Should we ignore SARS-CoV-2 disease?

Current World Health Organization (WHO) reports claim a decline in COVID-19 testing and reporting of new infections. To discuss the consequences of ignoring severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, the endemic characteristics of the disease in 2023 with the ones estimated before using 2022 data sets are compared. The accumulated numbers of cases and deaths reported to the WHO by the 10 most infected countries and global figures were used to calculate the average daily numbers of cases DCC and deaths DDC per capita and case fatality rates (CFRs = DDC/DCC) for two periods in 2023. In some countries, the DDC values can be higher than the upper 2022 limit and exceed the seasonal influenza mortality. The increase in CFR in 2023 shows that SARS-CoV-2 infection is still dangerous. The numbers of COVID-19 cases and deaths per capita in 2022 and 2023 do not demonstrate downward trends with the increase in the percentages of fully vaccinated people and boosters. The reasons may be both rapid mutations of the coronavirus, which reduced the effectiveness of vaccines and led to a large number of re-infections, and inappropriate management.

Multiple introductions of monkeypox virus to Ireland during the international mpox outbreak, May 2022 to October 2023.

BackgroundMpox, caused by monkeypox virus (MPXV), was considered a rare zoonotic disease before May 2022, when a global epidemic of cases in non-endemic countries led to the declaration of a Public Health Emergency of International Concern. Cases of mpox in Ireland, a country without previous mpox reports, could reflect extended local transmission or multiple epidemiological introductions.AimTo elucidate the origins and molecular characteristics of MPXV circulating in Ireland between May 2022 and October 2023.MethodsWhole genome sequencing of MPXV from 75% of all Irish mpox cases (182/242) was performed and compared to sequences retrieved from public databases (n = 3,362). Bayesian approaches were used to infer divergence time between sequences from different subclades and evaluate putative importation events from other countries.ResultsOf 242 detected mpox cases, 99% were males (median age: 35 years; range: 15-60). All 182 analysed genomes were assigned to Clade IIb and, presence of 12 distinguishable subclades suggests multiple introductions into Ireland. Estimation of time to divergence of subclades further supports the hypothesis for multiple importation events from numerous countries, indicative of extended and sustained international spread of mpox. Further analysis of sequences revealed that 92% of nucleotide mutations were from cytosine to thymine (or from guanine to adenine), leading to a high number of non-synonymous mutations across subclades; mutations associated with tecovirimat resistance were not observed.ConclusionWe provide insights into the international transmission dynamics supporting multiple introductions of MPXV into Ireland. Such information supported the implementation of evidence-informed public health control measures.

What Influence Could the Acceptance of Visitors Cause on the Epidemic Dynamics of a Reinfectious Disease?: A Mathematical Model.

The globalization in business and tourism becomes crucial more and more for the economical sustainability of local communities. In the presence of an epidemic outbreak, there must be such a decision on the policy by the host community as whether to accept visitors or not, the number of acceptable visitors, or the condition for acceptable visitors. Making use of an SIRI type of mathematical model, we consider the influence of visitors on the spread of a reinfectious disease in a community, especially assuming that a certain proportion of accepted visitors are immune. The reinfectivity of disease here means that the immunity gained by either vaccination or recovery is imperfect. With the mathematical results obtained by our analysis on the model for such an epidemic dynamics of resident and visitor populations, we find that the acceptance of visitors could have a significant influence on the disease's endemicity in the community, either suppressive or supportive.

Scale-free dynamics of COVID-19 in a Brazilian city.

A common basis to address the dynamics of directly transmitted infectious diseases, such as COVID-19, are compartmental (or SIR) models. SIR models typically assume homogenous population mixing, a simplification that is convenient but unrealistic. Here we validate an existing model of a scale-free fractal infection process using high-resolution data on COVID-19 spread in São Caetano, Brazil. We find that transmission can be described by a network in which each infectious individual has a small number of susceptible contacts, of the order of 2-5. This model parameter correlated tightly with physical distancing measured by mobile phone data, such that in periods of greater distancing the model recovered a lower average number of contacts, and vice versa. We show that the SIR model is a special case of our scale-free fractal process model in which the parameter that reflects population structure is set at unity, indicating homogeneous mixing. Our more general framework better explained the dynamics of COVID-19 in São Caetano, used fewer parameters than a standard SIR model and accounted for geographically localized clusters of disease. Our model requires further validation in other locations and with other directly transmitted infectious agents.

