The infection fatality rate (IFR) of COVID-19 is one of the measures of disease impact that can be of importance for policy making. Here we show that many of the studies on which these estimates are based are scientifically flawed for reasons which include: nonsensical equations, unjustified assumptions, small sample sizes, non-representative sampling (systematic biases), incorrect definitions of symptomatic and asymptomatic cases (identified and unidentified cases), typically assuming that cases which are asymptomatic at the time of testing are the same as completely asymptomatic (never symptomatic) cases. Moreover, a widely cited meta-analysis misrepresents some of the IFR values in the original studies, and makes inappropriate duplicate use of studies, or the information from studies, so that the results that are averaged are not independent from each other. The lack of validity of these research papers is of particular importance in view of their influence on policies that affect lives and well-being in confronting a worldwide pandemic.
We analyzed 5,484 close contacts of COVID-19 cases from Italy, all of them tested for SARS-CoV-2 infection. We found an infection fatality ratio of 2.2% (95%CI 1.69-2.81%) and identified male sex, age >70 years, cardiovascular comorbidities, and infection early in the epidemics as risk factors for death.
The relative case fatality rates (CFRs) between groups and countries are key measures of relative risk that guide policy decisions regarding scarce medical resource allocation during the ongoing COVID-19 pandemic. In the middle of an active outbreak when surveillance data is the primary source of information, estimating these quantities involves compensating for competing biases in time series of deaths, cases, and recoveries. These include time- and severity- dependent reporting of cases as well as time lags in observed patient outcomes. In the context of COVID-19 CFR estimation, we survey su…
As the ravages caused by COVID-19 pandemic are becoming inevitable with every moment, monitoring and understanding of transmission and fatality rate has become even more paramount for containing its spread. The key purpose of this analysis is to report the real-time effective reproduction rate ($R_t$ ) and case fatality rates (CFR) of COVID-19 in South Asia region. Data for this study are extracted from JHU CSSE COVID-19 Data source up to July 31, 2020. $R_t$ is estimated using exponential growth and time-dependent methods. R0 package in R-language is employed to estimate $R_t$ by fitting the …
The first cases of COVID-19 in France were detected on January 24, 2020. The number of screening tests carried out and the methodology used to target the patients tested do not allow for a direct computation of the real number of cases and the mortality rate.In this report, we develop a 'mechanistic-statistical' approach coupling a SIR ODE model describing the unobserved epidemiological dynamics, a probabilistic model describing the data acquisition process and a statistical inference method. The objective of this model is not to make forecasts but to estimate the real number of people infecte…
Understanding Covid-19 lethality and its variation from country to country is essential for supporting governments in the choice of appropriate strategies. Adopting correct indicators to monitor the lethality of the infection in the course of the outbreak is a crucial issue. This works highlights how far the time-dependent case fatality rate is a misleading indicator for estimating the fatality in the course of the outbreak, even if our attention is only restricted to the subset of confirmed cases. Our analysis proves that the final case fatality ratio for several major European countries is b…
A novel coronavirus disease (COVID-19) is sweeping the world and has taken away thousands of lives. As the current epicenter, the United States has the largest number of confirmed and death cases of COVID-19. Meteorological factors have been found associated with many respiratory diseases in the past studies. In order to understand that how and during which period of time do the meteorological factors have the strongest association with the transmission and fatality of COVID-19, we analyze the correlation between each meteorological factor during different time periods within the incubation wi…
In India the COVID-19 infected population has not yet been accurately established. As always in the early stages of any epidemic, the need to test serious cases first has meant that the population with asymptomatic or mild sub-clinical symptoms has not yet been analyzed. Using counts of fatalities, and previously estimated parameters for the progress of the disease, we give statistical estimates of the infected population. The doubling time is a crucial unknown input parameter which affects these estimates, and may differ strongly from one geographical location to another. We suggest a method …
Epidemic parameters are estimated through Bayesian inference using the daily fatality counts in Mumbai during the period from March 31 to April 14. A doubling time of 5.5 days (median with 95% CrI of 4.6-6.9 days) is observed. In the SEIR model this gives the basic reproduction rate R_0 of 3.4 (median with 95% CrI of 2.4-4.8). Using as input the infection fatality rate and the interval between infection and death, the number of infections in Mumbai is inferred. It is found that the ratio of the number of test positives to the total infections is 0.13\% (median), implying that tests are current…
The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic. Using German COVID-19 surveillance data and age-group specific IFR estimates from multiple international studies, this work investigates time-dependent variations in effective IFR over the course of the pandemic. Three different methods for estimating (effective) IFRs are presented: (a) population-averaged IFRs based on the assumption that the infection risk is independent of age and time, (b) effective IFRs based on the assumption that the age dist…
