Modelling a pandemic with asymptomatic patients, impact of lockdown and herd immunity, with applications to SARS-CoV-2

Asymptotic analysis on a new stochastic epidemic model involving isolation mechanism

In this paper, a new stochastic epidemic model is established and the dynamical behavior of its solutions is studied for this model. A deterministic epidemic model (ordinary differential equation) is first proposed by considering the isolation mechanism, and the transmission probability function is determined by a Wells-Riley model method to analyze the transmission in the quarantine. For this deterministic model, the basic reproduction number R0 is computed and it is used to determine the existence of disease-free and positive equilibria. The linearized stability of the equilibria is also discussed by analyzing the distribution of eigenvalues of the linear system. Following that, a corresponding stochastic epidemic model is further established by introducing stochastic disturbance. Then, the extinction result of the model is derived also with the help of the basic reproduction number R0s. Furthermore, by applying the theory of Markov semigroups, it is proved that the densities of the distributions of the solutions can converge to an invariant density or sweeping under certain conditions. At last, some numerical simulations are provided and discussed to illustrate the practicability of the model and the obtained theoretical results.

Taking cues from machine learning, compartmental and time series models for SARS-CoV-2 omicron infection in Indian provinces

SARS-CoV-2, the virus responsible for COVID-19, posed a significant threat to the world. We analyzed COVID-19 dissemination data in the top ten Indian provinces by infection incidences using the Susceptible-Infectious-Removed (SIR) model, an Autoregressive Integrated Moving Average (ARIMA) time series model, a machine learning model based on the Random Forest, and distribution fitting. Outbreaks are expected to continue if the Basic Reproduction Number (R0) > 1, and infection waves are anticipated to end if the R0 < 1, as determined by the SIR model. Different parametric probability distributions are also fitted. Data collected from December 12, 2021, to March 31, 2022, encompassing data from both before and during the implementation of strict control measures. Based on the estimates of the model parameters, health agencies and government policymakers can develop strategies to combat the spread of the disease in the future, and the most effective technique can be recommended for real-world application for other outbreaks of COVID-19. The best method out of these could be also implemented further on the epidemiological data of other similar infectious agents.

Learning to Mitigate Epidemic Risks: A Dynamic Population Game Approach

We present a dynamic population game model to capture the behavior of a large population of individuals in presence of an infectious disease or epidemic. Individuals can be in one of five possible infection states at any given time: susceptible, asymptomatic, symptomatic, recovered and unknowingly recovered, and choose whether to opt for vaccination, testing or social activity with a certain degree. We define the evolution of the proportion of agents in each epidemic state, and the notion of best response for agents that maximize long-run discounted expected reward as a function of the current state and policy. We further show the existence of a stationary Nash equilibrium and explore the transient evolution of the disease states and individual behavior under a class of evolutionary learning dynamics. Our results provide compelling insights into how individuals evaluate the trade-off among vaccination, testing and social activity under different parameter regimes, and the impact of different intervention strategies (such as restrictions on social activity) on vaccination and infection prevalence.

A survey on Lyapunov functions for epidemic compartmental models

In this survey, we propose an overview on Lyapunov functions for a variety of compartmental models in epidemiology. We exhibit the most widely employed functions, and provide a commentary on their use. Our aim is to provide a comprehensive starting point to readers who are attempting to prove global stability of systems of ODEs. The focus is on mathematical epidemiology, however some of the functions and strategies presented in this paper can be adapted to a wider variety of models, such as prey-predator or rumor spreading.

The Transmission Dynamics of a Compartmental Epidemic Model for COVID-19 with the Asymptomatic Population via Closed-Form Solutions