Balancing Quarantine and Self-Distancing Measures in Adaptive Epidemic Networks.

We study the relative importance of two key control measures for epidemic spreading: endogenous social self-distancing and exogenous imposed quarantine. We use the framework of adaptive networks, moment-closure, and ordinary differential equations to introduce new model types of susceptible-infected-recovered (SIR) dynamics. First, we compare computationally expensive, adaptive network simulations with their corresponding computationally efficient ODE equivalents and find excellent agreement. Second, we discover that there exists a critical curve in parameter space for the epidemic threshold, which suggests a mutual compensation effect between the two mitigation strategies: as long as social distancing and quarantine measures are both sufficiently strong, large outbreaks are prevented. Third, we study the total number of infected and the maximum peak during large outbreaks using a combination of analytical estimates and numerical simulations. Also for large outbreaks we find a similar compensation mechanism as for the epidemic threshold. This means that if there is little incentive for social distancing in a population, drastic quarantining is required, and vice versa. Both pure scenarios are unrealistic in practice. The new models show that only a combination of measures is likely to succeed to control epidemic spreading. Fourth, we analytically compute an upper bound for the total number of infected on adaptive networks, using integral estimates in combination with a moment-closure approximation on the level of an observable. Our method allows us to elegantly and quickly check and cross-validate various conjectures about the relevance of different network control measures. In this sense it becomes possible to adapt also other models rapidly to new epidemic challenges.

Iteratively regularized Gauss-Newton type methods for approximating quasi-solutions of irregular nonlinear operator equations in Hilbert space with an application to COVID-19 epidemic dynamics.

We investigate a class of iteratively regularized methods for finding a quasi-solution of a noisy nonlinear irregular operator equation in Hilbert space. The iteration uses an a priori stopping rule involving the error level in input data. In assumptions that the Frechet derivative of the problem operator at the desired quasi-solution has a closed range, and that the quasi-solution fulfills the standard source condition, we establish for the obtained approximation an accuracy estimate linear with respect to the error level. The proposed iterative process is applied to the parameter identification problem for a SEIR-like model of the COVID-19 pandemic.

Early Transmission Dynamics, Spread, and Genomic Characterization of SARS-CoV-2 in Panama.

We report an epidemiologic analysis of 4,210 cases of infection with severe acute respiratory syndrome coronavirus 2 and genetic analysis of 313 new near-complete virus genomes in Panama during March 9-April 16, 2020. Although containment measures reduced R0 and Rt, they did not interrupt virus spread in the country.

Potential Biases Arising From Epidemic Dynamics in Observational Seroprotection Studies.

The extent and duration of immunity following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are critical outstanding questions about the epidemiology of this novel virus, and studies are needed to evaluate the effects of serostatus on reinfection. Understanding the potential sources of bias and methods for alleviating biases in these studies is important for informing their design and analysis. Confounding by individual-level risk factors in observational studies like these is relatively well appreciated. Here, we show how geographic structure and the underlying, natural dynamics of epidemics can also induce noncausal associations. We take the approach of simulating serological studies in the context of an uncontrolled or controlled epidemic, under different assumptions about whether prior infection does or does not protect an individual against subsequent infection, and using various designs and analytical approaches to analyze the simulated data. We find that in studies assessing whether seropositivity confers protection against future infection, comparing seropositive persons with seronegative persons with similar time-dependent patterns of exposure to infection by stratifying or matching on geographic location and time of enrollment is essential in order to prevent bias.

Individual-based model for the control of Bovine Viral Diarrhea spread in livestock trade networks.

Bovine Viral Diarrhea (BVD) is a cattle disease that causes substantial financial losses, in particular to the dairy industry. Hence, several countries including Germany introduced compulsory disease control programs. For the case of Germany in particular, all animals had to be tested and persistently infected animals (PI animals) were removed from the population. The program was successful in reducing the number of PI animals, but was overtly expensive. Alternative approaches were therefore discussed to eliminate the remaining PI animals and alter the testing system in order to reduce costs. Contributing to these efforts, we developed an agent-based model that aimed to cover all relevant aspects of the disease biology and would allow to evaluate different control strategies. For the biological part of the infection spread, the model includes horizontal and vertical transmission, transient and persistent infections. Moreover, several control strategies including import of animals, trade restrictions, vaccination, as well as various testing schemes were included. The model was furthermore defined to be stochastic, event-driven and hierarchical, with cattle movements as the main route of spreading between farms. For the spread within farms, we included susceptible-infected-recovered (SIR) dynamics with an additional permanently infectious class. The interaction between the farms was described by a supply and demand farm manager mechanism governing the network structure and dynamics. Additionally, we carried out a sensitivity analysis of the input parameters to study the impact of extreme values on the model. Since the population size in the model is limited, we tested the influence of the initial population size on the model results. Our results showed that the model could accurately describe the dynamics of the disease in the presence and absence of disease control. Although we developed the model for the spread of BVD, it may be adapted to similar diseases of cattle and swine.

