The traditional long-term solutions for epidemic control involve eradication or population immunity. Here, we analytically derive the existence of a third viable solution: a stable equilibrium at low case numbers, where test-trace-and-isolate policies partially compensate for local spreading events, and only moderate restrictions remain necessary. In this equilibrium, daily cases stabilize around ten new infections per million people or less. However, stability is endangered if restrictions are relaxed or case numbers grow too high. The latter destabilization marks a tipping point beyond which the spread self-accelerates. We show that a lockdown can reestablish control and that recurring lockdowns are not necessary given sustained, moderate contact reduction. We illustrate how this strategy profits from vaccination and helps mitigate variants of concern. This strategy reduces cumulative cases (and fatalities) 4x more than strategies that only avoid hospital collapse. In the long term, immunization, large-scale testing, and international coordination will further facilitate control.
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…
This research quantifies the various South African lockdown regimes, for the SARS-CoV-2 pandemic, in terms of the basic reproduction number, $r_0$. It further calculates the levels of immunity required for these selfsame lockdown regimes to begin to work and predicts perceived values, should infections have been underestimated by a factor of 10. The latter results are compelling. The first, level-5 lockdown was a valiant attempt to contain the highly infectious, SARS-CoV-2 virus, based on a limited knowledge. Its basic reproduction number ($r_0 = 1.93$) never came anywhere close to the require…
During a pandemic, there are conflicting demands arising from public health and economic cost. Lockdowns are a common way of containing infections, but they adversely affect the economy. We study the question of how to minimise the economic damage of a lockdown while still containing infections. Our analysis is based on the SIR model, which we analyse using a clock set by the virus. This use of the "virus time" permits a clean mathematical formulation of our problem. We optimise the economic cost for a fixed health cost and arrive at a strategy for navigating the pandemic. This involves adjust…
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…
The novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19 was declared a pandemic on March 11, 2020 by the World Health Organization. Since then, the disease has spread all over the world, with the United States becoming the country with the highest number of cases. Governments around the world have undertaken varying degrees of public safety measures, including recommendations and ad campaigns for improved hygiene practices, enacting social distancing requirements and limiting large public gatherings, and stay-at-home orders and lockdowns. In the United States, while the response…
This paper develops an agent-level simulation model, termed ALPS, for simulating the spread of an infectious disease in a confined community. The mechanism of transmission is agent-to-agent contact, using parameters reported for Corona COVID-19 pandemic. The main goal of the ALPS simulation is analyze effects of preventive measures -- imposition and lifting of lockdown norms -- on the rates of infections, fatalities and recoveries. The model assumptions and choices represent a balance between competing demands of being realistic and being efficient for real-time inferences. The model provides …
This work examines the use of reinforcement learning (RL) to optimize cyclic lockdowns, which is one of the methods available for control of the COVID-19 pandemic. The problem is structured as an optimal control system for tracking a reference value, corresponding to the maximum usage level of a critical resource, such as ICU beds. However, instead of using conventional optimal control methods, RL is used to find optimal control policies. A framework was developed to calculate optimal cyclic lockdown timings using an RL-based on-off controller. The RL-based controller is implemented as an RL a…
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…
Lockdown procedures have been proven successful in mitigating the spread of the viruses in this COVID-19 pandemic, but they also have devastating impact on the economy. We use a modified Susceptible-Infectious-Recovered-Deceased model with time dependent infection rate to simulate how the infection is spread under lockdown. The economic cost due to the loss of workforce and incurred medical expenses is evaluated with a simple model. We find the best strategy, meaning the smallest economic cost for the entire course of the pandemic, is to keep the strict lockdown as long as possible.