Unlike previous viral diseases, COVID-19 has an "asymptomatic" group that has no symptoms but can still spread the disease to others at the same rate as symptomatic patients who are infected. In the literature, the mass action or standard incidence rates are considered for compartmental models with asymptomatic compartment for studying the transmission dynamics of COVID-19, but the quarantined adjusted incidence rate is not. To bridge this gap, we developed a Susceptible Asymptomatic Infectious Quarantined (SAIQ) model with a Quarantine-Adjusted (QA) incidence to investigate the emergence and containment of COVID-19. COVID-19 models are investigated using various methods, but only a few studies take into account closed-form solutions. The knowledge of closed-form solutions simplifies the construction of the various epidemic indicators that describe the epidemic phenomenon and makes the sensitivity analysis to variations in the data under consideration possible. The closed-form solutions of the systems of four nonlinear first-order ordinary differential equations (ODEs) are established. The Epidemic Peak (EP), Force of Infection (FOI) and Rate of Infection (ROI) are the important indicators for the control and prevention of disease. We examined these indicators using closed-form solutions and particular parameter values. Different disease control scenarios are thoroughly examined. The four scenarios to analyze COVID-19 propagation and containment are (i) lockdown, (ii) quarantine and other preventative measures, (iii) stabilizing the basic reproduction rate to a level where the pandemic can be contained and (iv) containing the epidemic through an appropriate combination of lockdown, quarantine and other preventative measures.

Modelling the first wave of COVID-19 in India

Estimating the burden of COVID-19 in India is difficult because the extent to which cases and deaths have been undercounted is hard to assess. Here, we use a 9-component, age-stratified, contact-structured epidemiological compartmental model, which we call the INDSCI-SIM model, to analyse the first wave of COVID-19 spread in India. We use INDSCI-SIM, together with Bayesian methods, to obtain optimal fits to daily reported cases and deaths across the span of the first wave of the Indian pandemic, over the period Jan 30, 2020 to Feb 15, 2021. We account for lock-downs and other non-pharmaceutical interventions (NPIs), an overall increase in testing as a function of time, the under-counting of cases and deaths, and a range of age-specific infection-fatality ratios. We first use our model to describe data from all individual districts of the state of Karnataka, benchmarking our calculations using data from serological surveys. We then extend this approach to aggregated data for Karnataka state. We model the progress of the pandemic across the cities of Delhi, Mumbai, Pune, Bengaluru and Chennai, and then for India as a whole. We estimate that deaths were undercounted by a factor between 2 and 5 across the span of the first wave, converging on 2.2 as a representative multiplier that accounts for the urban-rural gradient. We also estimate an overall under-counting of cases by a factor of between 20 and 25 towards the end of the first wave. Our estimates of the infection fatality ratio (IFR) are in the range 0.05—0.15, broadly consistent with previous estimates but substantially lower than values that have been estimated for other LMIC countries. We find that approximately 35% of India had been infected overall by the end of the first wave, results broadly consistent with those from serosurveys. These results contribute to the understanding of the long-term trajectory of COVID-19 in India.

Making sense of publicly available epidemiological data for the COVID-19 pandemic in India presents multiple challenges, largely to do with the quality of the data. Here, we describe ways of addressing these questions by studying the data using a well-parameterised, detailed compartmental model together with Bayesian methods, alongside information derived from pan-India serological surveys. We focus on the first wave of the Indian pandemic, across the interval Jan 30, 2020 to Feb 15, 2021. We estimate that deaths were under-counted by a factor between 2 and 5 across the span of the first wave and that cases were under-counted by a factor of between 20 and 25 towards its end. We estimate an infection fatality ratio (IFR) in the range 0.05—0.15. We find that approximately 35% of India had been infected overall by the end of the first wave, a number that helps us better understand the context in which the second and later waves unfolded.

Usage of Compartmental Models in Predicting COVID-19 Outbreaks

Accurately predicting the spread of the SARS-CoV-2, the cause of the COVID-19 pandemic, is of great value for global regulatory authorities to overcome a number of challenges including medication shortage, outcome of vaccination, and control strategies planning. Modeling methods that are used to simulate and predict the spread of COVID-19 include compartmental model, structured metapopulations, agent-based networks, deep learning, and complex network, with compartmental modeling as one of the most widely used methods. Compartmental model has two noteworthy features, a flexible framework that allows users to easily customize the model structure and its high adaptivity that allows well-matured approaches (e.g., Bayesian inference and mixed-effects modeling) to improve parameter estimation. We retrospectively evaluated the prediction performances of the compartmental models on the CDC COVID-19 Mathematical Modeling webpage based on data collected between August 2020 and February 2021, and subsequently discussed in detail their corresponding model enhancement. Finally, we presented examples using the compartmental models to assist policymaking. By evaluating all models in parallel, we systemically evaluated the performance and evolution of using compartmental models for COVID-19 pandemic prediction. In summary, as a 100-year-old epidemic approach, the compartmental model presents a powerful tool that is extremely adaptive and can be readily customized and implemented to address new data or emerging needs during a pandemic.

