Real-time estimation of the effective reproduction number of COVID-19 from behavioral data.

Monitoring the effective reproduction number [Formula: see text] of a rapidly unfolding pandemic in real-time is key to successful mitigation and prevention strategies. However, existing methods based on case numbers, hospital admissions or fatalities suffer from multiple measurement biases and temporal lags due to high test positivity rates or delays in symptom development or administrative reporting. Alternative methods such as web search and social media tracking are less directly indicating epidemic prevalence over time. We instead record age-stratified anonymous contact matrices at a daily resolution using a longitudinal online-offline survey in Hungary during the first two waves of the COVID-19 pandemic. This approach is innovative, cheap, and provides information in near real-time for estimating [Formula: see text] at a daily resolution. Moreover, it allows to complement traditional surveillance systems by signaling periods when official monitoring infrastructures are unreliable due to observational biases.

Fleeing lockdown and its impact on the size of epidemic outbreaks in the source and target regions - a COVID-19 lesson.

The COVID-19 pandemic forced authorities worldwide to implement moderate to severe restrictions in order to slow down or suppress the spread of the disease. It has been observed in several countries that a significant number of people fled a city or a region just before strict lockdown measures were implemented. This behavior carries the risk of seeding a large number of infections all at once in regions with otherwise small number of cases. In this work, we investigate the effect of fleeing on the size of an epidemic outbreak in the region under lockdown, and also in the region of destination. We propose a mathematical model that is suitable to describe the spread of an infectious disease over multiple geographic regions. Our approach is flexible to characterize the transmission of different viruses. As an example, we consider the COVID-19 outbreak in Italy. Projection of different scenarios shows that (i) timely and stricter intervention could have significantly lowered the number of cumulative cases in Italy, and (ii) fleeing at the time of lockdown possibly played a minor role in the spread of the disease in the country.

Early Phase of the COVID-19 Outbreak in Hungary and Post-Lockdown Scenarios.

COVID-19 epidemic has been suppressed in Hungary due to timely non-pharmaceutical interventions, prompting a considerable reduction in the number of contacts and transmission of the virus. This strategy was effective in preventing epidemic growth and reducing the incidence of COVID-19 to low levels. In this report, we present the first epidemiological and statistical analysis of the early phase of the COVID-19 outbreak in Hungary. Then, we establish an age-structured compartmental model to explore alternative post-lockdown scenarios. We incorporate various factors, such as age-specific measures, seasonal effects, and spatial heterogeneity to project the possible peak size and disease burden of a COVID-19 epidemic wave after the current measures are relaxed.

Risk Assessment of Novel Coronavirus COVID-19 Outbreaks Outside China.

We developed a computational tool to assess the risks of novel coronavirus outbreaks outside of China. We estimate the dependence of the risk of a major outbreak in a country from imported cases on key parameters such as: (i) the evolution of the cumulative number of cases in mainland China outside the closed areas; (ii) the connectivity of the destination country with China, including baseline travel frequencies, the effect of travel restrictions, and the efficacy of entry screening at destination; and (iii) the efficacy of control measures in the destination country (expressed by the local reproduction number R loc ). We found that in countries with low connectivity to China but with relatively high R loc , the most beneficial control measure to reduce the risk of outbreaks is a further reduction in their importation number either by entry screening or travel restrictions. Countries with high connectivity but low R loc benefit the most from policies that further reduce R loc . Countries in the middle should consider a combination of such policies. Risk assessments were illustrated for selected groups of countries from America, Asia, and Europe. We investigated how their risks depend on those parameters, and how the risk is increasing in time as the number of cases in China is growing.

Generalization of Pairwise Models to non-Markovian Epidemics on Networks.

In this Letter, a generalization of pairwise models to non-Markovian epidemics on networks is presented. For the case of infectious periods of fixed length, the resulting pairwise model is a system of delay differential equations, which shows excellent agreement with results based on stochastic simulations. Furthermore, we analytically compute a new R_{0}-like threshold quantity and an analytical relation between this and the final epidemic size. Additionally, we show that the pairwise model and the analytic results can be generalized to an arbitrary distribution of the infectious times, using integro-differential equations, and this leads to a general expression for the final epidemic size. By showing the rigorous link between non-Markovian dynamics and pairwise delay differential equations, we provide the framework for a more systematic understanding of non-Markovian dynamics.

Transmission Dynamics and Final Epidemic Size of Ebola Virus Disease Outbreaks with Varying Interventions.

The 2014 Ebola Virus Disease (EVD) outbreak in West Africa was the largest and longest ever reported since the first identification of this disease. We propose a compartmental model for EVD dynamics, including virus transmission in the community, at hospitals, and at funerals. Using time-dependent parameters, we incorporate the increasing intensity of intervention efforts. Fitting the system to the early phase of the 2014 West Africa Ebola outbreak, we estimate the basic reproduction number as 1.44. We derive a final size relation which allows us to forecast the total number of cases during the outbreak when effective interventions are in place. Our model predictions show that, as long as cases are reported in any country, intervention strategies cannot be dismissed. Since the main driver in the current slowdown of the epidemic is not the depletion of susceptibles, future waves of infection might be possible, if control measures or population behavior are relaxed.