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Register a new userModeling and Control of COVID-19 Epidemic through Testing Policies
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Added by
Muhammad Umar B. Niazi
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Testing for the infected cases is one of the most important mechanisms to control an epidemic. It enables to isolate the detected infected individuals, thereby limiting the disease transmission to the susceptible population. However, despite the significance of testing policies, the recent literature on the subject lacks a control-theoretic perspective. In this work, an epidemic model that incorporates the testing rate as a control input is presented. The proposed model differentiates the undetected infected from the detected infected cases, who are assumed to be removed from the disease spreading process in the population. First, the model is estimated and validated for COVID-19 data in France. Then, two testing policies are proposed, the so-called best-effort strategy for testing (BEST) and constant optimal strategy for testing (COST). The BEST policy is a suppression strategy that provides a lower bound on the testing rate such that the epidemic switches from a spreading to a non-spreading state. The COST policy is a mitigation strategy that provides an optimal value of testing rate that minimizes the peak value of the infected population when the total stockpile of tests is limited. Both testing policies are evaluated by predicting the number of active intensive care unit (ICU) cases and the cumulative number of deaths due to COVID-19.
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In late December 2019, a novel strand of Coronavirus (SARS-CoV-2) causing a severe, potentially fatal respiratory syndrome (COVID-19) was identified in Wuhan, Hubei Province, China and is causing outbreaks in multiple world countries, soon becoming a pandemic. Italy has now become the most hit country outside of Asia: on March 16, 2020, the Italian Civil Protection documented a total of 27980 confirmed cases and 2158 deaths of people tested positive for SARS-CoV-2. In the context of an emerging infectious disease outbreak, it is of paramount importance to predict the trend of the epidemic in order to plan an effective control strategy and to determine its impact. This paper proposes a new epidemic model that discriminates between infected individuals depending on whether they have been diagnosed and on the severity of their symptoms. The distinction between diagnosed and non-diagnosed is important because non-diagnosed individuals are more likely to spread the infection than diagnosed ones, since the latter are typically isolated, and can explain misperceptions of the case fatality rate and of the seriousness of the epidemic phenomenon. Being able to predict the amount of patients that will develop life-threatening symptoms is important since the disease frequently requires hospitalisation (and even Intensive Care Unit admission) and challenges the healthcare system capacity. We show how the basic reproduction number can be redefined in the new framework, thus capturing the potential for epidemic containment. Simulation results are compared with real data on the COVID-19 epidemic in Italy, to show the validity of the model and compare different possible predicted scenarios depending on the adopted countermeasures.
In this paper we propose a data-driven model for the spread of SARS-CoV-2 and use it to design optimal control strategies of human-mobility restrictions that both curb the epidemic and minimize the economic costs associated with implementing non-pharmaceutical interventions. We develop an extension of the SEIR epidemic model that captures the effects of changes in human mobility on the spread of the disease. The parameters of our data-driven model are learned using a multitask learning approach that leverages both data on the number of deaths across a set of regions, and cellphone data on individuals mobility patterns specific to each region. We propose an optimal control problem on this data-driven model with a tractable solution provided by geometric programming. The result of this framework is a mobility-based intervention strategy that curbs the spread of the epidemic while obeying a budget on the economic cost incurred. Furthermore, in the absence of a straightforward mapping from human mobility data to economic costs, we propose a practical method by which a budget on economic losses incurred may be chosen to eliminate excess deaths due to over-utilization of hospital resources. Our results are demonstrated with numerical simulations using real data from the Philadelphia metropolitan area.
In this paper we propose a novel SEIR stochastic epidemic model. A distinguishing feature of this new model is that it allows us to consider a set up under general latency and infectious period distributions. To some extent, queuing systems with infinitely many servers and a Markov chain with time-varying transition rate are the very technical underpinning of the paper. Although more general, the Markov chain is as tractable as previous models for exponentially distributed latency and infection periods. It is also significantly simpler and more tractable than semi-Markov models with a similar level of generality. Based on the notion of stochastic stability, we derive a sufficient condition for a shrinking epidemic in terms of the queuing systems occupation rate that drives the dynamics. Relying on this condition, we propose a class of ad-hoc stabilising mitigation strategies that seek to keep a balanced occupation rate after a prescribed mitigation-free period. We validate the approach in the light of recent data on the COVID-19 epidemic and assess the effect of different stabilising strategies. The results suggest that it is possible to curb the epidemic with various occupation rate levels, as long as the mitigation is not excessively procrastinated.
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.
We consider here an extended SIR model, including several features of the recent COVID-19 outbreak: in particular the infected and recovered individuals can either be detected (+) or undetected (-) and we also integrate an intensive care unit (ICU) capacity. Our model enables a tractable quantitative analysis of the optimal policy for the control of the epidemic dynamics using both lockdown and detection intervention levers. With parametric specification based on literature on COVID-19, we investigate the sensitivities of various quantities on the optimal strategies, taking into account the subtle trade-off between the sanitary and the socio-economic cost of the pandemic, together with the limited capacity level of ICU. We identify the optimal lockdown policy as an intervention structured in 4 successive phases: First a quick and strong lockdown intervention to stop the exponential growth of the contagion; second a short transition phase to reduce the prevalence of the virus; third a long period with full ICU capacity and stable virus prevalence; finally a return to normal social interactions with disappearance of the virus. The optimal scenario hereby avoids the second wave of infection, provided the lockdown is released sufficiently slowly. We also provide optimal intervention measures with increasing ICU capacity, as well as optimization over the effort on detection of infectious and immune individuals. Whenever massive resources are introduced to detect infected individuals, the pressure on social distancing can be released, whereas the impact of detection of immune individuals reveals to be more moderate.
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