Estimates of the reproduction ratio from epidemic surveillance may be biased in spatially structured populations

An accurate and timely estimate of the reproduction ratio R of an infectious disease epidemic is crucial to make projections on its evolution and set up the appropriate public health response. Estimates of R routinely come from statistical inference on timelines of cases or their proxies like symptomatic cases, hospitalizatons, deaths. Here, however, we prove that these estimates of R may not be accurate if the population is made up of spatially distinct communities, as the interplay between space and mobility may hide the true epidemic evolution from surveillance data. This means that surveillance may underestimate R over long periods, to the point of mistaking a growing epidemic for a subsiding one, misinforming public health response. To overcome this, we propose a correction to be applied to surveillance data that removes this bias and ensures an accurate estimate of R across all epidemic phases. We use COVID-19 as case study; our results, however, apply to any epidemic where mobility is a driver of circulation, including major challenges of the next decades: respiratory infections (influenza, SARS-CoV-2, emerging pathogens), vector-borne diseases (arboviruses). Our findings will help set up public health response to these threats, by improving epidemic monitoring and surveillance.Comment: 11 pages, 4 figures, plus Supplementary Informatio

Impact of a New SARS-CoV-2 Variant on the Population: A Mathematical Modeling Approach

[EN] Several SARS-CoV-2 variants have emerged around the world, and the appearance of other variants depends on many factors. These new variants might have different characteristics that can affect the transmissibility and death rate. The administration of vaccines against the coronavirus disease 2019 (COVID-19) started in early December of 2020 and in some countries the vaccines will not soon be widely available. For this article, we studied the impact of a new more transmissible SARS-CoV-2 strain on prevalence, hospitalizations, and deaths related to the SARS-CoV-2 virus. We studied different scenarios regarding the transmissibility in order to provide a scientific support for public health policies and bring awareness of potential future situations related to the COVID-19 pandemic. We constructed a compartmental mathematical model based on differential equations to study these different scenarios. In this way, we are able to understand how a new, more infectious strain of the virus can impact the dynamics of the COVID-19 pandemic. We studied several metrics related to the possible outcomes of the COVID-19 pandemic in order to assess the impact of a higher transmissibility of a new SARS-CoV-2 strain on these metrics. We found that, even if the new variant has the same death rate, its high transmissibility can increase the number of infected people, those hospitalized, and deaths. The simulation results show that health institutions need to focus on increasing non-pharmaceutical interventions and the pace of vaccine inoculation since a new variant with higher transmissibility, such as, for example, VOC-202012/01 of lineage B.1.1.7, may cause more devastating outcomes in the population.Funding support from the National Institute of General Medical Sciences (P20GM103451) via NM-INBRE is gratefully acknowledged by the first author.González Parra, G.; Martínez-Rodríguez, D.; Villanueva Micó, RJ. (2021). Impact of a New SARS-CoV-2 Variant on the Population: A Mathematical Modeling Approach. Mathematical and Computational Applications (Online). 26(2):1-21. https://doi.org/10.3390/mca26020025S12126

The combined role of distance and frequency travel restrictions on spread of disease

Travel restrictions have often been used as a measure to combat the spread of disease -- in particular, they have been extensively applied in 2020 against coronavirus disease 2019 (COVID-19). How to best restrict travel, however, is unclear. Most studies and policies simply constrain the distance r individuals may travel from their home or neighbourhood. However, the epidemic risk is related not only to distance travelled, but also to frequency of contacts, which is proxied by the frequency f with which individuals revisit locations over a given reference period. Inspired by recent literature that uncovers a clear universality pattern on how r and f interact in routine human mobility, this paper addresses the following question: does this universal relation between r and f carry over to epidemic spreading, so that the risk associated with human movement can be modeled by a single, unifying variable r * f? To answer this question, we use two large-scale datasets of individual human mobility to simulate disease spread. Results show that a universal relation between r and f indeed exists in the context of epidemic spread: in both of the datasets, the final size and the spatial distribution of the infected population depends on the product r * f more directly than on the individual values of r and f. The important implication here is that restricting r (where you can go), but not f (how frequently), could be unproductive: high frequency trips to nearby locations can be as dangerous for disease spread as low frequency trips to distant locations. This counter-intuitive discovery could explain the modest effectiveness of distance-based travel restrictions and could inform future policies on COVID-19 and other epidemics.Comment: 8 pages, 7 figure

