There are several reports in India that indicate hospitals and quarantined centers are COVID-19 hotspots. In the absence of efficient contact tracing tools, Govt. and the policymakers may not be paying attention to the risk of hospital-based transmission. To explore more on this important route and its possible impact on lockdown effect, we developed a mechanistic model with hospital-based transmission. Using daily notified COVID-19 cases from six states (Maharashtra, Delhi, Madhya Pradesh, Rajasthan, Gujarat, and Uttar Pradesh) and overall India, we estimated several important parameters of the model. Moreover, we provided an estimation of the basic ($R_{0}$), the community ($R_{C}$), and the hospital ($R_{H}$) reproduction numbers for those seven locations. To obtain a reliable forecast of future COVID-19 cases, a BMA post-processing technique is used to ensemble the mechanistic model with a hybrid statistical model. Using the ensemble model, we forecast COVID-19 notified cases (daily and cumulative) from May 3, 2020, till May 20, 2020, under five different lockdown scenarios in the mentioned locations. Our analysis of the mechanistic model suggests that most of the new COVID-19 cases are currently undetected in the mentioned seven locations. Furthermore, a global sensitivity analysis of four epidemiologically measurable \& controllable parameters on $R_{0}$ and as well on the lockdown effect, indicate that if appropriate preventive measures are not taken immediately, a much larger COVID-19 outbreak may trigger from hospitals and quarantined centers. In most of the locations, our ensemble model forecast indicates a substantial percentage of increase in the COVID-19 notified cases in the coming weeks in India. Based on our results, we proposed a containment policy that may reduce the threat of a larger COVID-19 outbreak in the coming days.
Within the context of SEIR models, we consider a lockdown that is both imposed and lifted at an early stage of an epidemic. We show that, in these models, although such a lockdown may delay deaths, it eventually does not avert a significant number of fatalities. Therefore, in these models, the efficacy of a lockdown cannot be gauged by simply comparing figures for the deaths at the end of the lockdown with the projected figure for deaths by the same date without the lockdown. We provide a simple but robust heuristic argument to explain why this conclusion should generalize to more elaborate co…
Background: Wuhan, China was the epicenter of COVID-19 pandemic. The goal of current study is to understand the infection transmission dynamics before intervention measures were taken. Methods: Data and key events were searched through pubmed and internet. Epidemiological data were calculated using data extracted from a variety of data sources. Results: We established a timeline showing by January 1, 2020, Chinese authorities had been presented convincing evidence of human-to-human transmission; however, it was not until January 20, 2020 that this information was shared with the public. Our st…
In the absence of neither an effective treatment or vaccine and with an incomplete understanding of the epidemiological cycle, Govt. has implemented a nationwide lockdown to reduce COVID-19 transmission in India. To study the effect of social distancing measure, we considered a new mathematical model on COVID-19 that incorporates lockdown effect. By validating our model to the data on notified cases from five different states and overall India, we estimated several epidemiologically important parameters as well as the basic reproduction number ($R_{0}$). Combining the mechanistic mathematical …
After the introduction of drastic containment measures aimed at stopping the epidemic contagion from SARS-CoV2, many governments have adopted a strategy based on a periodic relaxation of such measures in the face of a severe economic crisis caused by lockdowns. Assessing the impact of such openings in relation to the risk of a resumption of the spread of the disease is an extremely difficult problem due to the many unknowns concerning the actual number of people infected, the actual reproduction number and infection fatality rate of the disease. In this work, starting from a compartmental mode…
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…
We study variants of the SEIR model for interpreting some qualitative features of the statistics of the Covid-19 epidemic in France. Standard SEIR models distinguish essentially two regimes: either the disease is controlled and the number of infected people rapidly decreases, or the disease spreads and contaminates a significant fraction of the population until herd immunity is achieved. After lockdown, at first sight it seems that social distancing is not enough to control the outbreak. We discuss here a possible explanation, namely that the lockdown is creating social heterogeneity: even if …
