The global COVID-19 pandemic (SARS-CoV-2 virus) is the defining health crisis of our century. Due to the absence of vaccines and drugs that can help to fight it, the world solution to control the spread has been to consider public social distance measures that avoids the saturation of the health system. In this context, we investigate a Model Predictive Control (MPC) framework to determine the time and duration of social distancing policies. We use Brazilian data in the period from March to May of 2020. The available data regarding the number of infected individuals and deaths suffers from sub-notification due to the absence of mass tests and the relevant presence of the asymptomatic individuals. We estimate variations of the SIR model using an uncertainty-weighted Least-Squares criterion that considers both nominal and inconsistent-data conditions. Moreover, we add to our versions of the SIR model an additional dynamic state variable to mimic the response of the population to the social distancing policies determined by the government that affects the speed of COVID-19 transmission. Our control framework is within a mixed-logical formalism, since the decision variable is forcefully binary (the existence or the absence of social distance policy). A dwell-time constraint is included to avoid harsh shifting between these two states. Finally, we present simulation results to illustrate how such optimal control policy would operate. These results point out that no social distancing should be relaxed before mid August 2020. If relaxations are necessary, they should not be performed before the beginning this date and should be in small periods, no longer than 25 days. This paradigm would proceed roughly until January/2021. The second peak of infections, which has a forecast to the beginning of October, can be reduced if the periods of no-isolation days are shortened.
The novel coronavirus SARS-CoV-2 has rapidly emerged as a significant threat to global public health, in particular because -- as is not uncommon with novel pathogens -- there is no effective pharmaceutical treatment or prophylaxis to the viral syndrome it causes. In the absence of such specific treatment modalities, the mainstay of public health response rests on non-pharmaceutical interventions (NPIs), such as social distancing. This paper contributes to the understanding of social distancing against SARS-CoV-2 by quantitatively analysing the statistical dynamics of disease propagation as a …
Most countries have started vaccinating people against COVID-19. However, due to limited production capacities and logistical challenges it will take months/years until herd immunity is achieved. Therefore, vaccination and social distancing have to be coordinated. In this paper, we provide some insight on this topic using optimization-based control on an age-differentiated compartmental model. For real-life decision making, we investigate the impact of the planning horizon on the optimal vaccination/social distancing strategy. We find that in order to reduce social distancing in the long run, …
Understanding the number of individuals who have been infected with the novel coronavirus SARS-CoV-2, and the extent to which social distancing policies have been effective at limiting its spread, are critical for effective policy going forward. Here we present estimates of the extent to which confirmed cases in the United States undercount the true number of infections, and analyze how effective social distancing measures have been at mitigating or suppressing the virus. Our analysis uses a Bayesian model of COVID-19 fatalities with a likelihood based on an underlying differential equation mo…
In this paper, we formulate a Nonlinear Model Predictive Control (NMPC) to plan appropriate social distancing measures (and relaxations) in order to mitigate the COVID-19 pandemic effects, considering the contagion development in Brazil. The NMPC strategy is designed upon an adapted data-driven Susceptible-Infected-Recovered-Deceased (SIRD) contagion model, which takes into account the effects of social distancing. Furthermore, the adapted SIRD model includes time-varying auto-regressive contagion parameters, which dynamically converge according to the stage of the pandemic. This new model is …
This article contains a series of analyses done for the SARS-CoV-2 outbreak in Rio Grande do Sul (RS) in the south of Brazil. These analyses are focused on the high-incidence cities such as the state capital Porto Alegre and at the state level. We provide methodological details and estimates for the effective reproduction number $R_t$, a joint analysis of the mobility data together with the estimated $R_t$ as well as ICU simulations and ICU LoS (length of stay) estimation for hospitalizations in Porto Alegre/RS.
