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The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. “Superspreading,” or “over-dispersion,” is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities with data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.

The emergence of drug resistance during antimicrobial therapy is a major global health problem, especially for chronic infections like human immunodeficiency virus, hepatitis B and C, and tuberculosis. Sub-optimal adherence to long-term treatment is an important contributor to resistance risk. New long-acting drugs are being developed for weekly, monthly or less frequent dosing to improve adherence, but may lead to long-term exposure to intermediate drug levels. In this study, we analyse the effect of dosing frequency on the risk of resistance evolving during time-varying drug levels. We find that long-acting therapies can increase, decrease or have little effect on resistance, depending on the source (pre-existing or de novo) and degree of resistance, and rates of drug absorption and clearance. Long-acting therapies with rapid drug absorption, slow clearance and strong wild-type inhibition tend to reduce resistance caused by partially resistant strains in the early stages of treatment even if they do not improve adherence. However, if subpopulations of microbes persist and can reactivate during sub-optimal treatment, longer-acting therapies may substantially increase the resistance risk. Our results show that drug kinetics affect selection for resistance in a complicated manner, and that pathogen-specific models are needed to evaluate the benefits of new long-acting therapies.

Massive unemployment during the COVID-19 pandemic could result in an eviction crisis in US cities. Here we model the effect of evictions on SARS-CoV-2 epidemics, simulating viral transmission within and among households in a theoretical metropolitan area. We recreate a range of urban epidemic trajectories and project the course of the epidemic under two counterfactual scenarios, one in which a strict moratorium on evictions is in place and enforced, and another in which evictions are allowed to resume at baseline or increased rates. We find, across scenarios, that evictions lead to significant increases in infections. Applying our model to Philadelphia using locally-specific parameters shows that the increase is especially profound in models that consider realistically heterogenous cities in which both evictions and contacts occur more frequently in poorer neighborhoods. Our results provide a basis to assess eviction moratoria and show that policies to stem evictions are a warranted and important component of COVID-19 control., Massive unemployment during the COVID-19 pandemic could result in an eviction crisis in US cities. Here, the authors model the effect of evictions on SARS-CoV-2 epidemics, simulating viral transmission within and among households in a theoretical and applied urban settings.

The coronavirus disease 2019 (COVID-19) pandemic is straining public health systems worldwide, and major non-pharmaceutical interventions have been implemented to slow its spread1,2,3,4. During the initial phase of the outbreak, dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was primarily determined by human mobility from Wuhan, China5,6. Yet empirical evidence on the effect of key geographic factors on local epidemic transmission is lacking7. In this study, we analyzed highly resolved spatial variables in cities, together with case count data, to investigate the role of climate, urbanization and variation in interventions. We show that the degree to which cases of COVID-19 are compressed into a short period of time (peakedness of the epidemic) is strongly shaped by population aggregation and heterogeneity, such that epidemics in crowded cities are more spread over time, and crowded cities have larger total attack rates than less populated cities. Observed differences in the peakedness of epidemics are consistent with a meta-population model of COVID-19 that explicitly accounts for spatial hierarchies. We paired our estimates with globally comprehensive data on human mobility and predict that crowded cities worldwide could experience more prolonged epidemics.

Billions of doses of COVID-19 vaccines have been administered globally, dramatically reducing SARS-CoV-2 incidence and severity in some settings. Many studies suggest vaccines provide a high degree of protection against infection and disease, but precise estimates vary and studies differ in design, outcomes measured, dosing regime, location, and circulating virus strains. Here we conduct a systematic review of COVID-19 vaccines through February 2022. We included efficacy data from Phase 3 clinical trials for 15 vaccines undergoing WHO Emergency Use Listing evaluation and real-world effectiveness for 8 vaccines with observational studies meeting inclusion criteria. Vaccine metrics collected include protection against asymptomatic infection, any infection, symptomatic COVID-19, and severe outcomes including hospitalization and death, for partial or complete vaccination, and against variants of concern Alpha, Beta, Gamma, Delta, and Omicron. We additionally review the epidemiological principles behind the design and interpretation of vaccine efficacy and effectiveness studies, including important sources of heterogeneity.

