts were overall well-calibrated and most models outperformed simple benchmark models. These improvements were generally more substantial for age-stratified than pooled targets, and concentrated at lead times of two to three weeks. Anticipating the peak timing and magnitude proved to be challenging, with many models predicting too flat curves with a too early turnaround (e.g. already in late January rather than mid-February for SARI). The combined ensemble forecast was among the best-performing approaches, but unlike in previous related projects did not consistently outperform individual models. We conclude by discussing learnings on the organization of collaborative forecasting projects in post-COVID-19 times and the potential of AI-supported modelling.