We are currently facing a highly critical case of a world-wide pandemic. The novel coronavirus (SARS-CoV-2, a.k.a. COVID-19) has proved to be extremely contagious and the original outbreak from Asia has now spread to all continents. This situation will fruitfully profit from the study in regards of the spread of the virus, assessing effective countermeasures to weight the impact of the adopted strategies. The standard Susceptible-Infectious-Recovered (SIR) model is a very successful and widely used mathematical model for predicting the spread of an epidemic. We adopt the SIR model on a random …
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…
Few African countries have reported COVID-19 case numbers above $1\,000$ as of April 18, 2020, with South Africa reporting $3\,034$ cases being hit hardest in Sub-Saharan Africa. Several African countries, especially South Africa, have already taken strong non-pharmaceutical interventions that include physical distancing, restricted economic, educational and leisure activities and reduced human mobility options. The required strengths and overall effectiveness of such interventions, however, are debated because of simultaneous but opposing interests in most African countries: strongly limited …
We introduce a theoretical framework that highlights the impact of physical distancing variables such as human mobility and physical proximity on the evolution of epidemics and, crucially, on the reproduction number. In particular, in response to the coronavirus disease (CoViD-19) pandemic, countries have introduced various levels of 'lockdown' to reduce the number of new infections. Specifically we use a collisional approach to an infection-age structured model described by a renewal equation for the time homogeneous evolution of epidemics. As a result, we show how various contributions of th…
Several countries that have been successful in constraining the severity of COVID-19 pandemic via "lockdown" are now considering to slowly end it, mainly because of enormous socio-economic side-effects. An abrupt ending of lockdown can increase the basic reproductive number and undo everything; therefore, carefully designed exit strategies are needed to sustain its benefits post upliftment. To study the role of fear conditioning on mitigating the spread of COVID-19 in post-lockdown phase, in this work, we propose an age- and social contact- structures dependent Susceptible, Feared, Exposed, In…
The dense social contact networks and high mobility in congested urban areas facilitate the rapid transmission of infectious diseases. Typical mechanistic epidemiological models are either based on uniform mixing with ad-hoc contact processes or need real-time or archived population mobility data to simulate the social networks. However, the rapid and global transmission of the novel coronavirus (SARS-CoV-2) has led to unprecedented lockdowns at global and regional scales, leaving the archived datasets to limited use. While it is often hypothesized that population density is a significant driv…
During the early stage of the COVID-19 pandemic, many countries implemented non-pharmaceutical interventions (NPIs) to control the transmission of SARS-CoV-2, the causative pathogen of COVID-19. Among those NPIs, quarantine measures were widely adopted and enforced through stay-at-home and shelter-in-place orders. Understanding the effectiveness of quarantine measures can inform decision-making and control planning during the ongoing COVID-19 pandemic and for future disease outbreaks. In this study, we use mathematical models to evaluate the impact of quarantine measures on COVID-19 spread in …
We present a compartmental SEIRD model aimed at forecasting hospital occupancy in metropolitan areas during the current COVID-19 outbreak. The model features asymptomatic and symptomatic infections with detailed hospital dynamics. We model explicitly branching probabilities and non exponential residence times in each latent and infected compartments. Using both hospital admittance confirmed cases and deaths we infer the contact rate and the initial conditions of the dynamical system, considering break points to model lockdown interventions. Our Bayesian approach allows us to produce timely pro…
In order to analyze the effectiveness of three successive nationwide lockdown enforced in India, we present a data-driven analysis of four key parameters, reducing the transmission rate, restraining the growth rate, flattening the epidemic curve and improving the health care system. These were quantified by the consideration of four different metrics, namely, reproduction rate, growth rate, doubling time and death to recovery ratio. The incidence data of the COVID-19 (during the period of 2nd March 2020 to 31st May 2020) outbreak in India was analyzed for the best fit to the epidemic curve, ma…