Heterogeneous adaptive behavioral responses may increase epidemic burden

Non-pharmaceutical interventions (NPIs) constitute the front-line responses against epidemics. Yet, the interdependence of control measures and individual microeconomics, beliefs, perceptions and health incentives, is not well understood. Epidemics constitute complex adaptive systems where individual behavioral decisions drive and are driven by, among other things, the risk of infection. To study the impact of heterogeneous behavioral responses on the epidemic burden, we formulate a two risk-groups mathematical model that incorporates individual behavioral decisions driven by risk perceptions. Our results show a trade-off between the efforts to avoid infection by the risk-evader population, and the proportion of risk-taker individuals with relaxed infection risk perceptions. We show that, in a structured population, privately computed optimal behavioral responses may lead to an increase in the final size of the epidemic, when compared to the homogeneous behavior scenario. Moreover, we find that uncertain information on the individuals’ true health state may lead to worse epidemic outcomes, ultimately depending on the population’s risk-group composition. Finally, we find there is a set of specific optimal planning horizons minimizing the final epidemic size, which depend on the population structure.

New Results and Open Questions for SIR-PH Epidemic Models with Linear Birth Rate, Loss of Immunity, Vaccination, and Disease and Vaccination Fatalities

Our paper presents three new classes of models: SIR-PH, SIR-PH-FA, and SIR-PH-IA, and states two problems we would like to solve about them. Recall that deterministic mathematical epidemiology has one basic general law, the “R0 alternative” of Van den Driessche and Watmough, which states that the local stability condition of the disease-free equilibrium may be expressed as R0<1, where R0 is the famous basic reproduction number, which also plays a major role in the theory of branching processes. The literature suggests that it is impossible to find general laws concerning the endemic points. However, it is quite common that 1. When R0>1, there exists a unique fixed endemic point, and 2. the endemic point is locally stable when R0>1. One would like to establish these properties for a large class of realistic epidemic models (and we do not include here epidemics without casualties). We have introduced recently a “simple” but broad class of “SIR-PH models” with varying populations, with the express purpose of establishing for these processes the two properties above. Since that seemed still hard, we have introduced a further class of “SIR-PH-FA” models, which may be interpreted as approximations for the SIR-PH models, and which include simpler models typically studied in the literature (with constant population, without loss of immunity, etc.). For this class, the first “endemic law” above is “almost established”, as explicit formulas for a unique endemic point are available, independently of the number of infectious compartments, and it only remains to check its belonging to the invariant domain. This may yet turn out to be always verified, but we have not been able to establish that. However, the second property, the sufficiency of R0>1 for the local stability of an endemic point, remains open even for SIR-PH-FA models, despite the numerous particular cases in which it was checked to hold (via Routh–Hurwitz time-onerous computations, or Lyapunov functions). The goal of our paper is to draw attention to the two open problems above, for the SIR-PH and SIR-PH-FA, and also for a second, more refined “intermediate approximation” SIR-PH-IA. We illustrate the current status-quo by presenting new results on a generalization of the SAIRS epidemic model.

Computing R0 of dynamic models by a definition-based method

Objectives

Computing the basic reproduction number (R₀) in deterministic dynamical models is a hot topic and is frequently demanded by researchers in public health. The next-generation methods (NGM) are widely used for such computation, however, the results of NGM are usually not to be the true R₀ but only a threshold quantity with little interpretation. In this paper, a definition-based method (DBM) is proposed to solve such a problem.

Methods

Start with the definition of R₀, consider different states that one infected individual may develop into, and take expectations. A comparison with NGM has proceeded. Numerical verification is performed using parameters fitted by data of COVID-19 in Hunan Province.

Results

DBM and NGM give identical expressions for single-host models with single-group and interactive R_ij of single-host models with multi-groups, while difference arises for models partitioned into subgroups. Numerical verification showed the consistencies and differences between DBM and NGM, which supports the conclusion that R₀ derived by DBM with true epidemiological interpretations are better.