Adaptive SIR model for propagation of SARS-CoV-2 in Brazil.

We study the spreading of SARS-CoV-2 in Brazil based on official data available since March 22, 2020. Calculations are done via an adaptive susceptible-infected-removed (SIR) model featuring dynamical recuperation and propagation rates. We are able reproduce the number of confirmed cases over time with less than 5% error and also provide with short- and long-term predictions. The model can also be used to account for the epidemic dynamics in other countries with great accuracy.

An SIS model for the epidemic dynamics with two phases of the human day-to-day activity.

An SIS model is analyzed to consider the contribution of community structure to the risk of the spread of a transmissible disease. We focus on the human day-to-day activity introduced by commuting to a central place for the social activity. We assume that the community is classified into two subpopulations: commuter and non-commuter, of which the commuter has two phases of the day-to-day activity: private and social. Further we take account of the combination of contact patterns in two phases, making use of mass-action and ratio-dependent types for the infection force. We investigate the dependence of the basic reproduction number on the commuter ratio and the daily expected duration at the social phase as essential factors characterizing the community structure, and show that the dependence is significantly affected by the combination of contact patterns, and that the difference in the commuter ratio could make the risk of the spread of a transmissible disease significantly different.

The effect of behavior of wearing masks on epidemic dynamics.

Recently, COVID-19 has attracted a lot of attention of researchers from different fields. Wearing masks is a frequently adopted precautionary measure. In this paper, we investigate the effect of behavior of wearing masks on epidemic dynamics in the context of COVID-19. At each time, every susceptible individual chooses whether to wear a mask or not in the next time step, which depends on an evaluation of the potential costs and perceived risk of infection. When the cost of infection is high, the majority of the population choose to wear masks, where global awareness plays a significant role. However, if the mask source is limited, global awareness may give rise to a negative result. In this case, more mask source should be allocated to the individuals with high risk of infection.

Novel epidemic models on PSO-based networks.

This paper proposes two spatio-temporal epidemic network models based on popularity and similarity optimization (PSO), called r-SI and r-SIS, respectively, in which new connections take both popularity and similarity into account. In the spatial dimension, the epidemic process is described by the diffusion equation; in the time dimension, the growth of an epidemic is described by the logistic map. Both models are represented by partial differential equations, and can be easily solved. Simulations are performed on both artificial and real networks, demonstrating the effectiveness of the two models.

A model for epidemic dynamics in a community with visitor subpopulation.

With a five dimensional system of ordinary differential equations based on the SIR and SIS models, we consider the dynamics of epidemics in a community which consists of residents and short-stay visitors. Taking different viewpoints to consider public health policies to control the disease, we derive different basic reproduction numbers and clarify their common/different mathematical natures so as to understand their meanings in the dynamics of the epidemic. From our analyses, the short-stay visitor subpopulation could become significant in determining the fate of diseases in the community. Furthermore, our arguments demonstrate that it is necessary to choose one variant of basic reproduction number in order to formulate appropriate public health policies.

Unraveling the drivers of MERS-CoV transmission.

With more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% [95% credible interval (CI): 9%, 15%] of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.

Impact of host sex and group composition on parasite dynamics in experimental populations.

To better understand the spread of disease in nature, it is fundamentally important to have broadly applicable model systems with readily available species which can be replicated and controlled in the laboratory. Here we used an experimental model system of fish hosts and monogenean parasites to determine whether host sex, group size and group composition (single-sex or mixed-sex) influenced host-parasite dynamics at an individual and group level. Parasite populations reached higher densities and persisted longer in groups of fish compared with isolated hosts and reached higher densities on isolated females than on isolated males. However, individual fish within groups had similar burdens to isolated males regardless of sex, indicating that females may benefit more than males by being in a group. Relative condition was positively associated with high parasite loads for isolated males, but not for isolated females or grouped fish. No difference in parasite dynamics between mixed-sex groups and single-sex groups was detected. Overall, these findings suggest that while host sex influences dynamics on isolated fish, individual fish in groups have similar parasite burdens, regardless of sex. We believe our experimental results contribute to a mechanistic understanding of host-parasite dynamics, although we are cautious about directly extrapolating these results to other systems.