The case fatality ratio (CFR) for COVID-19 is difficult to estimate. One difficulty is due to ignoring or overestimating time delay between reporting and death. We claim that all of these cause large errors and artificial time dependence of the CFR. We find that for each country, there is a unique value of the time lag between reported cases and deaths versus time, that yields the optimal correlation between them is a specific sense. We find that the resulting corrected CFR (deaths shifted back by this time lag, divided by cases) is actually constant over many months, for many countries, but a…
The rapidly spreading Covid-19 that affected almost all countries, was first reported at the end of 2019. As a consequence of its highly infectious nature, countries all over the world have imposed extremely strict measures to control its spread. Since the earliest stages of this major pandemic, academics have done a huge amount of research in order to understand the disease, develop medication, vaccines and tests, and model its spread. Among these studies, a great deal of effort has been invested in the estimation of epidemic parameters in the early stage, for the countries affected by Covid-…
The COVID-19 pandemic has had high mortality rates in the elderly and frail worldwide, particularly in care homes. This is driven by the difficulty of isolating care homes from the wider community, the large population sizes within care facilities (relative to typical households), and the age/frailty of the residents. To quantify the mortality risk posed by disease, the case fatality risk (CFR) is an important tool. This quantifies the proportion of cases that result in death. Throughout the pandemic, CFR amongst care home residents in England has been monitored closely. To estimate CFR, we ap…
SARS-CoV-2 has disrupted the life of billions of people around the world since the first outbreak was officially declared in China at the beginning of 2020. Yet, important questions such as how deadly it is or its degree of spread within different countries remain unanswered. In this work, we exploit the `universal' growth of the mortality rate with age observed in different countries since the beginning of their respective outbreaks, combined with the results of the antibody prevalence tests in the population of Spain, to unveil both unknowns. We validate these results with an analogous antib…
Different ways of calculating mortality ratios during epidemics have yielded very different results, particularly during the current COVID-19 pandemic. We formulate both a survival probability model and an associated infection duration-dependent SIR model to define individual- and population-based estimates of dynamic mortality ratios. The key parameters that affect the dynamics of the different mortality estimates are the incubation period and the time individuals were infected before confirmation of infection. We stress that none of these ratios are accurately represented by the often misint…
Background: Recent work showed that the temporal growth of the novel coronavirus disease (COVID-19) follows a sub-exponential power-law scaling whenever effective control interventions are in place. Taking this into consideration, we present a new phenomenological logistic model that is well-suited for such power-law epidemic growth. Methods: We empirically develop the logistic growth model using simple scaling arguments, known boundary conditions and a comparison with available data from four countries, Belgium, China, Denmark and Germany, where (arguably) effective containment measures were …
The fatality rate of Covid-19 escalates with age and is larger in men than women. I show that these variations correlate strongly with the level of the viral receptor protein ACE2 in rat lungs, which is consistent with the still limited and apparently contradictory data on human ACE2. Surprisingly, lower levels of the receptor correlate with higher fatality. However, a previous mathematical model predicts that the speed of viral progression in the organism has a maximum and then declines with the receptor level. Moreover, many manifestations of severe CoViD-19, such as severe lung injury, exac…
Determinants of COVID-19 clinical severity are commonly assessed by transverse or longitudinal studies of the fatality counts. However, the fatality counts depend both on disease clinical severity and transmissibility, as more infected also lead to more deaths. Moreover, fatality counts (and related measures such as Case Fatality Rate) are dynamic quantities, as they appear with a delay to infections, while different geographic regions generally belong to different points on the epidemics curve. Instead, we use epidemiological modeling to propose a disease severity measure, which accounts for …
Relevance: Laboratory diagnosis of the novel coronavirus (SARS-CoV-2) infection combined with quarantine for contacts of infected individuals affects the spread of SARS-CoV-2 infection and levels of related mortality. Practices for testing for SARS-CoV-2 infection vary geographically in Russia. For example, in the city of St. Petersburg, where mortality rate for COVID-19 is the highest in the Russian Federation on Oct. 25, 2020, every death for COVID-19 corresponds to 15.7 detected cases of COVID-19 in the population, while the corresponding number for the whole of Russia is 58.1, suggesting l…
There are many hard-to-reconcile numbers circulating concerning Covid-19. Using reports from random testing, the fatality ratio per infection is evaluated and used to extract further information on the actual fraction of infections and the success of their identification for different countries.
