High impact epidemics constitute one of the largest threats humanity is facing in the 21st century. Testing, contact tracing and quarantining are critical in slowing down epidemic dynamics, but may prove insufficient for highly contagious diseases. In the absence of pharmaceutical interventions, physical distancing measures remain as the last resort to avoid a widespread outbreak. Here we show that such combined countermeasures drastically change the rules of the epidemic transition if testing capacities are limited: Instead of continuous the response to countermeasures becomes discontinuous and rather than following the conventional exponential growth, the outbreak accelerates and scales super-exponentially during an intermediate period. As a consequence, containment measures either suffice to stop the outbreak at low total case numbers or fail catastrophically if marginally too weak, thus implying large uncertainties in reliably estimating overall epidemic dynamics, both during initial phases and during second wave scenarios.
Epidemic spreading can be suppressed by the introduction of containment measures such as social distancing and lock downs. Yet, when such measures are relaxed, new epidemic waves and infection cycles may occur. Here we explore this issue in compartmentalized epidemic models on graphs in presence of a feedback between the infection state of the population and the structure of its social network for the case of discontinuous control. We show that in random graphs the effect of containment measures is simply captured by a renormalization of the effective infection rate that accounts for the chang…
The cataclysmic contagion based calamity -- Covid-19 has shown us a clear need for a comprehensive community based strategy that overcomes the sheer complexity of controlling it and the caveats of current methods. In this regard, as seen in earlier epidemics, testing has always been an integral part of containment policy. But one has to consider the optimality of a testing scheme based on the resultant disease spread in the community and not based on purely increasing testing efficiency. Therefore, taking a decision is no easy feat and must consider the community utility constrained by its pri…
Testing individuals for pathogens can affect the spread of epidemics. Understanding how individual-level processes of sampling and reporting test results can affect community- or population-level spread is a dynamical modeling question. The effect of testing processes on epidemic dynamics depends on factors underlying implementation, particularly testing intensity and on whom testing is focused. Here, we use a simple model to explore how the individual-level effects of testing might directly impact population-level spread. Our model development was motivated by the COVID-19 epidemic, but has g…
Drug resistance and strong contacts actually play crucial roles in epidemic spread in complex systems. Nevertheless, neither theoretical model or methodology is proposed to address this. We thus consider an edge-based epidemic spread model considering the two key ingredients, in which the contacts are grouped into two classes: strong contacts and normal ones. Next, we present a unified edge-based compartmental approach to the spread dynamics on Erdös-Rényi (ER) networks and validate its results by extensive numerical simulations. In case that epidemic is totally drug-resistant, we both numeric…
University of Gothenburg（哥德堡大学）；CNR-IPCF, Istituto per i Processi Chimico-Fisici（意大利国家研究委员会化学物理过程研究所）
Containment of epidemic outbreaks entails great societal and economic costs. Cost-effective containment strategies rely on efficiently identifying infected individuals, making the best possible use of the available testing resources. Therefore, quickly identifying the optimal testing strategy is of critical importance. Here, we demonstrate that machine learning can be used to identify which individuals are most beneficial to test, automatically and dynamically adapting the testing strategy to the characteristics of the disease outbreak. Specifically, we simulate an outbreak using the archetypa…
The spread of an infectious disease can, in some cases, promote the propagation of other pathogens favouring violent outbreaks, which cause a discontinuous transition to an endemic state. The topology of the contact network plays a crucial role in these cooperative dynamics. We consider a susceptible--infected--removed (SIR) type model with two mutually cooperative pathogens: an individual already infected with one disease has an increased probability of getting infected by the other. We present an heterogeneous mean-field theoretical approach to the co--infection dynamics on generic uncorrela…
We analyze equilibrium behavior and optimal policy within a Susceptible-Infected-Recovered epidemic model augmented with potentially undiagnosed agents who infer their health status and a social planner with imperfect enforcement of social distancing. We define and prove the existence of a perfect Bayesian Markov competitive equilibrium and contrast it with the efficient allocation subject to the same informational constraints. We identify two externalities, static (individual actions affect current risk of infection) and dynamic (individual actions affect future disease prevalence), and study…
The COVID-19 pandemic has challenged authorities at different levels of government administration around the globe. When faced with diseases of this severity, it is useful for the authorities to have prediction tools to estimate in advance the impact on the health system and the human, material, and economic resources that will be necessary. In this paper, we construct an extended Susceptible-Exposed-Infected-Recovered model that incorporates the social structure of Mar del Plata, the $4^\circ$ most inhabited city in Argentina and head of the Municipality of General Pueyrredón. Moreover, we co…
The interpretation of sampling data plays a crucial role in policy response to the spread of a disease during an epidemic, such as the COVID-19 epidemic of 2020. However, this is a non-trivial endeavor due to the complexity of real world conditions and limits to the availability of diagnostic tests, which necessitate a bias in testing favoring symptomatic individuals. A thorough understanding of sampling confidence and bias is necessary in order make accurate conclusions. In this manuscript, we provide a stochastic model of sampling for assessing confidence in disease metrics such as trend det…
