Public Health Impact of Paxlovid as Treatment for COVID-19, United States.

We evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizations and save US $56.95 billion (95% CI US $2.62-$122.63 billion). In a higher transmission scenario (effective reproduction number of 3), the benefits increase, potentially preventing 0.85 million (95% CI 0.36-1.38 million) hospitalizations and saving US $170.17 billion (95% CI US $60.49-$286.14 billion). Our findings suggest that timely and widespread use of Paxlovid could be an effective and economical approach to mitigate the effects of COVID-19.

The nature and nurture of network evolution.

Although the origin of the fat-tail characteristic of the degree distribution in complex networks has been extensively researched, the underlying cause of the degree distribution characteristic across the complete range of degrees remains obscure. Here, we propose an evolution model that incorporates only two factors: the node's weight, reflecting its innate attractiveness (nature), and the node's degree, reflecting the external influences (nurture). The proposed model provides a good fit for degree distributions and degree ratio distributions of numerous real-world networks and reproduces their evolution processes. Our results indicate that the nurture factor plays a dominant role in the evolution of social networks. In contrast, the nature factor plays a dominant role in the evolution of non-social networks, suggesting that whether nodes are people determines the dominant factor influencing the evolution of real-world networks.

The public health impact of Paxlovid COVID-19 treatment in the United States.

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario Re∼1.2 treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% CrI: 1.69, 71.15) thousand deaths averted, and US$52.16 (95% CrI: 2.62, 122.63) billion reduction in health- and treatment-related costs. Rapid and broad use of the antiviral Paxlovid could substantially reduce COVID-19 morbidity and mortality, while averting socioeconomic hardship.

Protocol for the automatic extraction of epidemiological information via a pre-trained language model.

The lack of systems to automatically extract epidemiological fields from open-access COVID-19 cases restricts the timeliness of formulating prevention measures. Here we present a protocol for using CCIE, a COVID-19 Cases Information Extraction system based on the pre-trained language model.1 We describe steps for preparing supervised training data and executing python scripts for named entity recognition and text category classification. We then detail the use of machine evaluation and manual validation to illustrate the effectiveness of CCIE. For complete details on the use and execution of this protocol, please refer to Wang et al.2.

Gender inequality and self-publication are common among academic editors.

Scientific editors shape the content of academic journals and set standards for their fields. Yet, the degree to which the gender makeup of editors reflects that of scientists, and the rate at which editors publish in their own journals, are not entirely understood. Here, we use algorithmic tools to infer the gender of 81,000 editors serving more than 1,000 journals and 15 disciplines over five decades. Only 26% of authors in our dataset are women, and we find even fewer women among editors (14%) and editors-in-chief (8%). Career length explains the gender gap among editors, but not editors-in-chief. Moreover, by analysing the publication records of 20,000 editors, we find that 12% publish at least one-fifth, and 6% publish at least one-third, of their papers in the journal they edit. Editors-in-chief tend to self-publish at a higher rate. Finally, compared with women, men have a higher increase in the rate at which they publish in a journal soon after becoming its editor.

Epidemic Surveillance of Influenza Infections: A Network-Free Strategy - Hong Kong Special Administrative Region, China, 2008-2011.

Introduction: The ease of coronavirus disease 2019 (COVID-19) non-pharmacological interventions and the increased susceptibility during the past COVID-19 pandemic could be a precursor for the resurgence of influenza, potentially leading to a severe outbreak in the winter of 2022 and future seasons. The recent increased availability of data on Electronic Health Records (EHR) in public health systems, offers new opportunities to monitor individuals to mitigate outbreaks. Methods: We introduced a new methodology to rank individuals for surveillance in temporal networks, which was more practical than the static networks. By targeting previously infected nodes, this method used readily available EHR data instead of the contact-network structure. Results: We validated this method qualitatively in a real-world cohort study and evaluated our approach quantitatively by comparing it to other surveillance methods on three temporal and empirical networks. We found that, despite not explicitly exploiting the contacts' network structure, it remained the best or close to the best strategy. We related the performance of the method to the public health goals, the reproduction number of the disease, and the underlying temporal-network structure (e.g., burstiness). Discussion: The proposed strategy of using historical records for sentinel surveillance selection can be taken as a practical and robust alternative without the knowledge of individual contact behaviors for public health policymakers.

Trading contact tracing efficiency for finding patient zero.

As the COVID-19 pandemic has demonstrated, identifying the origin of a pandemic remains a challenging task. The search for patient zero may benefit from the widely-used and well-established toolkit of contact tracing methods, although this possibility has not been explored to date. We fill this gap by investigating the prospect of performing the source detection task as part of the contact tracing process, i.e., the possibility of tuning the parameters of the process in order to pinpoint the origin of the infection. To this end, we perform simulations on temporal networks using a recent diffusion model that recreates the dynamics of the COVID-19 pandemic. We find that increasing the budget for contact tracing beyond a certain threshold can significantly improve the identification of infected individuals but has diminishing returns in terms of source detection. Moreover, disease variants of higher infectivity make it easier to find the source but harder to identify infected individuals. Finally, we unravel a seemingly-intrinsic trade-off between the use of contact tracing to either identify infected nodes or detect the source of infection. This trade-off suggests that focusing on the identification of patient zero may come at the expense of identifying infected individuals.