The Italian government has been one of the most responsive to COVID-19 emergency, through the adoption of quick and increasingly stringent measures to contain the outbreak. Despite this, Italy has suffered a huge human and social cost, especially in Lombardy. The aim of this paper is dual: i) first, to investigate the reasons of the case fatality rate (CFR) differences across Italian 20 regions and 107 provinces, using a multivariate OLS regression approach; and ii) second, to build a taxonomy of provinces with similar mortality risk of COVID-19, by using the Ward hierarchical agglomerative cl…
We present a simple technique to compare the development of the Covid-19 epidemic in different regions, based only on the time series of confirmed cases. Weekly new infections, taken for every day, are interpreted as infection potential of Covid-19. We derive a robust time-varying reproduction rate for the infection potential, including asymptomatic cases, which does not depend on death rate or testing intensity. It requires few assumptions and shows a more plausible time course than official reproduction rates in several countries.
Forecasting new cases, hospitalizations, and disease-induced deaths is an important part of infectious disease surveillance and helps guide health officials in implementing effective countermeasures. For disease surveillance in the U.S., the Centers for Disease Control and Prevention (CDC) combine more than 65 individual forecasts of these numbers in an ensemble forecast at national and state levels. We collected data on CDC ensemble forecasts of COVID-19 fatalities in the United States, and compare them with easily interpretable ``Euler'' forecasts serving as a model-free benchmark that is on…
Within-host models of COVID-19 infection dynamics enable the merits of different forms of antiviral therapy to be assessed in individual patients. A stochastic agent-based model of COVID-19 intracellular dynamics is introduced here, that incorporates essential steps of the viral life cycle targeted by treatment options. Integration of model predictions with an intercellular ODE model of within-host infection dynamics, fitted to patient data, generates a generic profile of disease progression in patients that have recovered in the absence of treatment. This is contrasted with the profiles obtai…
In the absence of other tools, monitoring the effects of protective measures, including social distancing and forecasting the outcome of outbreaks is of immense interest. Real-time data is noisy and very often hampered by systematic errors in reporting. Detailed epidemic models may contain a large number of empirical parameters, which cannot be determined with sufficient accuracy. In this paper, we show that the cumulative number of deaths can be regarded as a master variable, and the parameters of the epidemic such as the basic reproduction number, the size of the susceptible population, and …
We propose a new mathematical model to study the coinfection dynamics of COVID-19 and bacterial pneumonia. Our model includes two infection ways for pneumonia, corresponding to community-acquired and hospital-acquired infections. We show that the existence and local stability of equilibria depend on three different parameters, which are interpreted as the basic reproduction numbers of COVID-19, bacterial pneumonia, and bacterial population. Numerical simulations are performed to complement our theoretical analysis, and we show that both diseases can persist if the basic reproduction number of …
One clear aspect of behaviour in the COVID-19 pandemic has been people's focus on, and response to, reported or observed infection numbers in their community. We describe a simple model of infectious disease spread in a pandemic situation where people's behaviour is influenced by the current risk of infection and where this behavioural response acts homeostatically to return infection risk to a certain preferred level. This model predicts that the reproduction rate $R$ will be centered around a median value of 1, and that a related measure of relative change in the number of new infections wil…
Despite commercial airlines mandating masks, there have been multiple documented events of COVID-19 superspreading on flights. We used available data from three flights, including cabin layout and seat locations of infected and uninfected passengers, to suggest interventions to mitigate COVID-19 superspreading events during air travel. Specifically, we studied: 1) London to Hanoi with 201 passengers, including 13 secondary infections among passengers; 2) Singapore to Hangzhou with 321 passengers, including 12 to 14 secondary infections; 3) a non-superspreading event on a private jet in Japan w…