In almost all animals, the transfer of information from the brain to the motor circuitry is facilitated by a relatively small number of neurons, leading to a constraint on the amount of information that can be transmitted. Our knowledge of how animals encode information through this pathway, and the consequences of this encoding, however, is limited. In this study, we use a simple feed-forward neural network to investigate the consequences of having such a bottleneck and identify aspects of the network architecture that enable robust information transfer. We are able to explain some recently observed properties of descending neurons – that they exhibit a modular pattern of connectivity and that their excitation leads to consistent alterations in behavior that are often dependent upon the prior behavioral state (context-dependency). Our model predicts that in the presence of an information bottleneck, such a modular structure is needed to increase the efficiency of the network and to make it more robust to perturbations. However, it does so at the cost of an increase in context-dependency. Despite its simplicity, our model is able to provide intuition for the trade-offs faced by the nervous system in the presence of an information processing constraint and makes predictions for future experiments.

The emergence of drug resistance during antimicrobial therapy is a major global health problem, especially for chronic infections like HIV, hepatitis B and C, and TB. Sub-optimal adherence to long-term treatment is an important contributor to resistance risk. New long-acting drugs are being developed for weekly, monthly, or less frequent dosing to improve adherence, but may lead to long-term exposure to intermediate drug levels. In this study we analyze the effect of dosing frequency on the risk of resistance evolving in the presence of time-varying drug levels. We find that long-acting therapies can increase, decrease, or have little effect on resistance, depending on the source (pre-existing or de novo) and degree (full or partial) of resistance, and whether the drug is absorbed – as well as cleared – more slowly. For long-acting therapies with slow drug clearance but rapid absorption, and for partially-resistant strains, longer dosing intervals tend to reduce resistance risks even if they don’t improve adherence, and adherence improvements amplify these effects. In other scenarios, long-acting therapies are more susceptible to resistance and must substantially improve adherence to overcome this deficit. If subpopulations of microbes persist and can reactivate during suboptimal treatment, longer-acting therapies may substantially increase the risk of resistance. Our results show that drug kinetics affect selection for resistance in a complicated manner, and that pathogen-specific models are needed to evaluate the benefit of new long-acting therapies.

The COVID-19 pandemic is straining public health systems worldwide and major non-pharmaceutical interventions have been implemented to slow its spread1-4. During the initial phase of the outbreak the spread was primarily determined by human mobility5,6. Yet empirical evidence on the effect of key geographic factors on local epidemic spread is lacking7. We analyse highly-resolved spatial variables for cities in China together with case count data in order to investigate the role of climate, urbanization, and variation in interventions across China. Here we show that the epidemic intensity of COVID-19 is strongly shaped by crowding, such that epidemics in dense cities are more spread out through time, and denser cities have larger total incidence. Observed differences in epidemic intensity are well captured by a metapopulation model of COVID-19 that explicitly accounts for spatial hierarchies. Densely-populated cities worldwide may experience more prolonged epidemics. Whilst stringent interventions can shorten the time length of these local epidemics, although these may be difficult to implement in many affected settings.

The soft factorization theorem for 4D abelian gauge theory states that the $\mathcal{S}$-matrix factorizes into soft and hard parts, with the universal soft part containing all soft and collinear poles. Similarly, correlation functions on the sphere in a 2D CFT with a $U(1)$ Kac-Moody current algebra factorize into current algebra and non-current algebra factors, with the current algebra factor fully determined by its pole structure. In this paper, we show that these 4D and 2D factorizations are mathematically the same phenomena. The soft `tHooft-Wilson lines and soft photons are realized as a complexified 2D current algebra on the celestial sphere at null infinity. The current algebra level is determined by the cusp anomalous dimension. The associated complex $U(1)$ boson lives on a torus whose modular parameter is $\tau =\frac {2\pi i }{e^2}+\frac{\theta}{ 2 \pi}$. The correlators of this 2D current algebra fully reproduce the known soft part of the 4D $\mathcal{S}$-matrix, as well as a conjectured generalization involving magnetic charges., Comment: 20 pages