Widespread opinions and discussion exist regarding the efficiency of social distancing after crucial spread of the SARS-CoV-2 virus during the actual Covid-19 pandemic. While Germany has released a federal law that prohibits any type of direct contact for more than 2 people other countries including the US released curfews. People are now wondering whether these measures are helpful to stop or hamper the Covid-19 pandemic and to limit the spread of the new corona virus. A quantitative statement on this question depends on many parameters that are difficult to grasp mathematically and cannot th…
The COVID-19 pandemic is the profoundest health crisis of the 21rst century. The SARS-CoV-2 virus arrived in Brazil around March, 2020 and its social and economical backlashes are catastrophic. In this paper, it is investigated how Model Predictive Control (MPC) could be used to plan appropriate social distancing policies to mitigate the pandemic effects in Bahia and Santa Catarina, two states of different regions, culture, and population demography in Brazil. In addition, the parameters of Susceptible-Infected-Recovered-Deceased (SIRD) models for these two states are identified using an optim…
An epidemiological compartmental model was used to simulate social distancing strategies to contain the COVID-19 pandemic and prevent a second wave in Sao Paulo, Brazil. Optimization using genetic algorithm was used to determine the optimal solutions. Our results suggest the best-case strategy for Sao Paulo is to maintain or increase the current magnitude of social distancing for at least 60 more days and increase the current levels of personal protection behaviors by a minimum of 10% (e.g., wearing facemasks, proper hand hygiene and avoid agglomeration). Followed by a long-term oscillatory le…
We model and forecast the early evolution of the COVID-19 pandemic in Brazil using Brazilian recent data from February 25, 2020 to March 30, 2020. This early period accounts for unawareness of the epidemiological characteristics of the disease in a new territory, sub-notification of the real numbers of infected people and the timely introduction of social distancing policies to flatten the spread of the disease. We use two variations of the SIR model and we include a parameter that comprises the effects of social distancing measures. Short and long term forecasts show that the social distancin…
The emergence of SARS-CoV-2 and the coronavirus infectious disease (COVID-19) has become a pandemic. Social (physical) distancing is a key non-pharmacologic control measure to reduce the transmission rate of SARS-COV-2, but high-level adherence is needed. Using daily travel distance and stay-at-home time derived from large-scale anonymous mobile phone location data provided by Descartes Labs and SafeGraph, we quantify the degree to which social distancing mandates have been followed in the U.S. and its effect on growth of COVID-19 cases. The correlation between the COVID-19 growth rate and tra…
The COVID-19 pandemic (SARS-CoV-2 virus) is the defying global health crisis of our time. The absence of mass testing and the relevant presence of asymptomatic individuals causes the available data of the COVID-19 pandemic in Brazil to be largely under-reported regarding the number of infected individuals and deaths. We propose an adapted Susceptible-Infected-Recovered (SIR) model which explicitly incorporates the under-reporting and the response of the population to public policies (such as confinement measures, widespread use of masks, etc) to cast short-term and long-term predictions. Large…
Despite the progress in medical care, combined population-wide interventions (such as physical distancing, testing and contact tracing) are still crucial to manage the SARS-CoV-2 pandemic, aggravated by the emergence of new highly transmissible variants. We combine the compartmental SIDARTHE model, predicting the course of COVID-19 infections, with a new data-based model that projects new cases onto casualties and healthcare system costs. Based on the Italian case study, we outline several scenarios: mass vaccination campaigns with different paces, different transmission rates due to new varia…
A mathematical model to calculate the transmissibility of SARS-Cov-2 in Wuhan City was developed and published recently by Tian-Mu Chen et al., Infectious Diseases of Poverty, 2020, https://doi.org/10.1186/s40249-020-00640-3. This paper improves this model in order to study the effect of different scenarios that include actions to contain the pandemic, such as isolation and quarantine of infected and at-risk people. Comparisons made between the different scenarios show that the progress of the infection is found to strongly depend on measures taken in each case. The particular case of Brazil w…