This article reports a first update on the assesment of the model previously presented in arXiv:2003.13890v1. New available data have been used to feed the model and the comparison with real data still shows good agreement. The main novelty of the model is that it keeps track of the date of infection of a single individual and uses stochastic distributions to aggregate individuals who share the same date of infection. In addition, it uses two types of infections, mild and serious, with a different recovery time. These features are implemented in a set of differential equations which determine …
We investigate the distribution of numbers of secondary cases in households in the Office for National Statistics COVID-19 Infection Survey (ONS CIS), stratified by timing of vaccination and infection in the households. This shows a total effect of a statistically significant approximate halving of the secondary attack rate in households following vaccination.
Exploiting the SIQR model for COVID-19, I show that the wavy infection curve in Japan is the result of fluctuation of policy on isolation measure imposed by the government and obeyed by citizens. Assuming the infection coefficient be a two-valued function of the number of daily confirmed new cases, I show that when the removal rate of infected individuals is between these two values, the wavy infection curve is self-organized. On the basis of the infection curve, I classify the outbreak of COVID-19 into five types and show that these differences can be related to the relative magnitude of 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 …
An insufficient supply of effective SARS-CoV-2 vaccine in most countries demands an effective vaccination strategy to minimize the damage caused by the disease. Currently, many countries vaccinate their population in descending order of age (i.e. descending order of fatality rate) to minimize the deaths caused by the disease; however, the effectiveness of this strategy needs to be quantitatively assessed. We employ the susceptible-infected-recovered-dead (SIRD) model to investigate various vaccination strategies. We constructed a metapopulation model with heterogeneous contact and fatality rat…
In this short note we model the region-wise trends of the evolution to COVID-19 infections using a stochastic SIR model. The SIR dynamics are expressed using \textit{Itô-stochastic differential equations}. We first derive the parameters of the model from the available daily data from European regions based on a 24-day history of infections, recoveries and deaths. The derived parameters have been aggregated to project future trends for the Indian subcontinent, which is currently at an early stage in the infection cycle. The projections are meant to serve as a guideline for strategizing the soci…
In this paper we study the spatial spread of the COVID-19 infection in Lebanon. We inspect the spreading of the daily new infections across the 26 administrative districts of the country, and implement Moran's $I$ statistics in order to analyze the tempo-spatial clustering of the infection in relation to various variables parameterized by adjacency, proximity, population, population density, poverty rate and poverty density, and we find out that except for the poverty rate, the spread of the infection is clustered and associated to those parameters with varying magnitude for the time span betw…
Understanding how widely COVID-19 has spread is critical for examining the pandemic's progression. Despite efforts to carefully monitor the pandemic, the number of confirmed cases may underestimate the total number of infections. We introduce a demographic scaling model to estimate COVID-19 infections using an broadly applicable approach that is based on minimal data requirements: COVID-19 related deaths, infection fatality rates (IFRs), and life tables. As many countries lack reliable estimates of age-specific IFRs, we scale IFRs between countries using remaining life expectancy as a marker t…
The relation between the number of passengers in the main stations and the infection rate of COVID19 in Tokyo is empirically studied. Our analysis based on conventional compartment model suggests: 1) Average time from the true day of infection to the day the infections are reported is about $15$ days. 2) The scaling relation between the density of active population and the infection rate suggests that the increase of infection rate is linear to the active population rather than quadratic, as that is assumed in the conventional SIR model. 3) Notable deviations from the overall scaling relation …
The coronavirus disease 2019 (COVID-19) pandemic radically impacts our lives, while the transmission/infection and recovery dynamics of COVID-19 remain obscure. A time-dependent Susceptible, Exposed, Infectious, and Recovered (SEIR) model was proposed and applied to fit and then predict the time series of COVID-19 evolution observed in the last three months (till 3/22/2020) in various provinces and metropolises in China. The model results revealed the space dependent transmission/infection rate and the significant spatiotemporal variation in the recovery rate, likely due to the continuous impr…
