Impact of infectious density-induced additional screening and treatment saturation on COVID-19: Modeling and cost-effective optimal control.

This study introduces a novel SI2HR model, where "I2" denotes two infectious classes representing asymptomatic and symptomatic infections, aiming to investigate and analyze the cost-effective optimal control measures for managing COVID-19. The model incorporates a novel concept of infectious density-induced additional screening (IDIAS) and accounts for treatment saturation. Furthermore, the model considers the possibility of reinfection and the loss of immunity in individuals who have previously recovered. To validate and calibrate the proposed model, real data from November-December 2022 in Hong Kong are utilized. The estimated parameters obtained from this calibration process are valuable for prediction purposes and facilitate further numerical simulations. An analysis of the model reveals that delays in screening, treatment, and quarantine contribute to an increase in the basic reproduction number R0, indicating a tendency towards endemicity. In particular, from the elasticity of R0, we deduce that normalized sensitivity indices of baseline screening rate (θ), quarantine rates (γ, αs), and treatment rate (α) are negative, which shows that delaying any of these may cause huge surge in R0, ultimately increases the disease burden. Further, by the contour plots, we note the two-parameter behavior of the infectives (both symptomatic and asymptomatic). Expanding upon the model analysis, an optimal control problem (OCP) is formulated, incorporating three control measures: precautionary interventions, boosted IDIAS, and boosted treatment. The Pontryagin's maximum principle and the forward-backward sweep method are employed to solve the OCP. The numerical simulations highlight that enhanced screening and treatment, coupled with preventive interventions, can effectively contribute to sustainable disease control. However, the cost-effectiveness analysis (CEA) conducted in this study suggests that boosting IDIAS alone is the most economically efficient and cost-effective approach compared to other strategies. The CEA results provide valuable insights into identifying specific strategies based on their cost-efficacy ranking, which can be implemented to maximize impact while minimizing costs. Overall, this research offers significant insights for policymakers and healthcare professionals, providing a framework to optimize control efforts for COVID-19 or similar epidemics in the future.

Role of immigration and emigration on the spread of COVID-19 in a multipatch environment: a case study of India.

Human mobility has played a critical role in the spread of COVID-19. The understanding of mobility helps in getting information on the acceleration or control of the spread of disease. The COVID-19 virus has been spreading among several locations despite all the best efforts related to its isolation. To comprehend this, a multi-patch mathematical model of COVID-19 is proposed and analysed in this work, where-in limited medical resources, quarantining, and inhibitory behaviour of healthy individuals are incorporated into the model. Furthermore, as an example, the impact of mobility in a three-patch model is studied considering the three worst-hit states of India, i.e. Kerala, Maharashtra and Tamil Nadu, as three patches. Key parameters and the basic reproduction number are estimated from the available data. Through results and analyses, it is seen that Kerala has a higher effective contact rate and has the highest prevalence. Moreover, if Kerala is isolated from Maharashtra or Tamil Nadu, the number of active cases will increase in Kerala but reduce in the other two states. Our findings indicate that the number of active cases will decrease in the high prevalence state and increase in the lower prevalence states if the emigration rate is higher than the immigration rate in the high prevalence state. Overall, proper travel restrictions are to be implemented to reduce or control the spread of disease from the high-prevalence state to other states with lower prevalence rates.

Nonlinear dynamical behavior of an SEIR mathematical model: Effect of information and saturated treatment.

When a disease spreads in a population, individuals tend to change their behavior due to the presence of information about disease prevalence. Therefore, the infection rate is affected and incidence term in the model should be appropriately modified. In addition, a limitation of medical resources has its impact on the dynamics of the disease. In this work, we propose and analyze an Susceptible-Exposed-Infected-Recovered (SEIR) model, which accounts for the information-induced non-monotonic incidence function and saturated treatment function. The model analysis is carried out, and it is found that when R0 is below one, the disease may or may not die out due to the saturated treatment (i.e., a backward bifurcation may exist and cause multi-stability). Further, we note that in this case, disease eradication is possible if medical resources are available for all. When R0 exceeds one, there is a possibility of the existence of multiple endemic equilibria. These multiple equilibria give rise to rich and complex dynamics by showing various bifurcations and oscillations (via Hopf bifurcation). A global asymptotic stability of a unique endemic equilibrium (when it exists) is established under certain conditions. An impact of information is shown and also a sensitivity analysis of model parameters is performed. Various cases are considered numerically to provide the insight of model behavior mathematically and epidemiologically. We found that the model shows hysteresis. Our study underlines that a limitation of medical resources may cause bi(multi)-stability in the model system. Also, information plays a significant role and gives rise to a rich and complex dynamical behavior of the model.