The SARS-CoV-2 infectious outbreak has rapidly spread across the globe and precipitated varying policies to effectuate physical distancing to ameliorate its impact. In this study, we propose a new hybrid machine learning model, SIRNet, for forecasting the spread of the COVID-19 pandemic that couples with the epidemiological models. We use categorized spatiotemporally explicit cellphone mobility data as surrogate markers for physical distancing, along with population weighted density and other local data points. We demonstrate at varying geographical granularity that the spectrum of physical di…
In this study, we propose a time-dependent Susceptible-Exposed-Infected-Recovered (SEIR) model for the analysis of the SARS-CoV-2 epidemic outbreak in three different countries, the United States of America, Italy and Iceland using public data inherent the numbers of the epidemic wave. Since several types and grades of actions were adopted by the governments, including travel restrictions, social distancing, or limitation of movement, we want to investigate how these measures can affect the epidemic curve of the infectious population. The parameters of interest for the SEIR model were estimate…
Background: There is uncertainty about the role of different age groups in propagating the SARS-CoV-2 epidemics in different countries. Methods: We used the Koch Institute data on COVID-19 cases in Germany. To minimize the effect of changes in healthcare seeking behavior and testing practices, we included the following 5-year age groups in the analyses: 10-14y through 45-49y. For each age group g, we considered the proportion PL(g) of individuals in age group g among all detected cases aged 10-49y during weeks 13-14, 2020 (later period), as well as corresponding proportion PE(g) for weeks 10-1…
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…
In March of 2020, many U.S. state governments encouraged or mandated restrictions on social interactions to slow the spread of COVID-19, the disease caused by the novel coronavirus SARS-CoV-2 that has spread to nearly 180 countries. Estimating the effectiveness of these social-distancing strategies is challenging because surveillance of COVID-19 has been limited, with tests generally being prioritized for high-risk or hospitalized cases according to temporally and regionally varying criteria. Here we show that reductions in mobility across U.S. counties with at least 100 confirmed cases of COV…
Accurately estimating the effectiveness of stay-at-home orders (SHOs) on reducing social contact and disease spread is crucial for mitigating pandemics. Leveraging individual-level location data for 10 million smartphones, we observe that by April 30th---when nine in ten Americans were under a SHO---daily movement had fallen 70% from pre-COVID levels. One-quarter of this decline is causally attributable to SHOs, with wide demographic differences in compliance, most notably by political affiliation. Likely Trump voters reduce movement by 9% following a local SHO, compared to a 21% reduction amo…
We collected individualized (unidentifiable) and aggregated openly available data from various sources related to suspected/confirmed SARS-CoV-2 infections, vaccinations, non-pharmaceutical government interventions, human mobility, and levels of population inequality in Brazil. In addition, a data structure allowing real-time data collection, curation, integration, and extract-transform-load processes for different objectives was developed. The granularity of this dataset (state- and municipality-wide) enables its application to individualized and ecological epidemiological studies, statistica…
We propose a Markovian stochastic approach to model the spread of a SARS-CoV-2-like infection within a closed group of humans. The model takes the form of a Partially Observable Markov Decision Process (POMDP), whose states are given by the number of subjects in different health conditions. The model also exposes the different parameters that have an impact on the spread of the disease and the various decision variables that can be used to control it (e.g, social distancing, number of tests administered to single out infected subjects). The model describes the stochastic phenomena that underli…
Without a cure, vaccine, or proven long-term immunity against SARS-CoV-2, test-trace-and-isolate (TTI) strategies present a promising tool to contain its spread. For any TTI strategy, however, mitigation is challenged by pre- and asymptomatic transmission, TTI-avoiders, and undetected spreaders, who strongly contribute to hidden infection chains. Here, we studied a semi-analytical model and identified two tipping points between controlled and uncontrolled spread: (1) the behavior-driven reproduction number of the hidden chains becomes too large to be compensated by the TTI capabilities, and (2…
The novel coronavirus SARS-CoV-2 and resulting COVID-19 disease have had an unprecedented spread and continue to cause an increasing number of fatalities worldwide. While vaccines are still under development, social distancing, extensive testing, and quarantining of confirmed infected subjects remain the most effective measures to contain the pandemic. These measures carry a significant socioeconomic cost. In this work, we introduce a novel optimization-based decision-making framework for managing the COVID-19 outbreak in the US. This includes modeling the dynamics of affected populations, est…