This document aims to estimate and describe the effects of the social distancing measures implemented in several countries with the expectancy of controlling the spread of COVID-19. The procedure relies on the classic Susceptible-Infected-Removed (SIR) model, which is modified to incorporate a permissiveness index, representing the isolation achieved by the social distancing and the future development of vaccination campaigns and allowing the math model to reproduce more than one infection wave. The adjusted SIR models are used to study the compromise between the economy's reactivation and the…
We comparatively analyzed the spatiotemporal fluctuations of the 2019-novel coronavirus (COVID-19) and SARS outbreaks to understand their epidemiological characteristics. Methodologically, we introduced TPL (Taylor power law) to characterize their spatiotemporal heterogeneity/stability and Hubbell (2001) unified neutral theory of biodiversity (UNTB) [specifically Harris et al. (2015) HDP-MSN model (hierarchical Dirichlet process multi-site neutral model)] to approximate the metapopulation of coronavirus infections. First, TPL analysis suggested that the coronaviruses appear to have a specific …
We analyse the temporal and regional structure in mortality rates related to COVID-19 infections. We relate the fatality date of each deceased patient to the corresponding day of registration of the infection, leading to a nowcasting model which allows us to estimate the number of present-day infections that will, at a later date, prove to be fatal. The numbers are broken down to the district level in Germany. Given that death counts generally provide more reliable information on the spread of the disease compared to infection counts, which inevitably depend on testing strategy and capacity, t…
Some ideas are presented about the physical motivation of the apparent capacity of generalized logistic equations to describe the outbreak of the COVID-19 infection, and in general of quite many other epidemics. The main focuses here are: the complex, possibly fractal, structure of the locus describing the "contagion event set"; what can be learnt from the models of trophic webs with "herd behaviour".
The COVID-19 pandemic has posed significant challenges in modeling its complex epidemic transmissions, infection and contagion, which are very different from known epidemics. The challenges in quantifying COVID-19 complexities include effectively modeling its process and data uncertainties. The uncertainties are embedded in implicit and high-proportional undocumented infections, asymptomatic contagion, social reinforcement of infections, and various quality issues in the reported data. These uncertainties become even more apparent in the first two months of the COVID-19 pandemic, when the rele…
We present a robust data-driven machine learning analysis of the COVID-19 pandemic from its early infection dynamics, specifically infection counts over time. The goal is to extract actionable public health insights. These insights include the infectious force, the rate of a mild infection becoming serious, estimates for asymtomatic infections and predictions of new infections over time. We focus on USA data starting from the first confirmed infection on January 20 2020. Our methods reveal significant asymptomatic (hidden) infection, a lag of about 10 days, and we quantitatively confirm that t…
Aim of this manuscript is to show a simple method to infer the time-course of new COVID-19 infections (the most important information in order to establish the effect of containment strategies) from available aggregated data, such as number of deaths and hospitalizations. The method, that was used for HIV-AIDS and was named `back-calculation', relies on good estimates of the distribution of the delays between infection and the observed events; assuming that the epidemic follows a simple SIR model with a known generation interval, we can then estimate the parameters that define the time-varying…
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…
We propose to use the mean time between infections (MTBI) metric as obtained from a recently introduced non-homogeneous Markov stochastic model. Different types of parameter calibration are performed. We estimate the MTBI using data from different time windows and from the whole stage history and compare the results. In order to detect waves and stages in the input data, a preprocessing filtering technique is applied. The results of applying this indicator to the COVID-19 reported data of infections from Argentina, Germany and the United States are shown. We find that the MTBI behaves similarl…
