An exact method for quantifying the reliability of end-of-epidemic declarations in real time
File(s)pcbi.1008478.pdf (2.14 MB)
Published version
Author(s)
Parag, Kris
Donnelly, Christl
Jha, Rahul
Thompson, Robin
Type
Journal Article
Abstract
We derive and validate a novel and analytic method for estimating the probability that an epidemic has been eliminated (i.e. that no future local cases will emerge) in real time. When this probability crosses 0.95 an outbreak can be declared over with 95% confidence. Our method is easy to compute, only requires knowledge of the incidence curve and the serial interval distribution, and evaluates the statistical lifetime of the outbreak of interest. Using this approach, we show how the time-varying under-reporting of infected cases will artificially inflate the inferred probability of elimination, leading to premature (false-positive) end-of-epidemic declarations. Contrastingly, we prove that incorrectly identifying imported cases as local will deceptively decrease this probability, resulting in delayed (false-negative) declarations. Failing to sustain intensive surveillance during the later phases of an epidemic can therefore substantially mislead policymakers on when it is safe to remove travel bans or relax quarantine and social distancing advisories. World Health Organisation guidelines recommend fixed (though disease-specific) waiting times for end-of-epidemic declarations that cannot accommodate these variations. Consequently, there is an unequivocal need for more active and specialised metrics for reliably identifying the conclusion of an epidemic.
Date Issued
2020-11-30
Date Acceptance
2020-10-28
Citation
PLoS Computational Biology, 2020, 16 (11)
ISSN
1553-734X
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS Computational Biology
Volume
16
Issue
11
Copyright Statement
© 2020 Parag et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Sponsor
Medical Research Council (MRC)
Grant Number
MR/R015600/1
Subjects
Bioinformatics
01 Mathematical Sciences
06 Biological Sciences
08 Information and Computing Sciences
Publication Status
Published
Article Number
ARTN e1008478