The SARS-CoV-2 pandemic has necessitated mitigation efforts around the world. We use only reported deaths in the two weeks after the first death to determine infection parameters, in order to make predictions of hidden variables such as the time dependence of the number of infections. Early deaths are sporadic and discrete so the use of network models of epidemic spread is imperative, with the network itself a crucial random variable. Location-specific population age distributions and population densities must be taken into account when attempting to fit these events with parametrized models. …
The presence of a large number of infected individuals with few or no symptoms is an important epidemiological difficulty and the main mathematical feature of COVID-19. The A-SIR model, i.e. a SIR (Susceptible-Infected-Removed) model with a compartment for infected individuals with no symptoms or few symptoms was proposed by Giuseppe Gaeta, arXiv:2003.08720 [q-bio.PE] (2020). In this paper we investigate a slightly generalized version of the same model and propose a scheme for fitting the parameters of the model to real data using the time series only of the deceased individuals. The scheme is…
Accurate modeling of lockdown effects on SARS-CoV-2 epidemic evolution is a key issue in order e.g. to inform health-care decisions on emergency management. The compartmental and spatial models so far proposed use parametric descriptions of the contact rate, often assuming a time-invariant effect of the lockdown. In this paper we show that these assumptions may lead to erroneous evaluations on the ongoing pandemic. Thus, we develop a new class of nonparametric compartmental models able to describe how the impact of the lockdown varies in time. Exploiting regularization theory, hospitalized dat…
An epidemic carries human and fiscal costs. In the case of imported pandemics, the first-best solution is to restrict national borders to identify and isolate infected individuals. However, when that opportunity is not fully seized and there is no preventative intervention available, second-best options must be chosen. In this article we develop a system of differential equations that simulate both the fiscal and human costs associated to different mitigation measurements. After simulating several scenarios, we conclude that herd immunity (or unleashing the pandemic) is the worst policy in ter…
The development and authorization of COVID-19 vaccines has provided the clearest path forward to eliminate community spread hence end the ongoing SARS-CoV-2 pandemic. However, the limited pace at which the vaccine can be administered motivates the question, to what extent must we continue to adhere to social intervention measures such as mask wearing and social distancing? To address this question, we develop a mathematical model of COVID-19 spread incorporating both vaccine dynamics and socio-epidemiological parameters. We use this model to study two important measures of disease control and …
We study the potential scenarios from a Susceptible-Infected-Recovered-Asymptomatic-Symptomatic-Dead (SIRASD) model. As a novelty, we consider populations that differ in their degree of compliance with social distancing policies following socioeconomic attributes that are observed in emerging and developing countries. Considering epidemiological parameters estimated from data of the propagation of SARS-CoV-2 in Brazil -- where there is a significant stake of the population making their living in the informal economy and thus prone to not follow self-isolation -- we assert that if the confineme…
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…
The world evolution of the Severe acute respiratory syndrome coronavirus 2 (SARS-Cov2 or simply COVID-19) led the World Health Organization to declare it a pandemic. The disease appeared in China in December 2019, and it has spread fast around the world, specially in european countries like Italy and Spain. The first reported case in Brazil was recorded in February 26, and after that the number of cases growed fast. In order to slow down the initial growth of the disease through the country, confirmed positive cases were isolated to not transmit the disease. To better understand the early evol…
Identifying the main environmental drivers of SARS-CoV-2 transmissibility in the population is crucial for understanding current and potential future outbursts of COVID-19 and other infectious diseases. To address this problem, we concentrate on the basic reproduction number $R_0$, which is not sensitive to testing coverage and represents transmissibility in an absence of social distancing and in a completely susceptible population. While many variables may potentially influence $R_0$, a high correlation between these variables may obscure the result interpretation. Consequently, we combine Pr…