Conclusions

DBM is more suitable for single-host models, especially for models partitioned into subgroups. However, for multi-host dynamic models where the true R₀ is failed to define, we may turn to the NGM for the threshold R₀.

Why Controlling the Asymptomatic Infection Is Important: A Modelling Study with Stability and Sensitivity Analysis

The large proportion of asymptomatic patients is the major cause leading to the COVID-19 pandemic which is still a significant threat to the whole world. A six-dimensional ODE system (SEIAQR epidemical model) is established to study the dynamics of COVID-19 spreading considering infection by exposed, infected, and asymptomatic cases. The basic reproduction number derived from the model is more comprehensive including the contribution from the exposed, infected, and asymptomatic patients. For this more complex six-dimensional ODE system, we investigate the global and local stability of disease-free equilibrium, as well as the endemic equilibrium, whereas most studies overlooked asymptomatic infection or some other virus transmission features. In the sensitivity analysis, the parameters related to the asymptomatic play a significant role not only in the basic reproduction number R0. It is also found that the asymptomatic infection greatly affected the endemic equilibrium. Either in completely eradicating the disease or achieving a more realistic goal to reduce the COVID-19 cases in an endemic equilibrium, the importance of controlling the asymptomatic infection should be emphasized. The three-dimensional phase diagrams demonstrate the convergence point of the COVID-19 spreading under different initial conditions. In particular, massive infections will occur as shown in the phase diagram quantitatively in the case R0>1. Moreover, two four-dimensional contour maps of Rt are given varying with different parameters, which can offer better intuitive instructions on the control of the pandemic by adjusting policy-related parameters.

A Time-Delayed Deterministic Model for the Spread of COVID-19 with Calibration on a Real Dataset

During the evolution of the COVID-19 pandemic, each country has adopted different control measures to contrast the epidemic’s diffusion. Restrictions to mobility, public transport, and social life in general have been actuated to contain the spread of the pandemic. In this paper, we consider the deterministic SIRD model with delays proposed by (Calleri et al., 2021), which is improved by adding the vaccinated compartment V (SIRDV model) and considering a time-dependent contact frequency. The three delays take into account the incubation time of the disease, the healing time, and the death time. The aim of this work is to study the effect of the vaccination campaigns in Great Britain (GBR) and Israel (ISR) during the pandemic period. The different restriction periods are included by fitting the contact frequency on real datasets as a piecewise constant function. As expected, the vaccination campaign reduces the amount of deaths and infected people. Furthermore, for the different levels of restriction policy, we find specific values of the contact frequency that can be used to predict the trend of the pandemic.

Game-Theoretic Frameworks for Epidemic Spreading and Human Decision-Making: A Review

This review presents and reviews various solved and open problems in developing, analyzing, and mitigating epidemic spreading processes under human decision-making. We provide a review of a range of epidemic models and explain the pros and cons of different epidemic models. We exhibit the art of coupling between epidemic models and decision models in the existing literature. More specifically, we provide answers to fundamental questions in human decision-making amid epidemics, including what interventions to take to combat the disease, who are decision-makers, and when and how to take interventions, and how to make interventions. Among many decision models, game-theoretic models have become increasingly crucial in modeling human responses or behavior amid epidemics in the last decade. In this review, we motivate the game-theoretic approach to human decision-making amid epidemics. This review provides an overview of the existing literature by developing a multi-dimensional taxonomy, which categorizes existing literature based on multiple dimensions, including (1) types of games, such as differential games, stochastic games, evolutionary games, and static games; (2) types of interventions, such as social distancing, vaccination, quarantine, and taking antidotes; (3) the types of decision-makers, such as individuals, adversaries, and central authorities at different hierarchical levels. A fine-grained dynamic game framework is proposed to capture the essence of game-theoretic decision-making amid epidemics. We showcase three representative frameworks with unique ways of integrating game-theoretic decision-making into the epidemic models from a vast body of literature. Each of the three frameworks has their unique way of modeling and analyzing and develops results from different angles. In the end, we identify several main open problems and research gaps left to be addressed and filled.