In this paper, we investigate the ongoing dynamics of COVID-19 in India after its emergence in Wuhan, China in December 2019. We discuss the effect of nationwide lockdown implemented in India on March 25, 2020 to prevent the spread of COVID-19. Susceptible-Exposed-Infectious-Recovered (SEIR) model is used to forecast active COVID-19 cases in India considering the effect of nationwide lockdown and possible inflation in the active cases after its removal on May 3, 2020. Our model predicts that with the ongoing lockdown, the peak of active infected cases around 43,000 will occur in the mid of May…
Background: Restrictive mass quarantine or lockdown has been implemented as the most important controlling measure to fight against COVID-19. Many countries have enforced 2 - 4 weeks' lockdown and are extending the period depending on their current disease scenario. Most probably the 14-day period of estimated communicability of COVID-19 prompted such decision. But the idea that, if the susceptible population drops below certain threshold, the infection would naturally die out in small communities after a fixed time (following the outbreak), unless the disease is reintroduced from outside, was…
The current COVID-19 pandemic and subsequent lockdowns have highlighted the close and delicate relationship between a country's public health and economic health. Macroeconomic models that use preexisting epidemic models to calculate the impacts of a disease outbreak are therefore extremely useful for policymakers seeking to evaluate the best course of action in such a crisis. We develop an SIR model of the COVID-19 pandemic that explicitly considers herd immunity, behavior-dependent transmission rates, remote workers, and indirect externalities of lockdown. This model is presented as an exit …
We use daily data from Lombardy, the Italian region most affected by the COVID-19 outbreak, to calibrate a SIR model individually on each municipality. These are all covered by the same health system and, in the post-lockdown phase we focus on, all subject to the same social distancing regulations. We find that municipalities with a higher number of cases at the beginning of the period analyzed have a lower rate of diffusion, which cannot be imputed to herd immunity. In particular, there is a robust and strongly significant negative correlation between the estimated basic reproduction number (…
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 COVID-19 pandemic has, worldwide and up to December 2020, caused over 1.7 million deaths, and put the world's most advanced healthcare systems under heavy stress. In many countries, drastic restrictive measures adopted by political authorities, such as national lockdowns, have not prevented the outbreak of new pandemic's waves. In this article, we propose an integrated detection-estimation-forecasting framework that, using publicly available data, is designed to: (i) learn relevant features of the pandemic (e.g., the infection rate); (ii) detect as quickly as possible the onset (or the ter…
The rapid transmission of the highly contagious novel coronavirus has been represented through several data-guided approaches across targeted geographies, in an attempt to understand when the pandemic will be under control and imposed lockdown measures can be relaxed. However, these epidemiological models predominantly based on training data employing number of cases and fatalities are limited in that they do not account for the spatiotemporal population dynamics that principally contributes to the disease spread. Here, a stochastic cellular automata enabled predictive model is presented that …
Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods …
The SIQR model is reformulated where compartments for infected and quarantined are redefined so as to be appropriate to COVID-19, and exact properties of the model are presented. It is shown that the maximum number of infected at large depends strongly on the quarantine rate and that the quarantine measure is more effective than the lockdown measure in controlling the pandemic. The peak of the number of quarantined patients is shown to appear some time later than the time that the number of infected becomes maximum. On the basis of the expected utility theory, a theoretical framework to find o…
An AI-Enabled Agent-Based Simulation Platform for Studying COVID-19 Pandemic
Johns Hopkins University（约翰斯·霍普金斯大学）；University of Pennsylvania（宾夕法尼亚大学）；ICMR-National Institute for Research in Bacterial Infections（印度医学研究理事会-细菌性疾病研究所）；University of Nebraska-Lincoln（内布拉斯加大学林肯分校）
The very first case of corona-virus illness was recorded on 30 January 2020, in India and the number of infected cases, including the death toll, continues to rise. In this paper, we present short-term forecasts of COVID-19 for 28 Indian states and five union territories using real-time data from 30 January to 21 April 2020. Applying Holt's second-order exponential smoothing method and autoregressive integrated moving average (ARIMA) model, we generate 10-day ahead forecasts of the likely number of infected cases and deaths in India for 22 April to 1 May 2020. Our results show that the number …
