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 archetypal susceptible-infectious-recovered (SIR) model and we use data about the first confirmed cases to train a neural network that learns to make predictions about the rest of the population. Using these prediction, we manage to contain the outbreak more effectively and more quickly than with standard approaches. Furthermore, we demonstrate how this method can be used also when there is a possibility of reinfection (SIRS model) to efficiently eradicate an endemic disease.
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…
Resource support between individuals is of particular importance in controlling or mitigating epidemic spreading, especially during pandemics. Whereas there remains the question of how we can protect ourselves from being infected while helping others by donating resources in fighting against the epidemic. To answer the question, we propose a novel resource allocation model by considering the awareness of self-protection of individuals. In the model, a tuning parameter is introduced to quantify the reaction strength of individuals when they are aware of the disease. And then, a coupled model of…
Here, we focus on the data analysis of the growth of epidemic spread of Covid-19 in countries where different policies of containment were activated. It is known that the growth of pandemic spread at its threshold is exponential, but it is not known how to quantify the success of different containment policies. We identify that a successful approach gives an arrested phase regime following the Ostwald growth, where, over the course of time, one phase transforms into another metastable phase with a similar free energy as observed in oxygen interstitial diffusion in quantum complex matter and in…
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…
During the COVID pandemic, periods of exponential growth of the disease have been mitigated by containment measures that in different occasions have resulted in a power-law growth of the number of cases. The first observation of such behaviour has been obtained from 2020 late spring data coming from China by Ziff and Ziff in Ref. [1]. After this important observation the power-law scaling (albeit with different exponents) has also been observed in other countries during periods of containment of the spread. Early interpretations of these results suggest that this phenomenon might be due to spa…
The Covid-19 epidemic of the novel coronavirus (severe acute respiratory syndrome SARS - CoV-2) has been spreading around the world. While different containment policies using non-pharmaceutical interventions have been applied, their efficiency are not known quantitatively. We show that the doubling time Td(t) with the success s factor, the characteristic time of the exponential growth of Td(t) in the arrested regime, is a reliable tool for early predictions of epidemic spread time evolution and it provides a quantitative measure of the success of different containment measures. The efficiency…
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…
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…
Assessing and managing the impact of large-scale epidemics considering only the individual risk and severity of the disease is exceedingly difficult and could be extremely expensive. Economic consequences, infrastructure and service disruption, as well as the recovery speed, are just a few of the many dimensions along which to quantify the effect of an epidemic on society's fabric. Here, we extend the concept of resilience to characterize epidemics in structured populations, by defining the system-wide critical functionality that combines an individual's risk of getting the disease (disease at…
Effectiveness of probabilistic contact tracing in epidemic containment: the role of super-spreaders and transmission path reconstruction
Politecnico di Torino（都灵理工大学）；Italian Institute for Genomic Medicine（意大利基因组医学研究所）；Politecnico di Milano（米兰理工大学）；Universidad Complutense（康普顿斯大学）；Collegio Carlo Alberto（卡洛·阿尔贝托学院）
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…
The rapid spread of the Coronavirus (COVID-19) confronts policy makers with the problem of measuring the effectiveness of containment strategies, balancing public health considerations with the economic costs of social distancing measures. We introduce a modified epidemic model that we name the controlled-SIR model, in which the disease reproduction rate evolves dynamically in response to political and societal reactions. An analytic solution is presented. The model reproduces official COVID-19 cases counts of a large number of regions and countries that surpassed the first peak of the outbrea…
During an epidemic control, the containment of the disease is usually achieved through increasing devoted resource to shorten the duration of infectiousness. However, the impact of this resource expenditure has not been studied quantitatively. Using the well-documented cholera data, we observe empirically that the recovery rate which is related to the duration of infectiousness has a strong positive correlation with the average resource devoted to the infected individuals. By incorporating this relation we build a novel model and find that insufficient resource leads to an abrupt increase in t…
So far most of the analysis of coronavirus 2020 epidemic data has been focusing on a short-time window and consequently a quantitative test of statistical physical laws of Coronavirus Epidemics with Containment Measures (CEwCM) is currently lacking. Here we report a quantitative analysis of CEwCM over 230 days, covering the full-time lapse of the first epidemic wave. We use a 3D phase diagram tracking the simultaneous evolution of the doubling time Td(t) and reproductive number Rt(t) showing that this expanded parameter space is needed for biological physics of CEwCP. We have verified that in …
