No Arabic abstract
This study presents a new risk-averse multi-stage stochastic epidemics-ventilator-logistics compartmental model to address the resource allocation challenges of mitigating COVID-19. This epidemiological logistics model involves the uncertainty of untested asymptomatic infections and incorporates short-term human migration. Disease transmission is also forecasted through a new formulation of transmission rates that evolve over space and time with respect to various non-pharmaceutical interventions, such as wearing masks, social distancing, and lockdown. The proposed multi-stage stochastic model overviews different scenarios on the number of asymptomatic individuals while optimizing the distribution of resources, such as ventilators, to minimize the total expected number of newly infected and deceased people. The Conditional Value at Risk (CVaR) is also incorporated into the multi-stage mean-risk model to allow for a trade-off between the weighted expected loss due to the outbreak and the expected risks associated with experiencing disastrous pandemic scenarios. We apply our multi-stage mean-risk epidemics-ventilator-logistics model to the case of controlling the COVID-19 in highly-impacted counties of New York and New Jersey. We calibrate, validate, and test our model using actual infection, population, and migration data. The results indicate that short-term migration influences the transmission of the disease significantly. The optimal number of ventilators allocated to each region depends on various factors, including the number of initial infections, disease transmission rates, initial ICU capacity, the population of a geographical location, and the availability of ventilator supply. Our data-driven modeling framework can be adapted to study the disease transmission dynamics and logistics of other similar epidemics and pandemics.
We analyze risk factors correlated with the initial transmission growth rate of the recent COVID-19 pandemic in different countries. The number of cases follows in its early stages an almost exponential expansion; we chose as a starting point in each country the first day $d_i$ with 30 cases and we fitted for 12 days, capturing thus the early exponential growth. We looked then for linear correlations of the exponents $alpha$ with other variables, for a sample of 126 countries. We find a positive correlation, {it i.e. faster spread of COVID-19}, with high confidence level with the following variables, with respective $p$-value: low Temperature ($4cdot10^{-7}$), high ratio of old vs.~working-age people ($3cdot10^{-6}$), life expectancy ($8cdot10^{-6}$), number of international tourists ($1cdot10^{-5}$), earlier epidemic starting date $d_i$ ($2cdot10^{-5}$), high level of physical contact in greeting habits ($6 cdot 10^{-5}$), lung cancer prevalence ($6 cdot 10^{-5}$), obesity in males ($1 cdot 10^{-4}$), share of population in urban areas ($2cdot10^{-4}$), cancer prevalence ($3 cdot 10^{-4}$), alcohol consumption ($0.0019$), daily smoking prevalence ($0.0036$), UV index ($0.004$, 73 countries). We also find a correlation with low Vitamin D levels ($0.002-0.006$, smaller sample, $sim 50$ countries, to be confirmed on a larger sample). There is highly significant correlation also with blood types: positive correlation with types RH- ($3cdot10^{-5}$) and A+ ($3cdot10^{-3}$), negative correlation with B+ ($2cdot10^{-4}$). Several of the above variables are intercorrelated and likely to have common interpretations. We performed a Principal Component Analysis, in order to find their significant independent linear combinations. We also analyzed a possible bias: countries with low GDP-per capita might have less testing and we discuss correlation with the above variables.
A mathematical model for the COVID-19 pandemic spread, which integrates age-structured Susceptible-Exposed-Infected-Recovered-Deceased dynamics with real mobile phone data accounting for the population mobility, is presented. The dynamical model adjustment is performed via Approximate Bayesian Computation. Optimal lockdown and exit strategies are determined based on nonlinear model predictive control, constrained to public-health and socio-economic factors. Through an extensive computational validation of the methodology, it is shown that it is possible to compute robust exit strategies with realistic reduced mobility values to inform public policy making, and we exemplify the applicability of the methodology using datasets from England and France. Code implementing the described experiments is available at https://github.com/OptimalLockdown.
The coronavirus disease 2019 (COVID-19) had caused more that 8 million infections as of middle June 2020. Recently, Brazil has become a new epicentre of COVID-19, while India and African region are potential epicentres. This study aims to predict the inflection point and outbreak size of these new/potential epicentres at the early phase of the epidemics by borrowing information from more `mature curves from other countries. We modeled the cumulative cases to the well-known sigmoid growth curves to describe the epidemic trends under the mixed-effect models and using the four-parameter logistic model after power transformations. African region is predicted to have the largest total outbreak size of 3.9 million cases (2.2 to 6 million), and the inflection will come around September 13, 2020. Brazil and India are predicted to have a similar final outbreak size of around 2.5 million cases (1.1 to 4.3 million), with the inflection points arriving June 23 and July 26, respectively. We conclude in Brazil, India, and African the epidemics of COVI19 have not yet passed the inflection points; these regions potentially can take over USA in terms of outbreak size
Since the recent introduction of several viable vaccines for SARS-CoV-2, vaccination uptake has become the key factor that will determine our success in containing the COVID-19 pandemic. We argue that game theory and social network models should be used to guide decisions pertaining to vaccination programmes for the best possible results. In the months following the introduction of vaccines, their availability and the human resources needed to run the vaccination programmes have been scarce in many countries. Vaccine hesitancy is also being encountered from some sections of the general public. We emphasize that decision-making under uncertainty and imperfect information, and with only conditionally optimal outcomes, is a unique forte of established game-theoretic modelling. Therefore, we can use this approach to obtain the best framework for modelling and simulating vaccination prioritization and uptake that will be readily available to inform important policy decisions for the optimal control of the COVID-19 pandemic.
In a world being hit by waves of COVID-19, vaccination is a light on the horizon. However, the roll-out of vaccination strategies and their influence on the pandemic are still open problems. In order to compare the effect of various strategies proposed by the World Health Organization and other authorities, a previously developed SEIRS stochastic model of geographical spreading of the virus is extended by adding a compartment for vaccinated people. The parameters of the model were fitted to describe the pandemic evolution in Argentina, Mexico and Spain to analyze the effect of the proposed vaccination strategies. The mobility parameters allow to simulate different social behaviors (e.g. lock-down interventions). Schemes in which vaccines are applied homogeneously in all the country, or limited to the most densely-populated areas, are simulated and compared. The second strategy is found to be more effective. Moreover, under the current global shortage of vaccines, it should be remarked that immunization is enhanced when mobility is reduced. Additionally, repetition of vaccination campaigns should be timed considering the immunity lapse of the vaccinated (and recovered) people. Finally, the model is extended to include the effect of isolation of detected positive cases, shown to be important to reduce infections.