Motivated with various responses of world governments to COVID-19, here we develop a toy model of the dependence epidemics spreading on the availability of tests for disease. Our model, that we call SUDR+K, is based on usual SIR model, but it splits the total fraction of infected individuals into two components: those that are undetected and those that are detected through tests. Moreover, we assume that available tests increase at a constant rate from the beginning of epidemics but are consumed to detect infected individuals. Strikingly we find a bi-stable behavior between a phase with a gian…
This paper is based on the observation that, during Covid-19 epidemic, the choice of which individuals should be tested has an important impact on the effectiveness of selective confinement measures. This decision problem is closely related to the problem of optimal sensor selection, which is a very active research subject in control engineering. The goal of this paper is to propose a policy to smartly select the individuals to be tested. The main idea is to model the epidemics as a stochastic dynamic system and to select the individual to be tested accordingly to some optimality criteria, e.g…
The detection and management of diseases become quite complicated when pathogens contain asymptomatic phenotypes amongst their ranks, as evident during the recent COVID-19 pandemic. Spreading of diseases has been studied extensively under the paradigm of Susceptible - Infected - Recovered - Deceased (SIRD) dynamics. Various game-theoretic approaches have also addressed disease spread, many of which consider S, I, R, and D as strategies rather than as states. Remarkably, most studies from the above approaches do not account for the distinction between the symptomatic or asymptomatic aspect of t…
Emerging epidemics and local infection clusters are initially prone to stochastic effects that can substantially impact the epidemic trajectory. While numerous studies are devoted to the deterministic regime of an established epidemic, mathematical descriptions of the initial phase of epidemic growth are comparatively rarer. Here, we review existing mathematical results on the epidemic size over time, and derive new results to elucidate the early dynamics of an infection cluster started by a single infected individual. We show that the initial growth of epidemics that eventually take off is ac…
Mumbai, amongst the most densely populated cities in the world, has witnessed the fourth largest number of cases and the largest number of deaths among all the cities in India (as of 28th October 2020). Along with the rest of India, lockdowns (of varying degrees) have been in effect in Mumbai since March 25, 2020. Given the large economic toll on the country from the lockdown and the related restrictions on mobility of people and goods, swift opening of the economy especially in a financial hub such as Mumbai becomes critical. In this report, we use the IISc-TIFR agent based simulator to devel…
Motivated by the increasing number of COVID-19 cases that have been observed in many countries after the vaccination and relaxation of non-pharmaceutical interventions, we propose a mathematical model on time-varying networks for the spread of recurrent epidemic diseases in a partially vaccinated population. The model encapsulates several realistic features, such as the different effectiveness of the vaccine against transmission and development of severe symptoms, testing practices, the possible implementation of non-pharmaceutical interventions to reduce the transmission, isolation of detecte…
We study the effects of switching social contacts as a strategy to control epidemic outbreaks. Connections between susceptible and infective individuals can be broken by either individual, and then reconnected to a randomly chosen member of the population. It is assumed that the reconnecting individual has no previous information on the epidemiological condition of the new contact. We show that reconnection can completely suppress the disease, both by continuous and discontinuous transitions between the endemic and the infection-free states. For diseases with an asymptomatic phase, we analyze …
Timely estimation of the current value for COVID-19 reproduction factor $R$ has become a key aim of efforts to inform management strategies. $R$ is an important metric used by policy-makers in setting mitigation levels and is also important for accurate modelling of epidemic progression. This brief paper introduces a method for estimating $R$ from biased case testing data. Using testing data, rather than hospitalisation or death data, provides a much earlier metric along the symptomatic progression scale. This can be hugely important when fighting the exponential nature of an epidemic. We deve…
Rapid antigen tests detect proteins at the surface of virus particles, identifying the disease during its infectious phase. In contrast, PCR tests detect viral genomes; they can thus diagnose COVID-19 before the infectious phase but also react to remnants of the virus genome, even weeks after live virus ceases to be detectable in the respiratory tract. Furthermore, the logistics for administering the tests are different, with rapid antigen tests being much easier to administer at-scale. In this article, we discuss the relative advantages of the different testing procedures and summarise eviden…
How to prevent the spread of human diseases is a great challenge for the scientific community and so far there are many studies in which immunization strategies have been developed. However, these kind of strategies usually do not consider that medical institutes may have limited vaccine resources available. In this manuscript, we explore the Susceptible-Infected-Recovered (SIR) model with local dynamic vaccination, and considering limited vaccines. In this model, susceptibles in contact with an infected individual, are vaccinated -with probability $ω$- and then get infected -with probability …
In this paper we propose an epidemiological model for the spread of COVID-19. The dynamics of the spread is based on four fundamental categories of people in a population: Tested and infected, Non-Tested but infected, Tested but not infected, and non-Tested and not infected. The model is based on two levels of dynamics of spread in the population: at local level and at the global level. The local level growth is described with data and parameters which include testing statistics for COVID-19, preventive measures such as nationwide lockdown, and the migration of people across neighboring locati…