An outbreak of the Delta (B.1.617.2) variant of SARS-CoV-2 that began around mid-June 2021 in Sydney, Australia, quickly developed into a nation-wide epidemic. The ongoing epidemic is of major concern as the Delta variant is more infectious than previous variants that circulated in Australia in 2020. Using a re-calibrated agent-based model, we explored a feasible range of non-pharmaceutical interventions, including case isolation, home quarantine, school closures, and stay-at-home restrictions (i.e., "social distancing"). Our modelling indicated that the levels of reduced interactions in workp…
Until a vaccine or therapy is found against the SARS-CoV-2 coronavirus, reaching herd immunity appears to be the only mid-term option. However, if the number of infected individuals decreases and eventually fades only beyond this threshold, a significant proportion of susceptible may still be infected until the epidemic is over. A containment strategy is likely the best policy in the worst case where no vaccine or therapy is found. In order to keep the number of newly infected persons to a minimum, a possible strategy is to apply strict containment measures, so that the number of susceptible i…
To contain the Coronavirus disease (COVID-19) pandemic, one of the non-pharmacological epidemic control measures in response to the COVID-19 outbreak is reducing the transmission rate of SARS-COV-2 in the population through (physical) social distancing. An interactive web-based mapping platform that provides timely quantitative information on how people in different counties and states reacted to the social distancing guidelines was developed with the support of the National Science Foundation (NSF). It integrates geographic information systems (GIS) and daily updated human mobility statistica…
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…
In the present article we introduce an epidemiological model for the investigation of the spread of epidemics caused by viruses. The model is applied specifically to COVID-19, the disease caused by the SARS-Cov-2 virus (aka "novel coronavirus"). The SIR (Susceptible - Infectious - Recovered) model is used as a basis for studying the evolution of the epidemic. Nevertheless, we have modified some of the model hypotheses in order to obtain an estimate of the contamination free of overestimated predictions. This extended model is then applied to the case of the recent advance of the epidemic in Br…
In this work, we adapt the epidemiological SIR model to study the evolution of the dissemination of COVID-19 in Germany and Brazil (nationally, in the State of Paraiba, and in the City of Campina Grande). We prove the well posedness and the continuous dependence of the model dynamics on its parameters. We also propose a simple probabilistic method for the evolution of the active cases that is instrumental for the automatic estimation of parameters of the epidemiological model. We obtained statistical estimates of the active cases based the probabilistic method and on the confirmed cases data. …
Using a simple economic model in which social-distancing reduces contagion, we study the implications of waning immunity for the epidemiological dynamics and social activity. If immunity wanes, we find that COVID-19 likely becomes endemic and that social-distancing is here to stay until the discovery of a vaccine or cure. But waning immunity does not necessarily change optimal actions on the onset of the pandemic. Decentralized equilibria are virtually independent of waning immunity until close to peak infections. For centralized equilibria, the relevance of waning immunity decreases in the pr…
In this paper, it is shown that the Moyal distribution is an excelent tool to study the SARS-Cov-II (Covid-19) epidemiological associated curves and its propagation. The Moyal parameters give all the information to describe the form and the impact of the illness outbreak in the different affected countries and its global impact. We checked that the Moyal distribution can accurately fit the daily report of {\it{new confirmed cases of infected people}} (NCC) per country, in that places where the contagion is reaching their final phase, describing the beginning, the most intense phase and the des…
The recent global surge in COVID-19 infections has been fueled by new SARS-CoV-2 variants, namely Alpha, Beta, Gamma, Delta, etc. The molecular mechanism underlying such surge is elusive due to 4,653 non-degenerate mutations on the spike protein, which is the target of most COVID-19 vaccines. The understanding of the molecular mechanism of transmission and evolution is a prerequisite to foresee the trend of emerging vaccine-breakthrough variants and the design of mutation-proof vaccines and monoclonal antibodies. We integrate the genotyping of 1,489,884 SARS-CoV-2 genomes isolates, 130 human a…
As of December 2020, the COVID-19 pandemic has infected over 75 million people, making it the deadliest pandemic in modern history. This study develops a novel compartmental epidemiological model specific to the SARS-CoV-2 virus and analyzes the effect of common preventative measures such as testing, quarantine, social distancing, and vaccination. By accounting for the most prevalent interventions that have been enacted to minimize the spread of the virus, the model establishes a paramount foundation for future mathematical modeling of COVID-19 and other modern pandemics. Specifically, the mod…
