Delayed epidemic peak caused by infection and recovery rate fluctuations.

Forecasting epidemic scenarios has been critical to many decision-makers in imposing various public health interventions. Despite progresses in determining the magnitude and timing of epidemics, epidemic peak time predictions for H1N1 and COVID-19 were inaccurate, with the peaks delayed with respect to predictions. Here, we show that infection and recovery rate fluctuations play a critical role in peak timing. Using a susceptible-infected-recovered model with daily fluctuations on control parameters, we show that infection counts follow a lognormal distribution at the beginning of an epidemic wave, similar to price distributions for financial assets. The epidemic peak time of the stochastic solution exhibits an inverse Gaussian probability distribution, fitting the spread of the epidemic peak times observed across Italian regions. We also show that, for a given basic reproduction number R0, the deterministic model anticipates the peak with respect to the most probable and average peak time of the stochastic model. The epidemic peak time distribution allows one for a robust estimation of the epidemic evolution. Considering these results, we believe that the parameters' dynamical fluctuations are paramount to accurately predict the epidemic peak time and should be introduced in epidemiological models.

Interrupting vaccination policies can greatly spread SARS-CoV-2 and enhance mortality from COVID-19 disease: The AstraZeneca case for France and Italy.

Several European countries have suspended the inoculation of the AstraZeneca vaccine out of suspicion that it causes deep vein thrombosis. In this letter, we report some Fermi estimates performed using a stochastic model aimed at making a risk-benefit analysis of the interruption of the delivery of the AstraZeneca vaccine in France and Italy. Our results clearly show that excess deaths due to the interruption of the vaccination campaign injections largely overrun those due to thrombosis even in worst case scenarios of frequency and gravity of the vaccine side effects.

Modeling the second wave of COVID-19 infections in France and Italy via a stochastic SEIR model.

COVID-19 has forced quarantine measures in several countries across the world. These measures have proven to be effective in significantly reducing the prevalence of the virus. To date, no effective treatment or vaccine is available. In the effort of preserving both public health and the economical and social textures, France and Italy governments have partially released lockdown measures. Here, we extrapolate the long-term behavior of the epidemic in both countries using a susceptible-exposed-infected-recovered model, where parameters are stochastically perturbed with a lognormal distribution to handle the uncertainty in the estimates of COVID-19 prevalence and to simulate the presence of super-spreaders. Our results suggest that uncertainties in both parameters and initial conditions rapidly propagate in the model and can result in different outcomes of the epidemic leading or not to a second wave of infections. Furthermore, the presence of super-spreaders adds instability to the dynamics, making the control of the epidemic more difficult. Using actual knowledge, asymptotic estimates of COVID-19 prevalence can fluctuate of the order of 10×106 units in both countries.

On the uncertainty of real-time predictions of epidemic growths: A COVID-19 case study for China and Italy.

While COVID-19 is rapidly propagating around the globe, the need for providing real-time forecasts of the epidemics pushes fits of dynamical and statistical models to available data beyond their capabilities. Here we focus on statistical predictions of COVID-19 infections performed by fitting asymptotic distributions to actual data. By taking as a case-study the epidemic evolution of total COVID-19 infections in Chinese provinces and Italian regions, we find that predictions are characterized by large uncertainties at the early stages of the epidemic growth. Those uncertainties significantly reduce after the epidemics peak is reached. Differences in the uncertainty of the forecasts at a regional level can be used to highlight the delay in the spread of the virus. Our results warn that long term extrapolation of epidemics counts must be handled with extreme care as they crucially depend not only on the quality of data, but also on the stage of the epidemics, due to the intrinsically non-linear nature of the underlying dynamics. These results suggest that real-time epidemiological projections should include wide uncertainty ranges and urge for the needs of compiling high-quality datasets of infections counts, including asymptomatic patients.