Travel-related Importation and Exportation Risks of SARS-CoV-2 Omicron Variant in 367 Prefectures (Cities) - China, 2022.

Introduction: Minimizing the importation and exportation risks of coronavirus disease 2019 (COVID-19) is a primary concern for sustaining the "Dynamic COVID-zero" strategy in China. Risk estimation is essential for cities to conduct before relaxing border control measures. Methods: Informed by the daily number of passengers traveling between 367 prefectures (cities) in China, this study used a stochastic metapopulation model parameterized with COVID-19 epidemic characteristics to estimate the importation and exportation risks. Results: Under the transmission scenario (R0 =5.49), this study estimated the cumulative case incidence of Changchun City, Jilin Province as 3,233 (95% confidence interval: 1,480, 4,986) before a lockdown on March 14, 2022, which is close to the 3,168 cases reported in real life by March 16, 2022. In a total of 367 prefectures (cities), 127 (35%) had high exportation risks according to the simulation and could transmit the disease to 50% of all other regions within a period from 17 to 94 days. The average time until a new infection arrives in a location in 1 of the 367 prefectures (cities) ranged from 26 to 101 days. Conclusions: Estimating COVID-19 importation and exportation risks is necessary for preparedness, prevention, and control measures of COVID-19 - especially when new variants emerge.

Social diffusion sources can escape detection.

Influencing others through social networks is fundamental to all human societies. Whether this happens through the diffusion of rumors, opinions, or viruses, identifying the diffusion source (i.e., the person that initiated it) is a problem that has attracted much research interest. Nevertheless, existing literature has ignored the possibility that the source might strategically modify the network structure (by rewiring links or introducing fake nodes) to escape detection. Here, without restricting our analysis to any particular diffusion scenario, we close this gap by evaluating two mechanisms that hide the source-one stemming from the source's actions, the other from the network structure itself. This reveals that sources can easily escape detection, and that removing links is far more effective than introducing fake nodes. Thus, efforts should focus on exposing concealed ties rather than planted entities; such exposure would drastically improve our chances of detecting the diffusion source.

Epidemiologic information discovery from open-access COVID-19 case reports via pretrained language model.

Although open-access data are increasingly common and useful to epidemiological research, the curation of such datasets is resource-intensive and time-consuming. Despite the existence of a major source of COVID-19 data, the regularly disclosed case reports were often written in natural language with an unstructured format. Here, we propose a computational framework that can automatically extract epidemiological information from open-access COVID-19 case reports. We develop this framework by coupling a language model developed using deep neural networks with training samples compiled using an optimized data annotation strategy. When applied to the COVID-19 case reports collected from mainland China, our framework outperforms all other state-of-the-art deep learning models. The information extracted from our approach is highly consistent with that obtained from the gold-standard manual coding, with a matching rate of 80%. To disseminate our algorithm, we provide an open-access online platform that is able to estimate key epidemiological statistics in real time, with much less effort for data curation.

Optimizing COVID-19 surveillance using historical electronic health records of influenza infections.

Targeting surveillance resources toward individuals at high risk of early infection can accelerate the detection of emerging outbreaks. However, it is unclear which individuals are at high risk without detailed data on interpersonal and physical contacts. We propose a data-driven COVID-19 surveillance strategy using Electronic Health Record (EHR) data that identifies the most vulnerable individuals who acquired the earliest infections during historical influenza seasons. Our simulations for all three networks demonstrate that the EHR-based strategy performs as well as the most-connected strategy. Compared to the random acquaintance surveillance, our EHR-based strategy detects the early warning signal and peak timing much earlier. On average, the EHR-based strategy has 9.8 days of early warning and 13.5 days of peak timings, respectively, before the whole population. For the urban network, the expected values of our method are better than the random acquaintance strategy (24% for early warning and 14% in-advance for peak time). For a scale-free network, the average performance of the EHR-based method is 75% of the early warning and 109% in-advance when compared with the random acquaintance strategy. If the contact structure is persistent enough, it will be reflected by their history of infection. Our proposed approach suggests that seasonal influenza infection records could be used to monitor new outbreaks of emerging epidemics, including COVID-19. This is a method that exploits the effect of contact structure without considering it explicitly.

Optimal control of networked reaction-diffusion systems.

Patterns in nature are fascinating both aesthetically and scientifically. Alan Turing's celebrated reaction-diffusion model of pattern formation from the 1950s has been extended to an astounding diversity of applications: from cancer medicine, via nanoparticle fabrication, to computer architecture. Recently, several authors have studied pattern formation in underlying networks, but thus far, controlling a reaction-diffusion system in a network to obtain a particular pattern has remained elusive. We present a solution to this problem in the form of an analytical framework and numerical algorithm for optimal control of Turing patterns in networks. We demonstrate our method's effectiveness and discuss factors that affect its performance. We also pave the way for multidisciplinary applications of our framework beyond reaction-diffusion models.

