From individual-based epidemic models to McKendrick-von Foerster PDEs: a guide to modeling and inferring COVID-19 dynamics.

We present a unifying, tractable approach for studying the spread of viruses causing complex diseases requiring to be modeled using a large number of types (e.g., infective stage, clinical state, risk factor class). We show that recording each infected individual's infection age, i.e., the time elapsed since infection, has three benefits. First, regardless of the number of types, the age distribution of the population can be described by means of a first-order, one-dimensional partial differential equation (PDE) known as the McKendrick-von Foerster equation. The frequency of type i is simply obtained by integrating the probability of being in state i at a given age against the age distribution. This representation induces a simple methodology based on the additional assumption of Poisson sampling to infer and forecast the epidemic. We illustrate this technique using French data from the COVID-19 epidemic. Second, our approach generalizes and simplifies standard compartmental models using high-dimensional systems of ordinary differential equations (ODEs) to account for disease complexity. We show that such models can always be rewritten in our framework, thus, providing a low-dimensional yet equivalent representation of these complex models. Third, beyond the simplicity of the approach, we show that our population model naturally appears as a universal scaling limit of a large class of fully stochastic individual-based epidemic models, where the initial condition of the PDE emerges as the limiting age structure of an exponentially growing population starting from a single individual.

The stochastic dynamics of early epidemics: probability of establishment, initial growth rate, and infection cluster size at first detection.

Emerging epidemics and local infection clusters are initially prone to stochastic effects that can substantially impact the early epidemic trajectory. While numerous studies are devoted to the deterministic regime of an established epidemic, mathematical descriptions of the initial phase of epidemic growth are comparatively rarer. Here, we review existing mathematical results on the size of the epidemic over time, and derive new results to elucidate the early dynamics of an infection cluster started by a single infected individual. We show that the initial growth of epidemics that eventually take off is accelerated by stochasticity. As an application, we compute the distribution of the first detection time of an infected individual in an infection cluster depending on testing effort, and estimate that the SARS-CoV-2 variant of concern Alpha detected in September 2020 first appeared in the UK early August 2020. We also compute a minimal testing frequency to detect clusters before they exceed a given threshold size. These results improve our theoretical understanding of early epidemics and will be useful for the study and control of local infectious disease clusters.