Intervention to maximise the probability of epidemic fade-out

Optimal control of an SIR epidemic through finite-time non-pharmaceutical intervention

We consider the problem of controlling an SIR-model epidemic by temporarily reducing the rate of contact within a population. The control takes the form of a multiplicative reduction in the contact rate of infectious individuals. The control is allowed to be applied only over a finite time interval, while the objective is to minimize the total number of individuals infected in the long-time limit, subject to some cost function for the control. We first consider the no-cost scenario and analytically determine the optimal control and solution. We then study solutions when a cost of intervention is included, as well as a cost associated with overwhelming the available medical resources. Examples are studied through the numerical solution of the associated Hamilton-Jacobi-Bellman equation. Finally, we provide some examples related directly to the current pandemic.

Key questions for modelling COVID-19 exit strategies

Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented. Here, we report discussions from the Isaac Newton Institute 'Models for an exit strategy' workshop (11-15 May 2020). A diverse community of modellers who are providing evidence to governments worldwide were asked to identify the main questions that, if answered, would allow for more accurate predictions of the effects of different exit strategies. Based on these questions, we propose a roadmap to facilitate the development of reliable models to guide exit strategies. This roadmap requires a global collaborative effort from the scientific community and policymakers, and has three parts: (i) improve estimation of key epidemiological parameters; (ii) understand sources of heterogeneity in populations; and (iii) focus on requirements for data collection, particularly in low-to-middle-income countries. This will provide important information for planning exit strategies that balance socio-economic benefits with public health.