The outbreak of the novel coronavirus, COVID-19, has been declared a pandemic by the WHO. The structures of social contact critically determine the spread of the infection and, in the absence of vaccines, the control of these structures through large-scale social distancing measures appears to be the most effective means of mitigation. Here we use an age-structured SIR model with social contact matrices obtained from surveys and Bayesian imputation to study the progress of the COVID-19 epidemic in India. The basic reproductive ratio R0 and its time-dependent generalization are computed based o…
The goal of this study is to establish a general framework for predicting the so-called critical Turning Period in an infectious disease epidemic such as the COVID-19 outbreak in China early this year. This framework enabled a timely prediction of the turning period when applied to Wuhan COVID-19 epidemic and informed the relevant authority for taking appropriate and timely actions to control the epidemic. It is expected to provide insightful information on turning period for the world's current battle against the COVID-19 pandemic. The underlying mathematical model in our framework is the ind…
Background: The ongoing COVID-19 epidemic dilated rapidly throughout India. To end the global COVID-19 pandemic major behavioral, social distancing, contact tracing, and state interventions has been undertaken to reduce the outbreak and avert the persistence of the coronavirus in humans in India and worldwide. In absence of any vaccine or therapeutics, forecasting is of utmost priority for health care planning and control the transmission of COVID-19. Methods: We have proposed a mathematical model that explain the transmission dynamics of COVID-19 in India. Based on the estimated data our mode…
Strong social distancing restrictions have been crucial to controlling the COVID-19 outbreak thus far, and the next question is when and how to relax these restrictions. A sequential timing of relaxing restrictions across groups is explored in order to identify policies that simultaneously reduce health risks and economic stagnation relative to current policies. The goal will be to mitigate health risks, particularly among the most fragile sub-populations, while also managing the deleterious effect of restrictions on economic activity. The results of this paper show that a properly constructed…
The novel coronavirus disease (COVID-19) pandemic has resulted in over 200,000 cases in India. Thus far, India has implemented lockdown measures to curb disease transmission. However, commercial sex work in red-light areas (RLAs) has potential to lead to COVID-19 resurgence after lockdown. We developed a model of COVID-19 transmission in RLAs, evaluating the impact of extended RLA closure compared with RLA reopening on cases, hospitalizations, and mortality rates within the RLAs of five major Indian cities, within the cities, and across India. Closure lowered transmission at all scales. More t…
The sudden outbreak of the Coronavirus disease (COVID-19) swept across the world in early 2020, triggering the lockdowns of several billion people across many countries, including China, Spain, India, the U.K., Italy, France, Germany, and most states of the U.S. The transmission of the virus accelerated rapidly with the most confirmed cases in the U.S., and New York City became an epicenter of the pandemic by the end of March. In response to this national and global emergency, the NSF Spatiotemporal Innovation Center brought together a taskforce of international researchers and assembled imple…
COVID-19 in low-tolerance border quarantine systems: impact of the Delta variant of SARS-CoV-2
The University of Melbourne（墨尔本大学）；Melbourne School of Population and Global Health, The University of Melbourne（墨尔本大学人口与全球健康学院）；The Peter Doherty Institute for Infection and Immunity, The Royal Melbourne Hospital and The University of Melbourne（彼得·多赫蒂感染与免疫研究所、皇家墨尔本医院和墨尔本大学）；Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University（莫纳什大学阿尔弗雷德医院和中央临床学院传染病系）；School of Mathematics and Statistics, The University of Melbourne（墨尔本大学数学与统计学院）
The COVID-19 epidemic that emerged in Wuhan China at the end of 2019 hit Italy particularly hard, yielding the implementation of strict national lockdown rules (Phase 1). There is now a hot ongoing debate in Italy and abroad on what the best strategy is to restart a country to exit a national lockdown (Phase 2). Previous studies have focused on modelling possible restarting scenarios at the national level, overlooking the fact that Italy, as other nations around the world, is divided in administrative regions who can independently oversee their own share of the Italian National Health Service.…