Phenomenological and deterministic models are often used for the estimation of transmission parameters in an epidemic and for the prediction of its growth trajectory. Such analyses are usually based on single peak outbreak dynamics. In light of the present COVID-19 pandemic, there is a pressing need to better understand observed epidemic growth with multiple peak structures, preferably using first-principles methods. Along the lines of our previous work [Physica A 574, 126014 (2021)], here we apply 2D random-walk Monte Carlo calculations to better understand COVID-19 spread through contact int…
Widespread growth signatures in COVID-19 confirmed case counts are reported, with sharp transitions between three distinct dynamical regimes (exponential, superlinear and sublinear). Through analytical and numerical analysis, a novel framework is developed that exploits information in these signatures. An approach well known to physics is applied, where one looks for common dynamical features, independently from differences in other factors. These features and associated scaling laws are used as a powerful tool to pinpoint regions where analytical derivations are effective, get an insight into…
Epidemiological models with constant parameters may not capture satisfactory infection patterns in the presence of pharmaceutical and non-pharmaceutical mitigation measures during a pandemic, since infectiousness is a function of time. In this paper, an Epidemiology-Informed Neural Network algorithm is introduced to learn the time-varying transmission rate for the COVID-19 pandemic in the presence of various mitigation scenarios. There are asymptomatic infectives, mostly unreported, and the proposed algorithm learns the proportion of the total infective individuals that are asymptomatic infect…
Last time, an attempt was made to analyze the first wave of COVID-19 in Japan from February to May 2020 by the Avrami equation. This time, all infection waves that occurred repeatedly from February 2020 to September 2021 were simulated by developing the last work. The entire waveform was basically simulated by the superposition of five major waves, and the least-squares method was applied to each wave to determine the parameters of the equation. Despite the simulation using the single equation assuming that the parameters were constants, the accuracy of the simulated cumulative infection D was…
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 adapt the hybrid mechanistic-statistical approach of Ref. [1] to estimate the total number of undocumented Covid-19 infections in Cuba. This scheme is based on the maximum likelihood estimation of a SIR-like model parameters for the infected population, assuming that the detection process matches a Bernoulli trial. Our estimations show that (a) 60% of the infections were undocumented, (b) the real epidemics behind the data peaked ten days before the reports suggested, and (c) the reproduction number swiftly vanishes after 80 epidemic days.
A model of reactive social distancing in epidemics is proposed, in which the infection rate changes with the number infected. The final-size equation for the total number that the epidemic will infect can be derived analytically, as can the peak infection proportion. This model could assist planners during for example the COVID-19 pandemic.
The infections and fatalities due to SARS-CoV-2 virus for cases specific to India have been studied using a deterministic susceptible-exposed-infected-recovered-dead (SEIRD) compartmental model. One of the most significant epidemiological parameter, namely the effective reproduction number of the infection is extracted from the daily growth rate data of reported infections and it is included in the model with a time variation. We evaluate the effect of control interventions implemented till now and estimate the case numbers for infections and deaths averted by these restrictive measures. We fu…
In this paper, we introduce a novel modeling framework for incorporating fear of infection and frustration with social distancing into disease dynamics. We show that the resulting SEIR behavior-perception model has three principal modes of qualitative behavior---no outbreak, controlled outbreak, and uncontrolled outbreak. We also demonstrate that the model can produce transient and sustained waves of infection consistent with secondary outbreaks. We fit the model to cumulative COVID-19 case and mortality data from several regions. Our analysis suggests that regions which experience a significa…
The number of new infections per day is a key quantity for effective epidemic management. It can be estimated relatively directly by testing of random population samples. Without such direct epidemiological measurement, other approaches are required to infer whether the number of new cases is likely to be increasing or decreasing: for example, estimating the pathogen effective reproduction number, R, using data gathered from the clinical response to the disease. For Covid-19 (SARS-CoV-2) such R estimation is heavily dependent on modelling assumptions, because the available clinical case data a…
