Search

During the COVID-19 pandemic, control measures, especially massive contact tracing following prompt quarantine and isolation, play an important role in mitigating the disease spread, and quantifying the dynamic contact rate and quarantine rate and estimate their impacts remain challenging. To precisely quantify the intensity of interventions, we develop the mechanism of physics-informed neural network (PINN) to propose the extended transmission-dynamics-informed neural network (TDINN) algorithm by combining scattered observational data with deep learning and epidemic models. The TDINN algorithm can not only avoid assuming the specific rate functions in advance but also make neural networks follow the rules of epidemic systems in the process of learning. We show that the proposed algorithm can fit the multi-source epidemic data in Xi'an, Guangzhou and Yangzhou cities well, and moreover reconstruct the epidemic development trend in Hainan and Xinjiang with incomplete reported data. We inferred the temporal evolution patterns of contact/quarantine rates, selected the best combination from the family of functions to accurately simulate the contact/quarantine time series learned by TDINN algorithm, and consequently reconstructed the epidemic process. The selected rate functions based on the time series inferred by deep learning have epidemiologically reasonable meanings. In addition, the proposed TDINN algorithm has also been verified by COVID-19 epidemic data with multiple waves in Liaoning province and shows good performance. We find the significant fluctuations in estimated contact/quarantine rates, and a feedback loop between the strengthening/relaxation of intervention strategies and the recurrence of the outbreaks. Moreover, the findings show that there is diversity in the shape of the temporal evolution curves of the inferred contact/quarantine rates in the considered regions, which indicates variation in the intensity of control strategies adopted in various regions. Author summary: When applying the compartment model to simulate the disease transmission dynamics, some parameters or particular functions are assumed to describe the intensity of the control interventions. However, these preset specific functions may not accurately quantify the intervention strategies, which brings great challenges to accurately make prediction and evaluation. In this study, we developed an extended transmission-dynamics-informed neural network algorithm by integrating deep neural network with epidemic model. Even for insufficient case data, the proposed algorithm can still help us reconstruct the temporal evolution trend of the epidemic and infer unknown parameters. We inferred the time series on contract rate and quarantine rate for six regions based on the case data, on which the reasonable and interpretable functions, describing the dynamic variation in the intensity of control strategies, can be successfully selected and determined. The inferred contact/quarantine rates in various regions show the diverse shapes and regional dependent, and hence the variation in the intensity of control measures. This suggests the dynamic zero-case policy exhibits the different efficacy in reducing contacts and increasing the quarantine and isolation. [ABSTRACT FROM AUTHOR]

• A novel Filippov epidemic system involving three containment strategies is constructed. • Rich local and global sliding bifurcations indicate multi-stability dynamics. • Well data fitting results for epidemics A/H1N1 and COVID-19 reveal the applicability of the proposed model. • The final infected population can be maintained in a desired level through the proposed Filippov control measures. A non-smooth SIR Filippov system is proposed to investigate the impacts of three control strategies (media coverage, vaccination and treatment) on the spread of an infectious disease. We synthetically consider both the number of infected population and its changing rate as the switching condition to implement the curing measures. By using the properties of the Lambert W function, we convert the proposed switching condition to a threshold value related to the susceptible population. The classical epidemic model involving media coverage, linear functions describing injecting vaccine and treatment strategies is examined when the susceptible population exceeds the threshold value. In addition, we consider another SIR model accompanied with the vaccination and treatment strategies represented by saturation functions when the susceptible population is smaller than the threshold value. The dynamics of these two subsystems and the sliding domain are discussed in detail. Four types of local sliding bifurcation are investigated, including boundary focus, boundary node, boundary saddle and boundary saddle-node bifurcations. In the meantime, the global bifurcation involving the appearance of limit cycles is examined, including touching bifurcation, homoclinic bifurcation to the pseudo-saddle and crossing bifurcation. Furthermore, the influence of some key parameters related to the three treatment strategies is explored. We also validate our model by the epidemic data sets of A/H1N1 and COVID-19, which can be employed to reveal the effects of media report and existing strategy related to the control of emerging infectious diseases on the variations of confirmed cases. [ABSTRACT FROM AUTHOR]

Background: The continuous emergence of novel SARS-CoV-2 variants with markedly increased transmissibility presents major challenges to the zero-COVID policy in China. It is critical to adjust aspects of the policy about non-pharmaceutical interventions (NPIs) by searching for and implementing more effective ways. We use a mathematical model to mimic the epidemic pattern of the Omicron variant in Shanghai to quantitatively show the control challenges and investigate the feasibility of different control patterns in avoiding other epidemic waves. Methods: We initially construct a dynamic model with a core step-by-step release strategy to reveal its role in controlling the spread of COVID-19, including the city-based pattern and the district-based pattern. We used the least squares method and real reported case data to fit the model for Shanghai and its 16 districts, respectively. Optimal control theory was utilized to explore the quantitative and optimal solutions of the time-varying control strength (i.e., contact rate) to suppress the highly transmissible SARS-CoV-2 variants. Results: The necessary period for reaching the zero-COVID goal can be nearly 4 months, and the final epidemic size was 629,625 (95%CI: [608,049, 651,201]). By adopting the city-based pattern, 7 out of 16 strategies released the NPIs more or earlier than the baseline and ensured a zero-resurgence risk at the average cost of 10 to 129 more cases in June. By adopting the district-based pattern, a regional linked release can allow resumption of social activity to ~ 100% in the boundary-region group about 14 days earlier and allow people to flow between different districts without causing infection resurgence. Optimal solutions of the contact rate were obtained with various testing intensities, and higher diagnosis rate correlated with higher optimal contact rate while the number of daily reported cases remained almost unchanged. Conclusions: Shanghai could have been bolder and more flexible in unleashing social activity than they did. The boundary-region group should be relaxed earlier and more attention should be paid to the centre-region group. With a more intensive testing strategy, people could return to normal life as much as possible but still ensure the epidemic was maintained at a relatively low level. [ABSTRACT FROM AUTHOR]