Convex output feedback model predictive control for mitigation of COVID-19 pandemic

In this paper, a model predictive control approach is proposed for epidemic mitigation. The disease spreading dynamics is described by an 8-compartment smooth nonlinear model of the COVID-19 pandemic in Hungary known from the literature, where the manipulable control input is the stringency of the introduced non-pharmaceutical measures. It is assumed that only the number of hospitalized people is measured on-line, and the other state variables are computed using a state observer which is based on the dynamic inversion of a linear sub-system of the model. The objective function contains a measure of the direct harmful consequences of the restrictions, and the constraints refer to input bounds and to the capacity of the healthcare system. By exploiting the special properties of the model, the nonlinear optimization problem required by the control design is reformulated to convex tasks, allowing a computationally efficient solution. Two approaches are proposed: the first finds a suboptimal solution by geometric programming, while the second one further simplifies the problem and transforms it to a linear programming task. Simulations show that both suboptimal solutions fulfill the design specifications even in the presence of parameter uncertainties.

Continuous-time stochastic processes for the spread of COVID-19 disease simulated via a Monte Carlo approach and comparison with deterministic models

Two stochastic models are proposed to describe the evolution of the COVID-19 pandemic. In the first model the population is partitioned into four compartments: susceptible S, infected I, removed R and dead people D. In order to have a cross validation, a deterministic version of such a model is also devised which is represented by a system of ordinary differential equations with delays. In the second stochastic model two further compartments are added: the class A of asymptomatic individuals and the class L of isolated infected people. Effects such as social distancing measures are easily included and the consequences are analyzed. Numerical solutions are obtained with Monte Carlo simulations. Quantitative predictions are provided which can be useful for the evaluation of political measures, e.g. the obtained results suggest that strategies based on herd immunity are too risky. Finally, the models are calibrated on data referring to the second wave of infection in Italy.

Transmission dynamics of novel coronavirus SARS-CoV-2 among healthcare workers, a case study in Iran

One of the main concerns during the COVID-19 pandemic was the protection of healthcare workers against the novel coronavirus. The critical role and vulnerability of healthcare workers during the COVID-19 pandemic leads us to derive a mathematical model to express the spread of coronavirus between the healthcare workers. In the first step, the SECIRH model is introduced, and then the mathematical equations are written. The proposed model includes eight state variables, i.e., Susceptible, Exposed, Carrier, Infected, Hospitalized, ICU admitted, Dead, and finally Recovered. In this model, the vaccination, protective equipment, and recruitment policy are considered as preventive actions. The formal confirmed data provided by the Iranian ministry of health is used to simulate the proposed model. The simulation results revealed that the proposed model has a high degree of consistency with the actual COVID-19 daily statistics. In addition, the roles of vaccination, protective equipment, and recruitment policy for the elimination of coronavirus among the healthcare workers are investigated. The results of this research help the policymakers to adopt the best decisions against the spread of coronavirus among healthcare workers.

An SEIR model with infected immigrants and recovered emigrants

We present a deterministic SEIR model of the said form. The population in point can be considered as consisting of a local population together with a migrant subpopulation. The migrants come into the local population for a short stay. In particular, the model allows for a constant inflow of individuals into different classes and constant outflow of individuals from the R-class. The system of ordinary differential equations has positive solutions and the infected classes remain above specified threshold levels. The equilibrium points are shown to be asymptotically stable. The utility of the model is demonstrated by way of an application to measles.

Modelling SARS-CoV-2 unreported cases in Italy: Analysis of serological survey and vaccination scenarios

OBJECTIVES

Aim of the present paper is the study of the large unreported component, characterizing the SARS-CoV-2 epidemic event in Italy, taking advantage of the Istat survey. Particular attention is devoted to the sensitivity and specificity of the serological test and their effects.

METHODS

The model satisfactory reproduces the data of the Italian survey showing a relevant predictive power and relegating in a secondary position models which do not include, in the simulation, the presence of asymptomatic groups. The corrections due to the serological test sensitivity (in particular those ones depending on the symptoms onset) are crucial for a realistic analysis of the unreported (and asymptomatic) components.