We recently described a dynamic causal model of a COVID-19 outbreak within a single region. Here, we combine several of these (epidemic) models to create a (pandemic) model of viral spread among regions. Our focus is on a second wave of new cases that may result from loss of immunity--and the exchange of people between regions--and how mortality rates can be ameliorated under different strategic responses. In particular, we consider hard or soft social distancing strategies predicated on national (Federal) or regional (State) estimates of the prevalence of infection in the population. The mode…
The rapid spread of the Coronavirus SARS-2 is a major challenge that led almost all governments worldwide to take drastic measures to respond to the tragedy. Chief among those measures is the massive lockdown of entire countries and cities, which beyond its global economic impact has created some deep social and psychological tensions within populations. While the adopted mitigation measures (including the lockdown) have generally proven useful, policymakers are now facing a critical question: how and when to lift the mitigation measures? A carefully-planned exit strategy is indeed necessary t…
Modeling and analysis of the large scale Covid-19 pandemic data can yield inferences about it's dynamics and characteristics of disease propagation. These inferences can then be correlated with contextual factors like population density, effects of strategic interventions, heterogeneous disease propagation etc, and such set of validated inferences can serve as precedents for designing of subsequent mitigation strategies. In this work, we present the analysis of Covid-19 pandemic data in Indian context using growth functions fitting procedure and harmonic analysis method. Our results of growth …
The last leg of the year 2019 gave rise to a virus named COVID-19 (Corona Virus Disease 2019). Since the beginning of this infection in India, the government implemented several policies and restrictions to curtail its spread among the population. As the time passed, these restrictions were relaxed and people were advised to follow precautionary measures by themselves. These timely decisions taken by the Indian government helped in decelerating the spread of COVID-19 to a large extent. Despite these decisions, the pandemic continues to spread and hence, there is an urgent need to plan and cont…
The ongoing novel coronavirus epidemic has been announced a pandemic by the World Health Organization on March 11, 2020, and the Govt. of India has declared a nationwide lockdown from March 25, 2020, to prevent community transmission of COVID-19. Due to absence of specific antivirals or vaccine, mathematical modeling play an important role to better understand the disease dynamics and designing strategies to control rapidly spreading infectious diseases. In our study, we developed a new compartmental model that explains the transmission dynamics of COVID-19. We calibrated our proposed model wi…
The outbreak of a novel coronavirus causing severe acute respiratory syndrome in December 2019 has escalated into a worldwide pandemic. In this work, we propose a compartmental model to describe the dynamics of transmission of infection and use it to obtain the optimal vaccination control. The model accounts for the various stages of the vaccination and the optimisation is focused on minimising the infections to protect the population and relieve the healthcare system. As a case study we selected the Republic of Ireland. We use data provided by Ireland's COVID-19 Data-Hub and simulate the evol…
OBJECTIVES: to describe the first wave of the COVID-19 pandemic with a focus on undetected cases and to evaluate different post-lockdown scenarios. DESIGN: the study introduces a SEIR compartmental model, taking into account the region-specific fraction of undetected cases, the effects of mobility restrictions, and the personal protective measures adopted, such as wearing a mask and washing hands frequently. SETTING AND PARTICIPANTS: the model is experimentally validated with data of all the Italian regions, some European countries, and the US. MAIN OUTCOME MEASURES: the accuracy of the model …
This study presents a new risk-averse multi-stage stochastic epidemics-ventilator-logistics compartmental model to address the resource allocation challenges of mitigating COVID-19. This epidemiological logistics model involves the uncertainty of untested asymptomatic infections and incorporates short-term human migration. Disease transmission is also forecasted through a new formulation of transmission rates that evolve over space and time with respect to various non-pharmaceutical interventions, such as wearing masks, social distancing, and lockdown. The proposed multi-stage stochastic model…