The microdynamics shaping the relationship between democracy and corruption.

Physics has a long tradition of laying rigorous quantitative foundations for social phenomena. Here, we up the ante for physics' forays into the territory of social sciences by (i) empirically documenting a tipping point in the relationship between democratic norms and corruption suppression, and then (ii) demonstrating how such a tipping point emerges from a micro-scale mechanistic model of spin dynamics in a complex network. Specifically, the tipping point in the relationship between democratic norms and corruption suppression is such that democratization has little effect on suppressing corruption below a critical threshold, but a large effect above the threshold. The micro-scale model of spin dynamics underpins this phenomenon by reinterpreting spins in terms of unbiased (i.e. altruistic) and biased (i.e. parochial) other-regarding behaviour, as well as the corresponding voting preferences. Under weak democratic norms, dense social connections of parochialists enable coercing enough opportunist voters to vote in favour of perpetuating parochial in-group bias. Society may, however, strengthen democratic norms in a rapid turn of events during which opportunists adopt altruism and vote to subdue bias. The emerging model outcome at the societal scale thus mirrors the data, implying that democracy either perpetuates or suppresses corruption depending on the prevailing democratic norms.

The global migration network of sex-workers.

Differences in the social and economic environment across countries encourage humans to migrate in search of better living conditions, including job opportunities, higher salaries, security and welfare. Quantifying global migration is, however, challenging because of poor recording, privacy issues and residence status. This is particularly critical for some classes of migrants involved in stigmatised, unregulated or illegal activities. Escorting services or high-end prostitution are well-paid activities that attract workers all around the world. In this paper, we study international migration patterns of sex-workers by using network methods. Using an extensive international online advertisement directory of escorting services and information about individual escorts, we reconstruct a migrant flow network where nodes represent either origin or destination countries. The links represent the direct routes between two countries. The migration network of sex-workers shows different structural patterns than the migration of the general population. The network contains a strong core where mutual migration is often observed between a group of high-income European countries, yet Europe is split into different network communities with specific ties to non-European countries. We find non-reciprocal relations between countries, with some of them mostly offering while others attract workers. The Gross Domestic Product per capita (GDPc) is a good indicator of country attractiveness for incoming workers and service rates but is unrelated to the probability of emigration. The median financial gain of migrating, in comparison to working at the home country, is 15.9 % . Only sex-workers coming from 77 % of the countries have financial gains with migration and average gains decrease with the GDPc of the country of origin. Our results suggest that high-end sex-worker migration is regulated by economic, geographic and cultural aspects.

Mobility in China, 2020: a tale of four phases.

2020 was an unprecedented year, with rapid and drastic changes in human mobility due to the COVID-19 pandemic. To understand the variation in commuting patterns among the Chinese population across stable and unstable periods, we used nationwide mobility data from 318 million mobile phone users in China to examine the extreme fluctuations of population movements in 2020, ranging from the Lunar New Year travel season (chunyun), to the exceptional calm of COVID-19 lockdown, and then to the recovery period. We observed that cross-city movements, which increased substantially in chunyun and then dropped sharply during the lockdown, are primarily dependent on travel distance and the socio-economic development of cities. Following the Lunar New Year holiday, national mobility remained low until mid-February, and COVID-19 interventions delayed more than 72.89 million people returning to large cities. Mobility network analysis revealed clusters of highly connected cities, conforming to the social-economic division of urban agglomerations in China. While the mass migration back to large cities was delayed, smaller cities connected more densely to form new clusters. During the recovery period after travel restrictions were lifted, the netflows of over 55% city pairs reversed in direction compared to before the lockdown. These findings offer the most comprehensive picture of Chinese mobility at fine resolution across various scenarios in China and are of critical importance for decision making regarding future public-health-emergency response, transportation planning and regional economic development, among others.

Autopoietic Influence Hierarchies in Pancreatic ß Cells.

ß cells are biologically essential for humans and other vertebrates. Because their functionality arises from cell-cell interactions, they are also a model system for collective organization among cells. There are currently two contradictory pictures of this organization: the hub-cell idea pointing at leaders who coordinate the others, and the electrophysiological theory describing all cells as equal. We use new data and computational modeling to reconcile these pictures. We find via a network representation of interacting ß cells that leaders emerge naturally (confirming the hub-cell idea), yet all cells can take the hub role following a perturbation (in line with electrophysiology).

Concurrency measures in the era of temporal network epidemiology: a review.

Diseases spread over temporal networks of interaction events between individuals. Structures of these temporal networks hold the keys to understanding epidemic propagation. One early concept of the literature to aid in discussing these structures is concurrency-quantifying individuals' tendency to form time-overlapping 'partnerships'. Although conflicting evaluations and an overabundance of operational definitions have marred the history of concurrency, it remains important, especially in the area of sexually transmitted infections. Today, much of theoretical epidemiology uses more direct models of contact patterns, and there is an emerging body of literature trying to connect methods to the concurrency literature. In this review, we will cover the development of the concept of concurrency and these new approaches.