Modeling latent infection transmissions through biosocial stochastic dynamics

The events of the recent SARS-CoV-2 epidemics have shown the importance of social factors, especially given the large number of asymptomatic cases that effectively spread the virus, which can cause a medical emergency to very susceptible individuals. Besides, the SARS-CoV-2 virus survives for several hours on different surfaces, where a new host can contract it with a delay. These passive modes of infection transmission remain an unexplored area for traditional mean-field epidemic models. Here, we design an agent-based model for simulations of infection transmission in an open system driven by the dynamics of social activity; the model takes into account the personal characteristics of individuals, as well as the survival time of the virus and its potential mutations. A growing bipartite graph embodies this biosocial process, consisting of active carriers (host) nodes that produce viral nodes during their infectious period. With its directed edges passing through viral nodes between two successive hosts, this graph contains complete information about the routes leading to each infected individual. We determine temporal fluctuations of the number of exposed and the number of infected individuals, the number of active carriers and active viruses at hourly resolution. The simulated processes underpin the latent infection transmissions, contributing significantly to the spread of the virus within a large time window. More precisely, being brought by social dynamics and exposed to the currently existing infection, an individual passes through the infectious state until eventually spontaneously recovers or otherwise is moves to a controlled hospital environment. Our results reveal complex feedback mechanisms that shape the dependence of the infection curve on the intensity of social dynamics and other sociobiological factors. In particular, the results show how the lockdown effectively reduces the spread of infection and how it increases again after the lockdown is removed. Furthermore, a reduced level of social activity but prolonged exposure of susceptible individuals have adverse effects. On the other hand, virus mutations that can gradually reduce the transmission rate by hopping to each new host along the infection path can significantly reduce the extent of the infection, but can not stop the spreading without additional social strategies. Our stochastic processes, based on graphs at the interface of biology and social dynamics, provide a new mathematical framework for simulations of various epidemic control strategies with high temporal resolution and virus traceability

Spatially explicit effective reproduction numbers from incidence and mobility data

Current methods for near real-time estimation of effective reproduction numbers from surveillance data overlook mobility fluxes of infectors and susceptible individuals within a spatially connected network (the metapopulation). Exchanges of infections among different communities may thus be misrepresented unless explicitly measured and accounted for in the renewal equations. Here, we first derive the equations that include spatially explicit effective reproduction numbers, ℛk(t), in an arbitrary community k. These equations embed a suitable connection matrix blending mobility among connected communities and mobility-related containment measures. Then, we propose a tool to estimate, in a Bayesian framework involving particle filtering, the values of ℛk(t) maximizing a suitable likelihood function reproducing observed patterns of infections in space and time. We validate our tools against synthetic data and apply them to real COVID-19 epidemiological records in a severely affected and carefully monitored Italian region. Differences arising between connected and disconnected reproduction numbers (the latter being calculated with existing methods, to which our formulation reduces by setting mobility to zero) suggest that current standards may be improved in their estimation of disease transmission over time

A Survey of COVID-19 in Public Transportation: Transmission Risk, Mitigation and Prevention

The COVID-19 pandemic is posing significant challenges to public transport operators by drastically reducing demand while also requiring them to implement measures that minimize risks to the health of the passengers. While the collective scientific understanding of the SARS-CoV-2 virus and COVID-19 pandemic are rapidly increasing, currently there is a lack of understanding of how the COVID-19 relates to public transport operations. This article presents a comprehensive survey of the current research on COVID-19 transmission mechanisms and how they relate to public transport. We critically assess literature through a lens of disaster management and survey the main transmission mechanisms, forecasting, risks, mitigation, and prevention mechanisms. Social distancing and control on passenger density are found to be the most effective mechanisms. Computing and digital technology can support risk control. Based on our survey, we draw guidelines for public transport operators and highlight open research challenges to establish a research roadmap for the path forward.Peer reviewe