Optimal intertemporal curative drug expenses: The case of hepatitis C in France.

We study intertemporal tradeoffs that health authorities face when considering the control of an epidemic using innovative curative medical treatments. We set up a dynamically controlled susceptible-infected-recovered (SIR) model for an epidemic in which patients can be asymptomatic, and we analyze the optimality conditions of the sequence of cure expenses decided by health authorities at the onset of the drug innovation process. We show that analytical conclusions are ambiguous because of their dependence on parameter values. As an application, we focus on the case study of hepatitis C, the treatment for which underwent a major upheaval when curative drugs were introduced in 2014. We calibrate our controlled SIR model using French data and simulate optimal policies. We show that the optimal policy entails some front loading of the intertemporal budget. The analysis demonstrates how beneficial intertemporal budgeting can be compared to non-forward-looking constant budget allocation.

Time-varying human mobility patterns with metapopulation epidemic dynamics.

In this paper, explicitly considering the influences of an epidemic outbreak on human travel, a time-varying human mobility pattern is introduced to model the time variation of global human travel. The impacts of the pattern on epidemic dynamics in heterogeneous metapopulation networks, wherein each node represents a subpopulation with any number of individuals, are investigated by using a mean-field approach. The results show that the pattern does not alter the epidemic threshold, but can slightly lower the final average density of infected individuals as a whole. More importantly, we also find that the pattern produces different impacts on nodes with different degree, and that there exists a critical degree k c . For nodes with degree smaller than k c , the pattern produces a positive impact on epidemic mitigation; conversely, for nodes with degree larger than k c , the pattern produces a negative impact on epidemic mitigation.

How time-scale differences in asymptomatic and symptomatic transmission shape SARS-CoV-2 outbreak dynamics.

Asymptomatic and symptomatic SARS-CoV-2 infections can have different characteristic time scales of transmission. These time-scale differences can shape outbreak dynamics as well as bias population-level estimates of epidemic strength, speed, and controllability. For example, prior work focusing on the initial exponential growth phase of an outbreak found that larger time scales for asymptomatic vs. symptomatic transmission can lead to under-estimates of the basic reproduction number as inferred from epidemic case data. Building upon this work, we use a series of nonlinear epidemic models to explore how differences in asymptomatic and symptomatic transmission time scales can lead to changes in the realized proportion of asymptomatic transmission throughout an epidemic. First, we find that when asymptomatic transmission time scales are longer than symptomatic transmission time scales, then the effective proportion of asymptomatic transmission increases as total incidence decreases. Moreover, these time-scale-driven impacts on epidemic dynamics are enhanced when infection status is correlated between infector and infectee pairs (e.g., due to dose-dependent impacts on symptoms). Next we apply these findings to understand the impact of time-scale differences on populations with age-dependent assortative mixing and in which the probability of having a symptomatic infection increases with age. We show that if asymptomatic generation intervals are longer than corresponding symptomatic generation intervals, then correlations between age and symptoms lead to a decrease in the age of infection during periods of epidemic decline (whether due to susceptible depletion or intervention). Altogether, these results demonstrate the need to explore the role of time-scale differences in transmission dynamics alongside behavioral changes to explain outbreak features both at early stages (e.g., in estimating the basic reproduction number) and throughout an epidemic (e.g., in connecting shifts in the age of infection to periods of changing incidence).

An epidemic dynamics model with limited isolation capacity.

We consider a modified SIR model with a four-dimensional system of ordinary differential equations to consider the influence of a limited isolation capacity on the final epidemic size defined as the total number of individuals who experienced the disease at the end of an epidemic season. We derive the necessary and sufficient condition that the isolation reaches the capacity in a finite time on the way of the epidemic process, and show that the final epidemic size is monotonically decreasing in terms of the isolation capacity. We find further that the final epidemic size could have a discontinuous change at the critical value of isolation capacity below which the isolation reaches the capacity in a finite time. Our results imply that the breakdown of isolation with a limited capacity would cause a drastic increase of the epidemic size. Insufficient capacity of the isolation could lead to an unexpectedly severe epidemic situation, while such a severity would be avoidable with the sufficient isolation capacity.