• Periods of epidemics induced by different strains in Asian countries were classified by k-shape and hierarchical clustering methods. • Using correlation and regression analysis to explore the results of clustering Asian countries. • Revealing the reasons behind the development pattern of the epidemic in Asian countries. • Peak value of confirmed cases per capita in the Omicron phase are much higher, while mortality rate is significantly lower than in the earlier phases. • Vaccination rates were associated with lower mortality given the nature of the analysis. The COVID-19 epidemic has lasted for more than two years since the outbreak in late 2019. An urgent and challenging question is how to systematically evaluate epidemic developments in different countries, during different periods, and to determine which measures that could be implemented are key for successful epidemic prevention. In this study, SBD distance-based K-shape clustering and hierarchical clustering methods were used to analyse epidemics in Asian countries. For the hierarchical clustering, epidemic time series were divided into three periods (epidemics induced by the Original/Alpha, Delta and Omicron variants separately). Standard deviations, the Hurst index, mortality rates, peak value of confirmed cases per capita, average growth rates, and the control efficiency of each period were used to characterize the epidemics. In addition, the total numbers of cases in the different countries were analysed by correlation and regression in relation to 15 variables that could have impacts on COVID-19. Finally, some suggestions on prevention and control measures for each category of country are given. We found that the total numbers of cases per million of a population, total deaths per million and mortality rates were highly correlated with the proportion of people aged over 65 years, the prevalence of multiple diseases, and the national GDP. We also found significant associations between case numbers and vaccination rates, health expenditures, and stringency of control measures. Vaccinations have played a positive role in COVID-19, with a gradual decline in mortality rates in later periods, and are still playing protective roles against the Delta and Omicron strains. The stringency of control measures taken by a government is not an indicator of the appropriateness of a country's response to the outbreak, and a higher index does not necessarily mean more effective measures; a combination of factors such as national vaccination rates, the country's economic foundation and the availability of medical equipment is also needed. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics". [ABSTRACT FROM AUTHOR]

The mass vaccination program has been actively promoted since the end of 2020. However, waning immunity, antibody-dependent enhancement (ADE), and increased transmissibility of variants make the herd immunity untenable and the implementation of dynamic zero-COVID policy challenging in China. To explore how long the vaccination program can prevent China at low resurgence risk, and how these factors affect the long-term trajectory of the COVID-19 epidemics, we developed a dynamic transmission model of COVID-19 incorporating vaccination and waning immunity, calibrated using the data of accumulative vaccine doses administered and the COVID-19 epidemic in 2020 in mainland China. The prediction suggests that the vaccination coverage with at least one dose reach 95.87%, and two doses reach 77.92% on 31 August 2021. However, despite the mass vaccination, randomly introducing infected cases in the post-vaccination period causes large outbreaks quickly with waning immunity, particularly for SARS-CoV-2 variants with higher transmissibility. The results showed that with the current vaccination program and 50% of the population wearing masks, mainland China can be protected at low resurgence risk until 8 January 2023. However, ADE and higher transmissibility for variants would significantly shorten the low-risk period by over 1 year. Furthermore, intermittent outbreaks can occur while the peak values of the subsequent outbreaks decrease, indicating that subsequent outbreaks boosted immunity in the population level, further indicating that follow-up vaccination programs can help mitigate or avoid the possible outbreaks. The findings revealed that the integrated effects of multiple factors: waning immunity, ADE, relaxed interventions, and higher variant transmissibility, make controlling COVID-19 challenging. We should prepare for a long struggle with COVID-19, and not entirely rely on the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

• Countries pursuing 'zero COVID' rely on strong restrictions or even city lockdown. • Optimally balancing restrictions's length and confidence that the outbreak is ending is important. • The proportion of cases who miss the intervention restrictions and thus are capable of causing secondary transmission is estimated. • An iterative method is designed to quantify the daily end-of-outbreak confidence since the last reported case. • The projection of the end-of-outbreak day relies on the size of reproduction number and the acceptable risk threshold assuming the invariant distribution of serial interval. The end-of-outbreak declaration is an important part of epidemic control, marking the relaxation or cancellation of prevention and control measures. We propose a probability model to retrospectively quantify the confidence of giving the end-of-outbreak declaration during the COVID-19 epidemic in early 2020 in Wuhan. By using the linear spline, we firstly estimates the time-varying proportion of cases who miss the nonpharmaceutical interventions (NPIs) among all reported cases. Assuming the reproduction numbers being 1.5, 2.0, 3.0, 4.0, 5.0 and 6.0, the respective probability of the end of the COVID-19 outbreak with time after the last reported case can be iteratively computed. Consequently, the varying reproduction numbers produce slightly different increasing patterns of NPI effectiveness, and the end-of-outbreak declarations with 95% confidence are projected consistently earlier than the day when the lockdown was actually lifted. The reason for the timing discrepancy is discussed as well. [ABSTRACT FROM AUTHOR]