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Register a new userQuantitative assessment of the role of undocumented infection in the 2019 novel coronavirus (COVID-19) pandemic
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An urgent problem in controlling COVID-19 spreading is to understand the role of undocumented infection. We develop a five-state model for COVID-19, taking into account the unique features of the novel coronavirus, with key parameters determined by the government reports and mathematical optimization. Tests using data from China, South Korea, Italy, and Iran indicate that the model is capable of generating accurate prediction of the daily accumulated number of confirmed cases and is entirely suitable for real-time prediction. The drastically disparate testing and diagnostic standards/policies among different countries lead to large variations in the estimated parameter values such as the duration of the outbreak, but such uncertainties have little effect on the occurrence time of the inflection point as predicted by the model, indicating its reliability and robustness. Model prediction for Italy suggests that insufficient government action leading to a large fraction of undocumented infection plays an important role in the abnormally high mortality in that country. With the data currently available from United Kingdom, our model predicts catastrophic epidemic scenarios in the country if the government did not impose strict travel and social distancing restrictions. A key finding is that, if the percentage of undocumented infection exceeds a threshold, a non-negligible hidden population can exist even after the the epidemic has been deemed over, implying the likelihood of future outbreaks should the currently imposed strict government actions be relaxed. This could make COVID-19 evolving into a long-term epidemic or a community disease a real possibility, suggesting the necessity to conduct universal testing and monitoring to identify the hidden individuals.
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The all-pervasive lens that humans ordinarily use to watch and analyze the pandemic is time. This article considers an alternative. Instead of tracking incidence as a function of time, new cases are counted as a function of cumulative cases. This resource-centric perspective, which is more natural and physically justified, is the perspective of the virus. In this article, we demonstrate the relevance of this approach by characterizing an outbreak as an independent increments Gaussian process that fluctuates about a deterministic curve, called the incidence-cumulative cases (ICC) curve. We illustrate these concepts on Influenza A and COVID-19 outbreaks in the US. The novel perspective presented here reveals universal properties of disease spread that would otherwise remain hidden.
Within a short period of time, COVID-19 grew into a world-wide pandemic. Transmission by pre-symptomatic and asymptomatic viral carriers rendered intervention and containment of the disease extremely challenging. Based on reported infection case studies, we construct an epidemiological model that focuses on transmission around the symptom onset. The model is calibrated against incubation period and pairwise transmission statistics during the initial outbreaks of the pandemic outside Wuhan with minimal non-pharmaceutical interventions. Mathematical treatment of the model yields explicit expressions for the size of latent and pre-symptomatic subpopulations during the exponential growth phase, with the local epidemic growth rate as input. We then explore reduction of the basic reproduction number R_0 through specific disease control measures such as contact tracing, testing, social distancing, wearing masks and sheltering in place. When these measures are implemented in combination, their effects on R_0 multiply. We also compare our model behaviour to the first wave of the COVID-19 spreading in various affected regions and highlight generic and less generic features of the pandemic development.
Chest computed tomography (CT) has played an essential diagnostic role in assessing patients with COVID-19 by showing disease-specific image features such as ground-glass opacity and consolidation. Image segmentation methods have proven to help quantify the disease burden and even help predict the outcome. The availability of longitudinal CT series may also result in an efficient and effective method to reliably assess the progression of COVID-19, monitor the healing process and the response to different therapeutic strategies. In this paper, we propose a new framework to identify infection at a voxel level (identification of healthy lung, consolidation, and ground-glass opacity) and visualize the progression of COVID-19 using sequential low-dose non-contrast CT scans. In particular, we devise a longitudinal segmentation network that utilizes the reference scan information to improve the performance of disease identification. Experimental results on a clinical longitudinal dataset collected in our institution show the effectiveness of the proposed method compared to the static deep neural networks for disease quantification.
Objectives.--To estimate the basic reproduction number of the Wuhan novel coronavirus (2019-nCoV). Methods.--Based on the susceptible-exposed-infected-removed (SEIR) compartment model and the assumption that the infectious cases with symptoms occurred before January 25, 2020 are resulted from free propagation without intervention, we estimate the basic reproduction number of 2019-nCoV according to the reported confirmed cases and suspected cases, as well as the theoretical estimated number of infected cases by other research teams, together with some epidemiological determinants learned from the severe acute respiratory syndrome. Results The basic reproduction number falls between 2.8 to 3.3 by using the real-time reports on the number of 2019-nCoV infected cases from Peoples Daily in China, and falls between 3.2 and 3.9 on the basis of the predicted number of infected cases from colleagues. Conclusions.--The early transmission ability of 2019-nCoV is closed to or slightly higher than SARS. It is a controllable disease with moderate-high transmissibility. Timely and effective control measures are needed to suppress the further transmissions. Notes Added.--Using a newly reported epidemiological determinants for early 2019-nCoV, the estimated basic reproduction number is in the range [2.2,3.0].
There is a continuing debate on relative benefits of various mitigation and suppression strategies aimed to control the spread of COVID-19. Here we report the results of agent-based modelling using a fine-grained computational simulation of the ongoing COVID-19 pandemic in Australia. This model is calibrated to match key characteristics of COVID-19 transmission. An important calibration outcome is the age-dependent fraction of symptomatic cases, with this fraction for children found to be one-fifth of such fraction for adults. We apply the model to compare several intervention strategies, including restrictions on international air travel, case isolation, home quarantine, social distancing with varying levels of compliance, and school closures. School closures are not found to bring decisive benefits, unless coupled with high level of social distancing compliance. We report several trade-offs, and an important transition across the levels of social distancing compliance, in the range between 70% and 80% levels, with compliance at the 90% level found to control the disease within 13--14 weeks, when coupled with effective case isolation and international travel restrictions.
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