Network structural metrics as early warning signals of widespread vaccine refusal in social-epidemiological networks.

Sudden shifts in vaccine uptake, vaccine opinion, and infection incidence can occur in coupled behaviour-disease systems going through a bifurcation as the perceived risk of the vaccine increases. Literature shows that such regime shifts are sometimes foreshadowed by early warning signals (EWS). We propose and compare the performance of various measures of network structure as potential EWS indicators of epidemics and changes in population vaccine opinion. We construct a multiplex model coupling transmission of a vaccine-preventable childhood infectious disease and social dynamics concerning vaccine opinion. We find that the modularity of pro- and anti-vaccine network communities perform well as EWS, as do several measures of the number and size of opinion-based communities, and the size of pro-vaccine echo chambers. The number of opinion changes also gives early warnings, although the clustering coefficient and metrics concerning anti-vaccine echo chambers provide little warning. Stronger social norms are found to compromise the ability of all EWS metrics to provide advance warning. These exploratory results suggest that EWS indicators based on the network structure of online social media communities might assist public health preparedness by providing early warning of potential regime shifts.

Model-based projections for COVID-19 outbreak size and student-days lost to closure in Ontario childcare centres and primary schools.

There is a pressing need for evidence-based scrutiny of plans to re-open childcare centres during the COVID-19 pandemic. Here we developed an agent-based model of SARS-CoV-2 transmission within a childcare centre and households. Scenarios varied the student-to-educator ratio (15:2, 8:2, 7:3), family clustering (siblings together versus random assignment) and time spent in class. We also evaluated a primary school setting (with student-educator ratios 30:1, 15:1 and 8:1), including cohorts that alternate weekly. In the childcare centre setting, grouping siblings significantly reduced outbreak size and student-days lost. We identify an intensification cascade specific to classroom outbreaks of respiratory viruses with presymptomatic infection. In both childcare and primary school settings, each doubling of class size from 8 to 15 to 30 more than doubled the outbreak size and student-days lost (increases by factors of 2-5, depending on the scenario. Proposals for childcare and primary school reopening could be enhanced for safety by switching to smaller class sizes and grouping siblings.

Spatial early warning signals of social and epidemiological tipping points in a coupled behaviour-disease network.

The resurgence of infectious diseases due to vaccine refusal has highlighted the role of interactions between disease dynamics and the spread of vaccine opinion on social networks. Shifts between disease elimination and outbreak regimes often occur through tipping points. It is known that tipping points can be predicted by early warning signals (EWS) based on characteristic dynamics near the critical transition, but the study of EWS in coupled behaviour-disease networks has received little attention. Here, we test several EWS indicators measuring spatial coherence and autocorrelation for their ability to predict a critical transition corresponding to disease outbreaks and vaccine refusal in a multiplex network model. The model couples paediatric infectious disease spread through a contact network to binary opinion dynamics of vaccine opinion on a social network. Through change point detection, we find that mutual information and join count indicators provided the best EWS. We also show the paediatric infectious disease natural history generates a discrepancy between population-level vaccine opinions and vaccine immunity status, such that transitions in the social network may occur before epidemiological transitions. These results suggest that monitoring social media for EWS of paediatric infectious disease outbreaks using these spatial indicators could be successful.