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We develop a minimalist compartmental model to study the impact of mobility restrictions in Italy during the Covid-19 outbreak. We show that an early lockdown shifts the epidemic in time, while that beyond a critical value of the lockdown strength, the epidemic tend to restart after lifting the restrictions. As a consequence, specific mitigation strategies must be introduced. We characterize the relative importance of different broad strategies by accounting for two fundamental sources of heterogeneity, i.e. geography and demography. First, we consider Italian regions as separate administrative entities, in which social interactions between age classs occur. Due to the sparsity of the inter-regional mobility matrix, once started the epidemics tend to develop independently across areas, justifying the adoption of solutions specific to individual regions or to clusters of regions. Second, we show that social contacts between age classes play a fundamental role and that measures which take into account the age structure of the population can provide a significant contribution to mitigate the rebound effects. Our model is general, and while it does not analyze specific mitigation strategies, it highlights the relevance of some key parameters on non-pharmaceutical mitigation mechanisms for the epidemics.
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The dynamics of epidemics depend on how peoples behavior changes during an outbreak. The impact of this effect due to control interventions on the morbidity rate is obvious and supported by numerous studies based on SIR-type models. However, the existing models do not explain the difference in outbreak profiles in countries with different intrinsic socio-cultural features and are rather specific for describing the complex dynamics of an outbreak. A system of models of the COVID-19 pandemic is proposed, combining the dynamics of social stress described by the tools of sociophysics8 with classical epidemic models. Even the combination of a dynamic SIR model with the classic triad of stages of general adaptation syndrome, Alarm-Resistance-Exhaustion, makes it possible to describe the available statistics for various countries of the world with a high degree of accuracy. The conceptualization of social stress leads to the division of the vulnerable population into different groups according to behavior mode, which can be tracked in detail. The sets of kinetic constants corresponding to optimal fit of model to data clearly characterize the society ability to focus efforts on protection against pandemic and keep this concentration for a considerable time. Such characterization can further help in the development of management strategies specific to a particular society: country, region, or social group.
A generalisation of the Susceptible-Infectious model is made to include a time-dependent transmission rate, which leads to a close analytical expression in terms of a logistic function. The solution can be applied to any continuous function chosen to describe the evolution of the transmission rate with time. Taking inspiration from real data of the Covid-19, for the case of cumulative confirmed positives and deaths, we propose an exponentially decaying transmission rate with two free parameters, one for its initial amplitude and another one for its decaying rate. The resultant time-dependent SI model, which under extra conditions recovers the standard Gompertz functional form, is then compared with data from selected countries and its parameters fit using Bayesian inference. We make predictions about the asymptotic number of confirmed positives and deaths, and discuss the possible evolution of the disease in each country in terms of our parametrisation of the transmission rate.
We describe the population-based SEIR (susceptible, exposed, infected, removed) model developed by the Irish Epidemiological Modelling Advisory Group (IEMAG), which advises the Irish government on COVID-19 responses. The model assumes a time-varying effective contact rate (equivalently, a time-varying reproduction number) to model the effect of non-pharmaceutical interventions. A crucial technical challenge in applying such models is their accurate calibration to observed data, e.g., to the daily number of confirmed new cases, as the past history of the disease strongly affects predictions of future scenarios. We demonstrate an approach based on inversion of the SEIR equations in conjunction with statistical modelling and spline-fitting of the data, to produce a robust methodology for calibration of a wide class of models of this type.
The COVID-19 pandemic poses challenges for continuing economic activity while reducing health risks. While these challenges can be mitigated through testing, testing budget is often limited. Here we study how institutions, such as nursing homes, should utilize a fixed test budget for early detection of an outbreak. Using an extended network-SEIR model, we show that given a certain budget of tests, it is generally better to test smaller subgroups of the population frequently than to test larger groups but less frequently. The numerical results are consistent with an analytical expression we derive for the size of the outbreak at detection in an exponential spread model. Our work provides a simple guideline for institutions: distribute your total tests over several batches instead of using them all at once. We expect that in the appropriate scenarios, this easy-to-implement policy recommendation will lead to earlier detection and better mitigation of local COVID-19 outbreaks.
The current outbreak of the coronavirus disease 2019 (COVID-19) is an unprecedented example of how fast an infectious disease can spread around the globe (especially in urban areas) and the enormous impact it causes on public health and socio-economic activities. Despite the recent surge of investigations about different aspects of the COVID-19 pandemic, we still know little about the effects of city size on the propagation of this disease in urban areas. Here we investigate how the number of cases and deaths by COVID-19 scale with the population of Brazilian cities. Our results indicate small towns are proportionally more affected by COVID-19 during the initial spread of the disease, such that the cumulative numbers of cases and deaths per capita initially decrease with population size. However, during the long-term course of the pandemic, this urban advantage vanishes and large cities start to exhibit higher incidence of cases and deaths, such that every 1% rise in population is associated with a 0.14% increase in the number of fatalities per capita after about four months since the first two daily deaths. We argue that these patterns may be related to the existence of proportionally more health infrastructure in the largest cities and a lower proportion of older adults in large urban areas. We also find the initial growth rate of cases and deaths to be higher in large cities; however, these growth rates tend to decrease in large cities and to increase in small ones over time.
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