Flattening the curves: on-off lock-down strategies for COVID-19 with an application to Brazi
Celso Suckow da Fonseca Federal Center for Technological Education（塞尔索·苏科·达丰塞卡联邦技术教育中心）；Federal Rural University of Rio de Janeiro（里约热内卢联邦农村大学）；Federal University of Rio de Janeiro（里约热内卢联邦大学）；Cardiff University（卡迪夫大学）
L. Tarrataca, C. M. Dias, D. B. Haddad, E. F. Arruda
The current COVID-19 pandemic is affecting different countries in different ways. The assortment of reporting techniques alongside other issues, such as underreporting and budgetary constraints, makes predicting the spread and lethality of the virus a challenging task. This work attempts to gain a better understanding of how COVID-19 will affect one of the least studied countries, namely Brazil. Currently, several Brazilian states are in a state of lock-down. However, there is political pressure for this type of measures to be lifted. This work considers the impact that such a termination would have on how the virus evolves locally. This was done by extending the SEIR model with an on / off strategy. Given the simplicity of SEIR we also attempted to gain more insight by developing a neural regressor. We chose to employ features that current clinical studies have pinpointed has having a connection to the lethality of COVID-19. We discuss how this data can be processed in order to obtain a robust assessment.
In this work, we simulate the COVID-19 pandemic dynamics in a population modeled as a network of groups wherein infection can propagate both via intra-group and via inter-group interactions. Our results emphasize the importance of diminishing the inter-group infections in the effort of substantial flattening and delaying of the epi(demiologic) curve with concomitant mitigation of disastrous economy and social consequences. To exemplify with a limiting case, splitting a population into m (say, 5 or 10) noninteracting groups while keeping intra-group interaction unchanged yields a stretched epid…
To curb the spread of COVID-19, many governments around the world have implemented tiered lockdowns with varying degrees of stringency. Lockdown levels are typically increased when the disease spreads and reduced when the disease abates. A predictive control approach is used to develop optimized lockdown strategies for curbing the spread of COVID-19. The strategies are then applied to South African data. The South African case is of interest as the South African government has defined five distinct levels of lockdown, which serves as a discrete control input. An epidemiological model for the s…
To slow down the spread of Covid-19, administrative regions within Pakistan imposed complete and partial lockdown restrictions on socio-economic activities, religious congregations, and human movement. Here we examine the impact of regional lockdown strategies on Covid-19 outcomes. After conducting econometric analyses (Regression Discontinuity and Negative Binomial Regressions) on official data from the National Institute of Health (NIH) Pakistan, we find that the strategies did not lead to a similar level of Covid-19 caseload (positive cases and deaths) in all regions. In terms of reduction …
We consider here an extended SIR model, including several features of the recent COVID-19 outbreak: in particular the infected and recovered individuals can either be detected (+) or undetected (-) and we also integrate an intensive care unit (ICU) capacity. Our model enables a tractable quantitative analysis of the optimal policy for the control of the epidemic dynamics using both lockdown and detection intervention levers. With parametric specification based on literature on COVID-19, we investigate the sensitivities of various quantities on the optimal strategies, taking into account the su…
The special epistemic characteristics of the COVID-19, such as the long incubation period and the infection through asymptomatic cases, put severe challenge to the containment of its outbreak. By the end of March 2020, China has successfully controlled the within-spreading of COVID-19 at a high cost of locking down most of its major cities, including the epicenter, Wuhan. Since the low accuracy of outbreak data before the mid of Feb. 2020 forms a major technical concern on those studies based on statistic inference from the early outbreak. We apply the supervised learning techniques to identif…
In this paper, we estimate the impact of national lockdown on COVID-19 related total and daily deaths, per million people, in select European countries. In particular, we compare countries that imposed a nationwide lockdown (Treatment group); Belgium, Denmark, France, Germany, Italy, Norway, Spain, United Kingdom (UK), and the US, to Sweden (Control group) that did not impose national lockdown using a changes-in-changes (CIC) estimation model. The key advantage of the CIC model as compared to the standard difference-in-difference model is that CIC allows for mean and variance of the outcomes t…