RESULTS

The relevant presence of an unreported component during the second pandemic wave in Italy is confirmed and the ratio of reported to unreported cases is predicted to be roughly 1:4 in the last months of year 2020. A method to correct the serological data on the basis of the antibody sensitivity is suggested and systematically applied. The asymptomatic component is also studied in some detail and its amount quantified. A model analyses of the vaccination scenarios is performed confirming the relevance of a massive campaign (at least 80000 immunized per day) during the first six months of the year 2021, to obtain important immunization effects within August/September 2021.

Data-driven methods for present and future pandemics: Monitoring, modelling and managing

This survey analyses the role of data-driven methodologies for pandemic modelling and control. We provide a roadmap from the access to epidemiological data sources to the control of epidemic phenomena. We review the available methodologies and discuss the challenges in the development of data-driven strategies to combat the spreading of infectious diseases. Our aim is to bring together several different disciplines required to provide a holistic approach to epidemic analysis, such as data science, epidemiology, and systems-and-control theory. A 3M-analysis is presented, whose three pillars are: Monitoring, Modelling and Managing. The focus is on the potential of data-driven schemes to address three different challenges raised by a pandemic: (i) monitoring the epidemic evolution and assessing the effectiveness of the adopted countermeasures; (ii) modelling and forecasting the spread of the epidemic; (iii) making timely decisions to manage, mitigate and suppress the contagion. For each step of this roadmap, we review consolidated theoretical approaches (including data-driven methodologies that have been shown to be successful in other contexts) and discuss their application to past or present epidemics, such as Covid-19, as well as their potential application to future epidemics.

Analysis of Second Wave of COVID-19 in Different Countries

We analyse the evolution of the second wave of the COVID-19 pandemic in several countries by using a logistic model. The model uses a regression analysis based on the least-squares fitting. In particular, the growth rate of the infection has been fitted as an exponential increase, as compared to a power law increase, reported previously in logistic models. The data shows that the increase in the exponent of the exponential increase is around 0.03 day- 1 , with a standard deviation of 0.01  day- 1 . The present results suggest that duration of the peaking of the second wave is almost same for several countries considered. The growth rate is also on the same order of several countries regardless of the total number of infections in a particular country. Since the decay of the growth rate is self-similar to that during the increase in the second wave of several countries, we can predict the end of the second wave in India. The model suggests that the second wave will end in the first week of August 2021, with a growth rate of 0.1% day- 1 at that time.

Viral dynamics and antibody responses in people with asymptomatic SARS-CoV-2 infection

Over 40% of the coronavirus disease 2019 (COVID-19) COVID-19 patients were asymptomatically infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the immune responses of these asymptomatic individuals is a critical factor for developing the strategy to contain the COVID-19 pandemic. Here, we determined the viral dynamics and antibody responses among 143 asymptomatic individuals identified in a massive screening of more than 5 million people in eight districts of Wuhan in May 2020. Asymptomatic individuals were admitted to the government-designated centralized sites in accordance with policy. The incidence rate of asymptomatic infection is ~2.92/100,000. These individuals had low viral copy numbers (peaked at 315 copies/mL) and short-lived antibody responses with the estimated diminish time of 69 days. The antibody responses in individuals with persistent SARS-CoV-2 infection is much longer with the estimated diminish time of 257 days. These results imply that the immune responses in the asymptomatic individuals are not potent enough for preventing SARS-CoV-2 re-infection, which has recently been reported in recovered COVID-19 patients. This casts doubt on the efficacy of forming “herd-immunity” through natural SARS-CoV-2 infection and urges for the development of safe and effective vaccines.

Modelling the spread of SARS-CoV-2 pandemic - Impact of lockdowns & interventions

BACKGROUND & OBJECTIVES

To handle the current COVID-19 pandemic in India, multiple strategies have been applied and implemented to slow down the virus transmission. These included clinical management of active cases, rapid development of treatment strategies, vaccines computational modelling and statistical tools to name a few. This article presents a mathematical model for a time series prediction and analyzes the impact of the lockdown.

METHODS

Several existing mathematical models were not able to account for asymptomatic patients, with limited testing capability at onset and no data on serosurveillance. In this study, a new model was used which was developed on lines of susceptible-asymptomatic-infected-recovered (SAIR) to assess the impact of the lockdown and make predictions on its future course. Four parameters were used, namely β, γ, η and ε. β measures the likelihood of the susceptible person getting infected, and γ denotes recovery rate of patients. The ratio β/γ is denoted by R0 (basic reproduction number).