In this paper, we study the dynamics of contagious spreading processes taking place in complex contact networks. We specifically present a lower-bound on the decay rate of the number of nodes infected by a susceptible-infected-susceptible (SIS) stochastic spreading process. A precise quantification of this decay rate is crucial for designing efficient strategies to contain epidemic outbreaks. However, existing lower-bounds on the decay rate based on first-order mean-field approximations are often accompanied by a large error resulting in inefficient containment strategies. To overcome this def…
Max Planck Institute for Intelligent Systems（马克斯·普朗克智能系统研究所）；ETH Zürich（苏黎世联邦理工学院）；Imperial College（帝国理工学院）
Simulating the spread of infectious diseases in human communities is critical for predicting the trajectory of an epidemic and verifying various policies to control the devastating impacts of the outbreak. Many existing simulators are based on compartment models that divide people into a few subsets and simulate the dynamics among those subsets using hypothesized differential equations. However, these models lack the requisite granularity to study the effect of intelligent policies that influence every individual in a particular way. In this work, we introduce a simulator software capable of m…
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 a…
Containment measures implemented by some countries to suppress the spread of COVID-19 have resulted in a slowdown of the epidemic characterized by time series of daily infections plateauing over extended periods of time. We prove that such a dynamical pattern is compatible with critical Susceptible-Infected-Removed (SIR) dynamics. In traditional analyses of the critical SIR model, the critical dynamical regime is started from a single infected node. The application of containment measures to an ongoing epidemic, however, has the effect to make the system enter in its critical regime with a num…
We study the effect of the connectivity pattern of complex networks on the propagation dynamics of epidemics. The growth time scale of outbreaks is inversely proportional to the network degree fluctuations, signaling that epidemics spread almost instantaneously in networks with scale-free degree distributions. This feature is associated with an epidemic propagation that follows a precise hierarchical dynamics. Once the highly connected hubs are reached, the infection pervades the network in a progressive cascade across smaller degree classes. The present results are relevant for the developmen…
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…
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic threatens the health of humans and causes great economic losses. Predictive modelling and forecasting the epidemic trends are essential for developing countermeasures to mitigate this pandemic. We develop a network model, where each node represents an individual and the edges represent contacts between individuals where the infection can spread. The individuals are classified based on the number of contacts they have each day (their node degrees) and their infection status. The transmission network model was respectively fitted to the re…
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…
For centuries isolation has been the main control strategy of unforeseen epidemic outbreaks. When implemented in full and without delay, isolation is very effective. However, flawless implementation is seldom feasible in practice. We present an epidemic model called SIQ with an isolation protocol, focusing on the consequences of delays and incomplete identification of infected hosts. The continuum limit of this model is a system of Delay Differential Equations, the analysis of which reveals clearly the dependence of epidemic evolution on model parameters including disease reproductive number, …
COVID-19 has spread from China across Europe and the United States and has become a global pandemic. In countries of the Global South, due to often weaker socioeconomic options and health care systems, effective local countermeasures remain debated. We combine large-scale socioeconomic and traffic survey data with detailed agent-based simulations of local transportation to analyze COVID-19 spreading in a regional model for the Nelson Mandela Bay Municipality in South Africa under a range of countermeasure scenarios. The simulations indicate that any realistic containment strategy, including th…
ETH Zürich（苏黎世联邦理工学院）；Max Planck Institute for Intelligent Systems（马克斯·普朗克智能系统研究所）；École Polytechnique Fédérale de Lausanne（洛桑联邦理工学院）；Max Planck Institute for Software Systems（马克斯·普朗克软件系统研究所）；Zerobase Foundation（零基基金会）
Multiple lines of evidence strongly suggest that infection hotspots, where a single individual infects many others, play a key role in the transmission dynamics of COVID-19. However, most of the existing epidemiological models fail to capture this aspect by neither representing the sites visited by individuals explicitly nor characterizing disease transmission as a function of individual mobility patterns. In this work, we introduce a temporal point process modeling framework that specifically represents visits to the sites where individuals get in contact and infect each other. Under our mode…
After the sudden outbreak of Coronavirus in Wuhan, continuous and rich data of the epidemic has been made public as the vital fact for decision support in control measures and aggressive implementation of containment strategies and plans. With the further growth and spreading of the virus, future resource allocation and planning under updated strategies and measures rely on careful study of the epidemic data and characteristics for accurate prediction and estimation. By using the SIR model and reported data, key parameters are obtained from least sum of squared errors for an accurate predictio…