Spectral analysis characterises oscillatory time series behaviours such as cycles, but accurate estimation requires reasonable numbers of observations. Current COVID-19 time series for many countries are short: pre- and post-lockdown series are shorter still. Accurate estimation of potentially interesting cycles within such series seems beyond reach. We solve the problem of obtaining accurate estimates from short time series by using recent Bayesian spectral fusion methods. Here we show that transformed new daily COVID-19 cases for many countries generally contain three cycles operating at wav…
The investigation focuses on an on-off protocol for controlling the COVID-19 widespread. The protocol establishes a working period of 4 days for all the citizens, followed by 8 days of lock-down. We further propose splitting people into smaller groups that undergo the on-off protocol, but shifted in time. This procedure is expected to regularize the overall economic activity. Our results show that either the on-of protocol and the splitting into groups reduces the amount of infected people. However, the latter seems to be better for economic reasons. Our simulations further show that the start…
A mathematical model for the COVID-19 pandemic spread, which integrates age-structured Susceptible-Exposed-Infected-Recovered-Deceased dynamics with real mobile phone data accounting for the population mobility, is presented. The dynamical model adjustment is performed via Approximate Bayesian Computation. Optimal lockdown and exit strategies are determined based on nonlinear model predictive control, constrained to public-health and socio-economic factors. Through an extensive computational validation of the methodology, it is shown that it is possible to compute robust exit strategies with r…
Following the highly restrictive measures adopted by many countries for combating the current pandemic, the number of individuals infected by SARS-CoV-2 and the associated number of deaths is steadily decreasing. This fact, together with the impossibility of maintaining the lockdown indefinitely, raises the crucial question of whether it is possible to design an exit strategy based on quantitative analysis. Guided by rigorous mathematical results, we show that this is indeed possible: we present a robust numerical algorithm which can compute the cumulative number of deaths that will occur as a…
COVID-19--a viral infectious disease--has quickly emerged as a global pandemic infecting millions of people with a significant number of deaths across the globe. The symptoms of this disease vary widely. Depending on the symptoms an infected person is broadly classified into two categories namely, asymptomatic and symptomatic. Asymptomatic individuals display mild or no symptoms but continue to transmit the infection to otherwise healthy individuals. This particular aspect of asymptomatic infection poses a major obstacle in managing and controlling the transmission of the infectious disease. I…
Social distancing and isolation have been introduced widely to counter the COVID-19 pandemic. However, more moderate contact reduction policies become desirable owing to adverse social, psychological, and economic consequences of a complete or near-complete lockdown. Adopting a social network approach, we evaluate the effectiveness of three targeted distancing strategies designed to 'keep the curve flat' and aid compliance in a post-lockdown world. These are limiting interaction to a few repeated contacts, seeking similarity across contacts, and strengthening communities via triadic strategies…
In the wake of the COVID-19 pandemic many countries implemented containment measures to reduce disease transmission. Studies using digital data sources show that the mobility of individuals was effectively reduced in multiple countries. However, it remains unclear whether these reductions caused deeper structural changes in mobility networks, and how such changes may affect dynamic processes on the network. Here we use movement data of mobile phone users to show that mobility in Germany has not only been reduced considerably: Lockdown measures caused substantial and long-lasting structural cha…
Motivated by COVID-19, we develop and analyze a simple stochastic model for a disease spread in human population. We track how the number of infected and critically ill people develops over time in order to estimate the demand that is imposed on the hospital system. To keep this demand under control, we consider a class of simple policies for slowing down and reopening the society and we compare their efficiency in mitigating the spread of the virus from several different points of view. We find that in order to avoid overwhelming of the hospital system, a policy must impose a harsh lockdown o…
We develop a multiple-events model and exploit within and between country variation in the timing, type and level of intensity of various public policies to study their dynamic effects on the daily incidence of COVID-19 and on population mobility patterns across 135 countries. We remove concurrent policy bias by taking into account the contemporaneous presence of multiple interventions. The main result of the paper is that cancelling public events and imposing restrictions on private gatherings followed by school closures have quantitatively the most pronounced effects on reducing the daily in…