RESULTS

The disease spread was reduced due to initial lockdown. An increase in γ reflects healthcare and hospital services, medications and protocols put in place. In Delhi, the predictions from the model were corroborated with July and September serosurveys, which showed antibodies in 23.5 and 33 per cent population, respectively.

INTERPRETATION & CONCLUSIONS

The SAIR model has helped understand the disease better. If the model is correct, we may have reached herd immunity with about 380 million people already infected. However, personal protective measures remain crucial. If there was no lockdown, the number of active infections would have peaked at close to 14.7 million, resulted in more than 2.6 million deaths, and the peak would have arrived by June 2020. The number of deaths with the current trends may be less than 0.2 million.

Universal features of epidemic models under social distancing guidelines

Social distancing as a form of nonpharmaceutical intervention has been enacted in many countries as a form of mitigating the spread of COVID-19. There has been a large interest in mathematical modeling to aid in the prediction of both the total infected population and virus-related deaths, as well as to aid government agencies in decision making. As the virus continues to spread, there are both economic and sociological incentives to minimize time spent with strict distancing mandates enforced, and/or to adopt periodically relaxed distancing protocols, which allow for scheduled economic activity. The main objective of this study is to reduce the disease burden in a population, here measured as the peak of the infected population, while simultaneously minimizing the length of time the population is socially distanced, utilizing both a single period of social distancing as well as periodic relaxation. We derive a linear relationship among the optimal start time and duration of a single interval of social distancing from an approximation of the classic epidemic SIR model. Furthermore, we see a sharp phase transition region in start times for a single pulse of distancing, where the peak of the infected population changes rapidly; notably, this transition occurs well before one would intuitively expect. By numerical investigation of more sophisticated epidemiological models designed specifically to describe the COVID-19 pandemic, we see that all share remarkably similar dynamic characteristics when contact rates are subject to periodic or one-shot changes, and hence lead us to conclude that these features are universal in epidemic models. On the other hand, the nonlinearity of epidemic models leads to non-monotone behavior of the peak of infected population under periodic relaxation of social distancing policies. This observation led us to hypothesize that an additional single interval social distancing at a proper time can significantly decrease the infected peak of periodic policies, and we verified this improvement numerically. While synchronous quarantine and social distancing mandates across populations effectively minimize the spread of an epidemic over the world, relaxation decisions should not be enacted at the same time for different populations.

Mathematical Model of the Role of Asymptomatic Infection in Outbreaks of Some Emerging Pathogens

Preparation for outbreaks of emerging infectious diseases is often predicated on beliefs that we will be able to understand the epidemiological nature of an outbreak early into its inception. However, since many rare emerging diseases exhibit different epidemiological behaviors from outbreak to outbreak, early and accurate estimation of the epidemiological situation may not be straightforward in all cases. Previous studies have proposed considering the role of active asymptomatic infections co-emerging and co-circulating as part of the process of emergence of a novel pathogen. Thus far, consideration of the role of asymptomatic infections in emerging disease dynamics have usually avoided considering some important sets of influences. In this paper, we present and analyze a mathematical model to explore the hypothetical scenario that some (re)emerging diseases may actually be able to maintain stable, endemic circulation successfully in an entirely asymptomatic state. We argue that an understanding of this potential mechanism for diversity in observed epidemiological dynamics may be of considerable importance in understanding and preparing for outbreaks of novel and/or emerging diseases.

What Can COVID-19 Teach Us about Using AI in Pandemics?

The COVID-19 pandemic put significant strain on societies and their resources, with the healthcare system and workers being particularly affected. Artificial Intelligence (AI) offers the unique possibility of improving the response to a pandemic as it emerges and evolves. Here, we utilize the WHO framework of a pandemic evolution to analyze the various AI applications. Specifically, we analyzed AI from the perspective of all five domains of the WHO pandemic response. To effectively review the current scattered literature, we organized a sample of relevant literature from various professional and popular resources. The article concludes with a consideration of AI’s weaknesses as key factors affecting AI in future pandemic preparedness and response.