Sub-spreading events limit the reliable elimination of heterogeneous epidemics
File(s)rsif.2021.0444.pdf (1.05 MB)
Published version
Author(s)
Parag, Kris
Type
Journal Article
Abstract
We show that sub-spreading events i.e., transmission events in which an infection propagates to few or no individuals, can be surprisingly important for defining the lifetime of an infectious disease epidemic and hence its waiting time to elimination or fade-out, measured from the time-point of its last observed case. While limiting super-spreading promotes more effective control when cases are growing, we find that when incidence is waning, curbing sub-spreading is more important for achieving reliable elimination of the epidemic. Controlling super-spreading in this low-transmissibility phase offers diminishing returns over non-selective, population-wide measures. By restricting sub-spreading we efficiently dampen remaining variations among the reproduction numbers of infectious events, which minimises the risk of premature and late end-of-epidemic declarations. Because case-ascertainment or reporting rates can be modelled in exactly the same way as control policies, we concurrently show that the under-reporting of sub-spreading events during waning phases will engender overconfident assessments of epidemic elimination. While controlling sub-spreading may not be easily realised, the likely neglecting of these events by surveillance systems could result in unexpectedly risky end-of-epidemic declarations. Super-spreading controls the size of the epidemic peak but sub-spreading mediates the variability of its tail.
Date Issued
2021-08-18
Date Acceptance
2021-07-22
Citation
Journal of the Royal Society Interface, 2021, 18 (181), pp.1-10
ISSN
1742-5662
Publisher
The Royal Society
Start Page
1
End Page
10
Journal / Book Title
Journal of the Royal Society Interface
Volume
18
Issue
181
Copyright Statement
© 2021 The Authors.
Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.
Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.
License URL
Sponsor
Medical Research Council (MRC)
Identifier
https://royalsocietypublishing.org/doi/10.1098/rsif.2021.0444
Grant Number
MR/R015600/1
Subjects
Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
infectious diseases
heterogeneity
overdispersion
super-spreading
elimination
reproduction numbers
OUTBREAK
TRANSMISSION
FRAMEWORK
END
elimination
heterogeneity
infectious diseases
overdispersion
reproduction numbers
super-spreading
General Science & Technology
Publication Status
Published
Date Publish Online
2021-08-18