Background: To prevent future outbreaks of COVID-19, Australia is pursuing a mass-vaccination approach in which a targeted group of the population comprising healthcare workers, aged-care residents and other individuals at increased risk of exposure will receive a highly effective priority vaccine. The rest of the population will instead have access to a less effective vaccine. Methods: We apply a large-scale agent-based model of COVID-19 in Australia to investigate the possible implications of this hybrid approach to mass-vaccination. The model is calibrated to recent epidemiological and demo…
By the end of July 2020, the COVID-19 pandemic had infected more than seventeen million people and had spread to almost all countries worldwide. In response, many countries all over the world have used different methods to reduce the infection rate, such as including case isolation, the closure of schools and universities, banning public events, and mostly forcing social distancing, including local and national lockdowns. We use a Monte-Carlo (MC) based algorithm to predict the virus infection rate for different population densities using the most recent epidemic data in our work. We test the …
Strategies adopted globally to mitigate the threat of COVID-19 have primarily involved lockdown measures with substantial economic and social costs with varying degrees of success. Morbidity patterns of COVID-19 variants have a strong association with age, while restrictive lockdown measures have association with negative mental health outcomes in some age groups. Reduced economic prospects may also afflict some age cohorts more than others. Motivated by this, we propose a model to describe COVID-19 community spread incorporating the role of age-specific social interactions. Through a flexible…
As Europe is facing the second wave of the CoViD-19 pandemic, each country should carefully review how it dealt with the first wave of outbreak. Lessons from the first experience should be useful to avoid indiscriminate closures and, above all, to determine universal (understandable) parameters to guide the introduction of containment measures to reduce the spreading of the virus. The use of few (effective) parameters is indeed of extreme importance to create a link between authorities and population, allowing the latter to understand the reason for some restrictions and, consequently, to allo…
We model further development of the COVID-19 epidemic in the UK given the current data and assuming different scenarios of handling the epidemic. In this research, we further extend the stochastic model suggested in \cite{us} and incorporate in it all available to us knowledge about parameters characterising the behaviour of the virus and the illness induced by it. The models we use are flexible, comprehensive, fast to run and allow us to incorporate the following: -time-dependent strategies of handling the epidemic; -spatial heterogeneity of the population and heterogeneity of development of …
The SIR evolutionary model predicts too sharp a decrease of the fractions of people infected with COVID-19 in France after the start of the national lockdown, compared to what is observed. I fit the daily hospital data: arrivals in regular and critical care units, releases and deaths, using extended SEIR models. These involve ratios of evolutionary timescales to branching fractions, assumed uniform throughout a country, and the basic reproduction number, $R_0$, before and during the national lockdown, for each region of France. The joint-region Bayesian analysis allows precise evaluations of t…
A new epidemic model for Covid-19 has been constructed and simulated for eight US states. The coefficients for this model, based on seven coupled differential equations, are carefully evaluated against recorded data on cases and deaths. These projections reveal that Covid-19 will become endemic, spreading for more than two years. If stay-at-home orders are relaxed, most states may experience a secondary peak in 2021. The number of Covid-19 deaths could have been significantly lower in most states that opened up, if lockdowns had been maintained. Additionally, our model predicts that decreasing…
We study and predict the evolution of Covid-19 in six US states from the period May 1 through August 31 using a discrete compartment-based model and prescribe active intervention policies, like lockdowns, on the basis of minimizing a loss function, within the broad framework of partially observed Markov decision processes. For each state, Covid-19 data for 40 days (starting from May 1 for two northern states and June 1 for four southern states) are analyzed to estimate the transition probabilities between compartments and other parameters associated with the evolution of the epidemic. These qu…
More and more countries show a significant slowdown in the number of new COVID-19 infections due to effective governmentally instituted lockdown and social distancing measures. We have analyzed the growth behavior of the top 25 most affected countries by means of a local slope analysis and found three distinct patterns that individual countries follow depending on the strictness of the lockdown protocols: exponential rise and fall, power law, or logistic. For countries showing power law growth we have determined the scaling exponents. For countries that showed a strong slowdown in the rate of …