The infectious diseases are spreading due to human interactions enabled by various social networks. Therefore, when a new pathogen such as SARS-CoV-2 causes an outbreak, the non-pharmaceutical isolation strategies (e.g., social distancing) are the only possible response to disrupt its spreading. To this end, we introduce the new epidemic model (SICARS) and compare the centralized (C), decentralized (D), and combined (C+D) social distancing strategies, and analyze their efficiency to control the dynamics of COVID-19 on heterogeneous complex networks. Our analysis shows that the centralized soci…
We are currently living in a state of uncertainty due to the pandemic caused by the Sars-CoV-2 virus. There are several factors involved in the epidemic spreading such as the individual characteristics of each city/country. The true shape of the epidemic dynamics is a large, complex system such as most of the social systems. In this context, Complex networks are a great candidate to analyze these systems due to their ability to tackle structural and dynamical properties. Therefore this study presents a new approach to model the COVID-19 epidemic using a multi-layer complex network, where nodes…
The rapid emergence and the disastrous impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on public health, societies, and economies around the world has created an urgent need for understanding the pathways critical for virus transmission. Airborne virus transmission by asymptomatic SARS-CoV-2-infected individuals is considered to be a major contributor to the spread of SARS-CoV-2 and social distancing and wearing of face masks in public have been implemented as countermeasures in many countries. However, a comprehensive risk assessment framework for the airbo…
We investigate, through a fractional mathematical model, the effects of physical distance on the SARS-CoV-2 virus transmission. Two controls are considered in our model for eradication of the spread of COVID-19: media education, through campaigns explaining the importance of social distancing, use of face masks, etc., towards all population, while the second one is quarantine social isolation of the exposed individuals. A general fractional order optimal control problem, and associated optimality conditions of Pontryagin type, are discussed, with the goal to minimize the number of susceptible …
A recent work (DOI 10.1101/2020.05.06.20093310) indicated that temporarily splitting larger populations into smaller groups can efficiently mitigate the spread of SARS-CoV-2 virus. The fact that, soon afterwards, on May 15, 2020, the two million people Slovenia was the first European country proclaiming the end of COVID-19 epidemic within national borders may be relevant from this perspective. Motivated by this evolution, in this paper we investigate the time dynamics of coronavirus cases in Slovenia with emphasis on how efficient various containment measures act to diminish the number of COVI…
Coronavirus disease (COVID-19) which is caused by SARS-COV2 has become a pandemic. This disease is highly infectious and potentially fatal, causing a global public health concern. To contain the spread of COVID-19, governments are adopting nationwide interventions, like lockdown, containment and quarantine, restrictions on travel, cancelling social events and extensive testing. To understand the effects of these measures on the control of the epidemic in a data-driven manner, we propose a probabilistic cellular automata (PCA) based modified SEIQR model. The transitions associated with the mode…
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…
We develop an agent-based model to assess the cumulative number of deaths during hypothetical Covid-19-like epidemics for various non-pharmaceutical intervention strategies. We consider local and non-local modes of disease transmission. The first simulates transmission through social contacts in the vicinity of the place of residence while the second through social contacts in public places: schools, hospitals, airports, etc., where many people meet, who live in remote geographic locations. Epidemic spreading is modeled as a discrete-time stochastic process on random geometric networks. We use…
Controlling the spread of COVID-19 - even after a licensed vaccine is available - requires the effective use of non-pharmaceutical interventions: physical distancing, limits on group sizes, mask wearing, etc. To date, such interventions have neither been uniformly nor systematically implemented in most countries. For example, even when under strict stay-at-home orders, numerous jurisdictions granted exceptions and/or were in close proximity to locations with entirely different regulations in place. Here, we investigate the impact of such geographic inconsistencies in epidemic control policies …