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…
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…
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…
SARS-COV-2 has stopped the world in its footsteps and a third of the population has been forced to stay at home. Here we present a comparative study of the performance of states of India, in curbing the spread of the disease, that are most affected by the pandemic. We have done so based on the data collected between 14th March, 2020 to 17th April, 2020. We do this by comparing the smoothened time series and percentage changes along with change point detection of the daily confirmed cases. We also discuss the different policies and strategies adopted by the states in curbing the disease and the…
Covid-19 is one of the most dreaded pandemics/epidemics in the world threatening the human population. The dynamics of this pandemic is quite complicated and prediction of pandemic states often fails. In this work, we study and correlate the SIR epidemiological model with the ongoing pandemic and found that pandemic dynamics and states are quite sensitively dependent on model parameters. The analysis of the exact parametric solution of the deterministic SIR model shows that the fixed points ($g^*$) depend on the SIR parameters, where, if $g^*\langle\fracγ{βx_0}$ then $g^*$ is stable and the pa…
Covid-19 is raging a devastating trail with the highest mortality-to-infected ratio ever for a pandemic. Lack of vaccine and therapeutic has rendered social exclusion through lockdown as the singular mode of containment. Harnessing the predictive powers of Machine Learning within a 6 dimensional infection kinetic model, depicting interactive evolution of 6 infection stages - healthy susceptible ($H$), predisposed comorbid susceptible ($P$), infected ($I$), recovered ($R$), herd immunized ($V$) and mortality ($D$) - the model, PHIRVD, provides the first accurate mortality prediction of 18 count…
The benefits, both in terms of productivity and public health, are investigated for different levels of engagement with the test, trace and isolate procedures in the context of a pandemic in which there is little or no herd immunity. Simple mathematical modelling is used in the context of a single, relatively closed workplace such as a factory or back-office where, in normal operation, each worker has lengthy interactions with a fixed set of colleagues. A discrete-time SEIR model on a fixed interaction graph is simulated with parameters that are motivated by the recent COVID-19 pandemic in the…
The effective reproduction number is a key figure to monitor the course of the COVID-19 pandemic. In this study we consider a retrospective modelling approach for estimating the effective reproduction number based on death counts during the first year of the pandemic in Germany. The proposed Bayesian hierarchical model incorporates splines to estimate reproduction numbers flexibly over time while adjusting for varying effective infection fatality rates. The approach also provides estimates of dark figures regarding undetected infections over time. Results for Germany illustrate that estimated …
Several non-pharmaceutical interventions have been proposed to control the spread of the COVID-19 pandemic. On the large scale, these empirical solutions, often associated with extended and complete lockdowns, attempt to minimize the costs associated with mortality, economic losses and social factors, while being subject to constraints such as finite hospital capacity. Here we pose the question of how to mitigate pandemic costs subject to constraints by adopting the language of optimal control theory. This allows us to determine top-down policies for the nature and dynamics of social contact r…
Several analytical models have been used in this work to describe the evolution of death cases arising from coronavirus (COVID-19). The Death or `D' model is a simplified version of the SIR (susceptible-infected-recovered) model, which assumes no recovery over time, and allows for the transmission-dynamics equations to be solved analytically. The D-model can be extended to describe various focuses of infection, which may account for the original pandemic (D1), the lockdown (D2) and other effects (Dn). The evolution of the COVID-19 pandemic in several countries (China, Spain, Italy, France, UK,…
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…
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 …
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）
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…
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 …
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 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 …
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…
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…
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…
In the context of the ongoing Covid-19 pandemic, several reports and studies have attempted to model and predict the spread of the disease. There is also intense debate about policies for limiting the damage, both to health and to the economy. On the one hand, the health and safety of the population is the principal consideration for most countries. On the other hand, we cannot ignore the potential for long-term economic damage caused by strict nation-wide lockdowns. In this working paper, we present a quantitative way to compute lockdown decisions for individual cities or regions, while balan…
In the framework of homogeneous susceptible-infected-recovered (SIR) models, we use a control theory approach to identify optimal pandemic mitigation strategies. We derive rather general conditions for reaching herd immunity while minimizing the costs incurred by the introduction of societal control measures (such as closing schools, social distancing, lockdowns, etc.), under the constraint that the infected fraction of the population does never exceed a certain maximum corresponding to public health system capacity. Optimality is derived and verified by variational and numerical methods for a…
We have proposed an SEIR compartmental mathematical model. The prime objective of this study is to analyze and forecast the pandemic in Italy for the upcoming months. The basic reproduction number has been calculated. Based on the current situation in Italy, in this paper, we will estimate the possible time for the end of the pandemic in the country. The impact of lockdown and rapid isolation on the spread of the pandemic are also discussed. Further, we have studied four of the most pandemic affected regions in Italy. Using the proposed model, a prediction has been made about the duration of p…
The pandemic caused by the novel Coronavirus SARS-CoV2 has been responsible for life threatening health complications, and extreme pressure on healthcare systems. While preventive and definite curative medical interventions are yet to arrive, Non-Pharmaceutical Interventions (NPIs) like physical isolation, quarantine and drastic social measures imposed by governing agencies are effective in arresting the spread of infections in a population. In densely populated countries like India, lockdown interventions are partially effective due to social and administrative complexities. Using detailed de…
COVID-19 is now the largest pandemic crisis of this century, with over 16 million registered cases worldwide. African countries have now begun registering an increasing number of cases, yet, not many models developed focus in specific African countries. In our study we use a simple SEIR model to evaluate and predict future scenarios regarding the pandemic crisis in Mozambique. We compare the effect of different policies on the infection curve and estimate epidemiological parameters such as the current infection reproduction number Rt and the growth rate g. We have found a low value for Rt, ran…
We here propose to model active and cumulative cases data from COVID-19 by a continuous effective model based on a modified diffusion equation under Lifshitz scaling with a dynamic diffusion coefficient. The proposed model is rich enough to capture different aspects of a complex virus diffusion as humanity has been recently facing. The model being continuous it is bound to be solved analytically and/or numerically. So, we investigate two possible models where the diffusion coefficient associated with possible types of contamination are captured by some specific profiles. The active cases curve…
The main focus of this chapter is on public health control strategies which are currently the main way to mitigate COVID-19 pandemic. We introduce and compare compartmental models of increasing complexity for COVID-19 transmission to describe dynamics of the disease spread. We begin by considering an SEAIR model including basic characteristics related to COVID-19. Next, we shall pay attention to age-structure modeling to emphasis the role of age-group individuals on the disease spread. A Model with constant delay is also formulated to show the impact of the latency period on the severity of CO…
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…
