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1.
Preprint in English | medRxiv | ID: ppmedrxiv-21252583

ABSTRACT

Epidemiological simulations as a method are used to better understand and predict the spreading of infectious diseases, for example of COVID-19. This paper presents an approach that combines a well-established approach from transportation modelling that uses person-centric data-driven human mobility modelling with a mechanistic infection model and a person-centric disease progression model. The model includes the consequences of different room sizes, air exchange rates, disease import, changed activity participation rates over time (coming from mobility data), masks, indoors vs. outdoors leisure activities, and of contact tracing. The model is validated against the infection dynamics in Berlin (Germany). The model can be used to understand the contributions of different activity types to the infection dynamics over time. The model predicts the effects of contact reductions, school closures/vacations, masks, or the effect of moving leisure activities from outdoors to indoors in fall, and is thus able to quantitatively predict the consequences of interventions. It is shown that these effects are best given as additive changes of the reinfection rate R. The model also explains why contact reductions have decreasing marginal returns, i.e. the first 50% of contact reductions have considerably more effect than the second 50%. Our work shows that is is possible to build detailed epidemiological simulations from microscopic mobility models relatively quickly. They can be used to investigate mechanical aspects of the dynamics, such as the transmission from political decisions via human behavior to infections, consequences of different lockdown measures, or consequences of wearing masks in certain situations. The results can be used to inform political decisions. Author summaryEvidently, there is an interest in models that are able to predict the effect of interventions in the face of pandemic diseases. The so-called compartmental models have difficulties to include effects that stem from spatial, demographic or temporal inhomongeneities. Person-centric models, often using social contact matrices, are difficult and time-consuming to build up. In the present paper, we describe how we built a largely data-driven person-centric infection model within less than a month when COVID-19 took hold in Germany. The model is based on our extensive experience with mobility modelling, and a synthetic data pipeline that starts with mobile phone data, while taking the infection dynamics and the disease progression from the literature. The approach makes the model portable to all places that have similar so-called activity-based models of travel in place, which are many places world-wide, and the number is continuously increasing. The model has been used since its inception to regularly advise the German government on expected consequences of interventions.

2.
Preprint in English | medRxiv | ID: ppmedrxiv-20241885

ABSTRACT

The Covid-19 disease has caused a world-wide pandemic with more than 60 million positive cases and more than 1.4 million deaths by the end of November 2020. As long as effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, self-isolation and quarantine as well as far-reaching shutdowns of economic activity and public life are the only available strategies to prevent the virus from spreading. These interventions must meet conflicting requirements where some objectives, like the minimization of disease-related deaths or the impact on health systems, demand for stronger counter-measures, while others, such as social and economic costs, call for weaker counter-measures. Therefore, finding the optimal compromise of counter-measures requires the solution of a multi-objective optimization problem that is based on accurate prediction of future infection spreading for all combinations of counter-measures under consideration. We present a strategy for construction and solution of such a multi-objective optimization problem with real-world applicability. The strategy is based on a micro-model allowing for accurate prediction via a realistic combination of person-centric data-driven human mobility and behavior, stochastic infection models and disease progression models including micro-level inclusion of governmental intervention strategies. For this micro-model, a surrogate macro-model is constructed and validated that is much less computationally expensive and can therefore be used in the core of a numerical solver for the multi-objective optimization problem. The resulting set of optimal compromises between counter-measures (Pareto front) is discussed and its meaning for policy decisions is outlined.

3.
Preprint in English | medRxiv | ID: ppmedrxiv-20160093

ABSTRACT

Epidemiological simulations as a method are used to better understand and predict the spreading of infectious diseases, for example of COVID-19. This paper presents an approach that combines person-centric data-driven human mobility modelling with a mechanistic infection model and a person-centric disease progression model. Results show that in Berlin (Germany), behavioral changes of the population mostly happened before the government-initiated so-called contact ban came into effect. Also, the model is used to determine differentiated changes to the reinfection rate for different interventions such as reductions in activity participation, the wearing of masks, or contact tracing followed by quarantine-at-home. One important result is that successful contact tracing reduces the reinfection rate by about 30 to 40%, and that if contact tracing becomes overwhelmed then infection rates immediately jump up accordingly, making rather strong lockdown measures necessary to bring the reinfection rate back to below one.

4.
Preprint in English | medRxiv | ID: ppmedrxiv-20045302

ABSTRACT

1Executive summaryWe use human mobility models, for which we are experts, and attach a virus infection dynamics to it, for which we are not experts but have taken it from the literature, including recent publications. This results in a virus spreading dynamics model. The results should be verified, but because of the current time pressure, we publish them in their current state. Recommendations for improvement are welcome. We come to the following conclusions: O_LIComplete lockdown works. About 10 days after lockdown, the infection dynamics dies down. This assumes that lockdown is complete, which can be guaranteed in the simulation, but not in reality. Still, it gives strong support to the argument that it is never too late for complete lockdown. C_LIO_LIAs a rule of thumb, we would suggest complete lockdown no later than once 10% of hospital capacities available for COVID-19 are in use, and possibly much earlier. This is based on the following insights: O_LIEven after lockdown, the infection dynamics continues at home, leading to another tripling of the cases before the dynamics is slowed. C_LIO_LIThere will be many critical cases coming from people who were infected before lockdown. Because of the exponential growth dynamics, their number will be large. C_LIO_LIResearchers with more detailed disease progression models should improve upon these statements. C_LI C_LIO_LIOur simulations say that complete removal of infections at child care, primary schools, workplaces and during leisure activities will not be enough to sufficiently slow down the infection dynamics. It would have been better, but still not sufficient, if initiated earlier. C_LIO_LIInfections in public transport play an important role. In the simulations shown later, removing infections in the public transport system reduces the infection speed and the height of the peak by approximately 20%. Evidently, this depends on the infection parameters, which are not well known. - This does not point to reducing public transport capacities as a reaction to the reduced demand, but rather use it for lower densities of passengers and thus reduced infection rates. C_LIO_LIIn our simulations, removal of infections at child care, primary schools, workplaces, leisure activities, and in public transport may barely have been sufficient to control the infection dynamics if implemented early on. Now according to our simulations it is too late for this, and (even) harsher measures will have to be initiated until possibly a return to such a restrictive, but still somewhat functional regime will again be possible. C_LI Evidently, all of these results have to be taken with care. They are based on preliminary infection parameters taken from the literature, used inside a model that has more transport/movement details than all others that we are aware of but still not enough to describe all aspects of reality, and suffer from having to write computer code under time pressure. Optimally, they should be confirmed independently. Short of that, given current knowledge we believe that they provide justification for "complete lockdown" at the latest when about 10% of available hospital capacities for COVID-19 are in use (and possibly earlier; we are no experts of hospital capabilities).1 What was not investigated in detail in our simulations was contact tracing, i.e. tracking down the infection chains and moving all people along infection chains into quarantine. The case of Singapore has so far shown that this may be successful. Preliminary simulation of that tactic shows that it is difficult to implement for COVID-19, since the incubation time is rather long, people are contagious before they feel sick, or maybe never feel sufficiently sick at all. We will investigate in future work if and how contact tracing can be used together with a restrictive, but not totally locked down regime. When opening up after lockdown, it would be important to know the true fraction of people who are already immune, since that would slow down the infection dynamics by itself. For Wuhan, the currently available numbers report that only about 0.1% of the population was infected, which would be very far away from "herd immunity". However, there have been and still may be many unknown infections (Frankfurter Allgemeine Zeitung GmbH 2020).

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