Modelling preventive measures and their effect on generation times in emerging epidemics

Angular reproduction numbers improve estimates of transmissibility when disease generation times are misspecified or time-varying

We introduce the angular reproduction number Ω, which measures time-varying changes in epidemic transmissibility resulting from variations in both the effective reproduction number R, and generation time distribution w. Predominant approaches for tracking pathogen spread infer either R or the epidemic growth rate r. However, R is biased by mismatches between the assumed and true w, while r is difficult to interpret in terms of the individual-level branching process underpinning transmission. R and r may also disagree on the relative transmissibility of epidemics or variants (i.e. rA > rB does not imply RA > RB for variants A and B). We find that Ω responds meaningfully to mismatches and time-variations in w while mostly maintaining the interpretability of R. We prove that Ω > 1 implies R > 1 and that Ω agrees with r on the relative transmissibility of pathogens. Estimating Ω is no more difficult than inferring R, uses existing software, and requires no generation time measurements. These advantages come at the expense of selecting one free parameter. We propose Ω as complementary statistic to R and r that improves transmissibility estimates when w is misspecified or time-varying and better reflects the impact of interventions, when those interventions concurrently change R and w or alter the relative risk of co-circulating pathogens.

Generalized epidemic model incorporating non-Markovian infection processes and waning immunity

The Markovian approach, which assumes exponentially distributed interinfection times, is dominant in epidemic modeling. However, this assumption is unrealistic as an individual's infectiousness depends on its viral load and varies over time. In this paper, we present a Susceptible-Infected-Recovered-Vaccinated-Susceptible epidemic model incorporating non-Markovian infection processes. The model can be easily adapted to accurately capture the generation time distributions of emerging infectious diseases, which is essential for accurate epidemic prediction. We observe noticeable variations in the transient behavior under different infectiousness profiles and the same basic reproduction number R_{0}. The theoretical analyses show that only R_{0} and the mean immunity period of the vaccinated individuals have an impact on the critical vaccination rate needed to achieve herd immunity. A vaccination level at the critical vaccination rate can ensure a very low incidence among the population in the case of future epidemics, regardless of the infectiousness profiles.