We propose an epidemiological model that includes the mobility patterns of the individuals, in the spirit to those considered in (Barmak, 2011, 2016) and (Medus, 2011). We assume that people move around in a city of 120x120 blocks with 300 inhabitants in each block. The mobility pattern is associated to a complex network in which nodes represent blocks while the links represent the traveling path of the individuals. We implemented three confinement strategies in order to mitigate the disease spreading: 1) global confinement, 2) partial restriction to mobility, and 3) localized confinement. In …
The recent outbreak of COVID-19 in Mainland China is characterized by a distinctive algebraic, sub-exponential increase of confirmed cases during the early phase of the epidemic, contrasting an initial exponential growth expected for an unconstrained outbreak with sufficiently large reproduction rate. Although case counts vary significantly between affected provinces in Mainland China, the scaling law $t^μ$ is surprisingly universal, with a range of exponents $μ=2.1\pm0.3$. The universality of this behavior indicates that despite social, regional, demographical, geographical, and socio-economi…
In the context of the ongoing Ebola epidemic in DRC, active conflict and community distrust are undermining control efforts, including vaccination strategies. In this paper, we employed an individual-level stochastic structured transmission model to assess the impact of vaccination strategies on epidemic control in the context of variable levels of household inaccessibility. We found that a ring vaccination strategy of close contacts would not be effective for containing the epidemic in the context of significant delays to vaccinating contacts even for low levels of household inaccessibility a…
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…
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…
We propose a novel testing and containment strategy in order to contain the spread of SARS-CoV2 while permitting large parts of the population to resume social and economic activity. Our approach recognises the fact that testing capacities are severely constrained in many countries. In this setting, we show that finding the best way to utilise this limited number of tests during a pandemic can be formulated concisely as an allocation problem. Our problem formulation takes into account the heterogeneity of the population and uses pooled testing to identify and isolate individuals while prioriti…
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…
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 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…
After their re-emergence in the last decades, dengue fever and other vector-borne diseases are a potential threat to the lives of millions of people. Based on a data set of dengue cases in the Brazilian city of Fortaleza, collected from 2011 to 2016, we study the spatio-temporal characteristics of dengue outbreaks to characterize epidemic and non-epidemic years. First, we identify regions that show a high prevalence of dengue cases and mosquito larvae in different years and also analyze their corresponding correlations. Our results show that the characteristic correlation length of the epidemi…
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…
Assessing the risk of epidemic spread on networks and developing strategies for its containment is of tremendous practical importance, both due to direct effects in public health and its impact on economies. In this work we present the numerical results of a stochastic, event-driven, hierarchical agent-based model designed to reproduce the infectious dynamics of the cattle disease called Bovine Viral Diarrhea (BVD), for which the corresponding network of movements is the main route of spreading. For the farm-node dynamics, the model takes into account a vast number of breeding, infectious and …
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…
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…
In late December 2019, a novel strand of Coronavirus (SARS-CoV-2) causing a severe, potentially fatal respiratory syndrome (COVID-19) was identified in Wuhan, Hubei Province, China and is causing outbreaks in multiple world countries, soon becoming a pandemic. Italy has now become the most hit country outside of Asia: on March 16, 2020, the Italian Civil Protection documented a total of 27980 confirmed cases and 2158 deaths of people tested positive for SARS-CoV-2. In the context of an emerging infectious disease outbreak, it is of paramount importance to predict the trend of the epidemic in o…
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. …
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…
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 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…
Consider a Markovian SIR epidemic model in a homogeneous community. To this model we add a rate at which individuals are tested, and once an infectious individual tests positive it is isolated and each of their contacts are traced and tested independently with some fixed probability. If such a traced individual tests positive it is isolated, and the contact tracing is iterated. This model is analysed using large population approximations, both for the early stage of the epidemic when the "to-be-traced components" of the epidemic behaves like a branching process, and for the main stage of the e…
We study the effectiveness of tracking and testing in mitigating or suppressing epidemic outbreaks, in combination with or as an alternative to quarantines and global lockdowns. We study these intervention methods on a network-based SEIR model, augmented with an additional probability to model symptomatic, asymptomatic and pre-symptomatic cases. Our focus is on the basic trade-offs between economic costs and human lives lost, and how these trade-offs change under different lockdown, quarantine, tracking and testing policies. Our main findings are as follows: (i) Tests combined with patient qua…
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…
