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  5. Fundamental limits on inferring epidemic resurgence in real time using effective reproduction numbers
 
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Fundamental limits on inferring epidemic resurgence in real time using effective reproduction numbers
File(s)
journal.pcbi.1010004.pdf (1.92 MB)
Published version
Author(s)
Parag, Kris
Donnelly, Christl
Type
Journal Article
Abstract
We find that epidemic resurgence, defined as an upswing in the effective reproduction number (R) of the contagion from subcritical to supercritical values, is fundamentally difficult to detect in real time. Inherent latencies in pathogen transmission, coupled with smaller and intrinsically noisier case incidence across periods of subcritical spread, mean that resurgence cannot be reliably detected without significant delays of the order of the generation time of the disease, even when case reporting is perfect. In contrast, epidemic suppression (where R falls from supercritical to subcritical values) may be ascertained 5–10 times faster due to the naturally larger incidence at which control actions are generally applied. We prove that these innate limits on detecting resurgence only worsen when spatial or demographic heterogeneities are incorporated. Consequently, we argue that resurgence is more effectively handled proactively, potentially at the expense of false alarms. Timely responses to recrudescent infections or emerging variants of concern are more likely to be possible when policy is informed by a greater quality and diversity of surveillance data than by further optimisation of the statistical models used to process routine outbreak data.
Date Issued
2022-04-11
Date Acceptance
2022-04-06
Citation
PLoS Computational Biology, 2022, 18 (4)
URI
http://hdl.handle.net/10044/1/96889
DOI
https://www.dx.doi.org/10.1371/journal.pcbi.1010004
ISSN
1553-734X
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS Computational Biology
Volume
18
Issue
4
Copyright Statement
© 2022 Parag, Donnelly. 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
https://creativecommons.org/licenses/by/4.0/
Sponsor
Medical Research Council (MRC)
Grant Number
MR/R015600/1
Subjects
Basic Reproduction Number
Disease Outbreaks
Epidemics
Incidence
Incidence
Disease Outbreaks
Basic Reproduction Number
Epidemics
Bioinformatics
01 Mathematical Sciences
06 Biological Sciences
08 Information and Computing Sciences
Publication Status
Published
Article Number
ARTN e1010004
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