In this article we propose a compartmental model for the dynamics of Coronavirus Disease 2019 (COVID-19). We take into account the presence of asymptomatic infections and the main policies that have been adopted so far to contain the epidemic: isolation (or social distancing) of a portion of the population, quarantine for confirmed cases and testing. We model isolation by separating the population in two groups: one composed by key-workers that keep working during the pandemic and have a usual contact rate, and a second group consisting of people that are enforced/recommended to stay at home. …
We propose a tractable epidemic model that includes containment measures. In the absence of containment measures, the epidemics spread exponentially fast whenever the infectivity rate is positive, $λ>0$. The containment measures are modeled by considering a time-dependent modulation of the bare infectivity $λ$ leading to effective infectivity that decays in time for each infected individual, mimicking for instance the combined effect of the asymptomatic onset of the disease, testing policies and quarantine. We consider a wide range of temporal kernels for effective infectivity and we investiga…
A significant proportion of the infections driving the current {SARS-CoV-2} pandemic are transmitted asymptomatically. Here we introduce and study a simple epidemic model with separate compartments comprising asymptomatic and symptomatic infected individuals. The linear dynamics determining the outbreak condition of the model is equivalent to a renewal theory approach with exponential waiting time distributions. Exploiting a nontrivial conservation law of the full nonlinear dynamics, we derive analytic bounds on the peak number of infections in the absence and presence of mitigation through is…
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 …
In this work, we provide a general mathematical formalism to study the optimal control of an epidemic, such as the COVID-19 pandemic, via incentives to lockdown and testing. In particular, we model the interplay between the government and the population as a principal-agent problem with moral hazard, à la Cvitanić, Possamaï, and Touzi [27], while an epidemic is spreading according to dynamics given by compartmental stochastic SIS or SIR models, as proposed respectively by Gray, Greenhalgh, Hu, Mao, and Pan [45] and Tornatore, Buccellato, and Vetro [88]. More precisely, to limit the spread of a…
Major advances in public health have resulted from disease prevention. However, prevention of a new infectious disease by vaccination or pharmaceuticals is made difficult by the slow process of vaccine and drug development. We propose an additional intervention that allows rapid control of emerging infectious diseases, and can also be used to eradicate diseases that rely almost exclusively on human-to-human transmission. The intervention is based on (1) testing every individual for the disease, (2) repeatedly, and (3) isolation of infected individuals. We show here that at a sufficient rate of…
The renowned general epidemic process describes the stochastic evolution of a population of individuals which are either susceptible, infected or dead. A second order phase transition belonging to the universality class of dynamic isotropic percolation lies between endemic or pandemic behavior of the process. We generalize the general epidemic process by introducing a fourth kind of individuals, viz. individuals which are weakened by the process but not yet infected. This sensibilization gives rise to a mechanism that introduces a global instability in the spreading of the process and therefor…
This paper gives an introduction to rule-based modelling applied to topics in infectious diseases. Rule-based models generalise reaction-based models with reagents that have internal state and may be bound together to form complexes, as in chemistry. Rule-based modelling is directly transferable from molecular biology to epidemiology and allows us to express a broad class of models for processes of interest in epidemiology that would not otherwise be feasible in compartmental models. This includes dynamics commonly found in compartmental models such as the spread of a virus from an infectious …
Motivated by the rapid spread of COVID-19 all across the globe, we have performed simulations of a system dynamic epidemic spread model in different possible situations. The simulation, not only captures the model dynamic of the spread of the virus, but also, takes care of population and mobility data. The model is calibrated based on epidemic data and events specifically of Pakistan, which can easily be generalized. The simulation results are quite disturbing, indicating that, even with stringent social distancing and testing strategies and for a quite long time (even beyond one year), the sp…
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…
MEmilio -- A high performance Modular EpideMIcs simuLatIOn software for multi-scale and comparative simulations of infectious disease dynamics
German Aerospace Center（德国航空航天中心）；University of Bonn（波恩大学）；Helmholtz Centre for Infection Research（亥姆霍兹感染研究中心）；Forschungszentrum Jülich GmbH（于利希研究中心有限公司）
Spatiotemporal modelling of infectious diseases such as COVID-19 involves using a variety of epidemiological metrics such as regional proportion of cases or regional positivity rates. Although observing their changes over time is critical to estimate the regional disease burden, the dynamical properties of these measures as well as cross-relationships are not systematically explained. Here we provide a spatiotemporal framework composed of six commonly used and newly constructed epidemiological metrics and conduct a case study evaluation. We introduce a refined risk model that is biased neither…
Modeling epidemic dynamics plays an important role in studying how diseases spread, predicting their future course, and designing strategies to control them. In this letter, we introduce a model of SIR (susceptible-infected-removed) type which explicitly incorporates the effect of {\it cooperative coinfection}. More precisely, each individual can get infected by two different diseases, and an individual already infected with one disease has an increased probability to get infected by the other. Depending on the amount of this increase, we observe different threshold scenarios. Apart from the s…
