The Role of Mobility in the Dynamics of the COVID-19 Epidemic in Andalusia.

Metapopulation models have been a popular tool for the study of epidemic spread over a network of highly populated nodes (cities, provinces, countries) and have been extensively used in the context of the ongoing COVID-19 pandemic. In the present work, we revisit such a model, bearing a particular case example in mind, namely that of the region of Andalusia in Spain during the period of the summer-fall of 2020 (i.e., between the first and second pandemic waves). Our aim is to consider the possibility of incorporation of mobility across the province nodes focusing on mobile-phone time-dependent data, but also discussing the comparison for our case example with a gravity model, as well as with the dynamics in the absence of mobility. Our main finding is that mobility is key toward a quantitative understanding of the emergence of the second wave of the pandemic and that the most accurate way to capture it involves dynamic (rather than static) inclusion of time-dependent mobility matrices based on cell-phone data. Alternatives bearing no mobility are unable to capture the trends revealed by the data in the context of the metapopulation model considered herein.

Backcasting COVID-19: a physics-informed estimate for early case incidence.

It is widely accepted that the number of reported cases during the first stages of the COVID-19 pandemic severely underestimates the number of actual cases. We leverage delay embedding theorems of Whitney and Takens and use Gaussian process regression to estimate the number of cases during the first 2020 wave based on the second wave of the epidemic in several European countries, South Korea and Brazil. We assume that the second wave was more accurately monitored, even though we acknowledge that behavioural changes occurred during the pandemic and region- (or country-) specific monitoring protocols evolved. We then construct a manifold diffeomorphic to that of the implied original dynamical system, using fatalities or hospitalizations only. Finally, we restrict the diffeomorphism to the reported cases coordinate of the dynamical system. Our main finding is that in the European countries studied, the actual cases are under-reported by as much as 50%. On the other hand, in South Korea-which had a proactive mitigation approach-a far smaller discrepancy between the actual and reported cases is predicted, with an approximately 18% predicted underestimation. We believe that our backcasting framework is applicable to other epidemic outbreaks where (due to limited or poor quality data) there is uncertainty around the actual cases.

Modelling of spatial infection spread through heterogeneous population: from lattice to partial differential equation models.

We present a simple model for the spread of an infection that incorporates spatial variability in population density. Starting from first-principle considerations, we explore how a novel partial differential equation with state-dependent diffusion can be obtained. This model exhibits higher infection rates in the areas of higher population density-a feature that we argue to be consistent with epidemiological observations. The model also exhibits an infection wave, the speed of which varies with population density. In addition, we demonstrate the possibility that an infection can 'jump' (i.e. tunnel) across areas of low population density towards areas of high population density. We briefly touch upon the data reported for coronavirus spread in the Canadian province of Nova Scotia as a case example with a number of qualitatively similar features as our model. Lastly, we propose a number of generalizations of the model towards future studies.

Reaction-diffusion spatial modeling of COVID-19: Greece and Andalusia as case examples.

We examine the spatial modeling of the outbreak of COVID-19 in two regions: the autonomous community of Andalusia in Spain and the mainland of Greece. We start with a zero-dimensional (0D; ordinary-differential-equation-level) compartmental epidemiological model consisting of Susceptible, Exposed, Asymptomatic, (symptomatically) Infected, Hospitalized, Recovered, and deceased populations (SEAIHR model). We emphasize the importance of the viral latent period (reflected in the exposed population) and the key role of an asymptomatic population. We optimize model parameters for both regions by comparing predictions to the cumulative number of infected and total number of deaths, the reported data we found to be most reliable, via minimizing the ℓ^{2} norm of the difference between predictions and observed data. We consider the sensitivity of model predictions on reasonable variations of model parameters and initial conditions, and we address issues of parameter identifiability. We model both the prequarantine and postquarantine evolution of the epidemic by a time-dependent change of the viral transmission rates that arises in response to containment measures. Subsequently, a spatially distributed version of the 0D model in the form of reaction-diffusion equations is developed. We consider that, after an initial localized seeding of the infection, its spread is governed by the diffusion (and 0D model "reactions") of the asymptomatic and symptomatically infected populations, which decrease with the imposed restrictive measures. We inserted the maps of the two regions, and we imported population-density data into the finite-element software package COMSOL Multiphysics®, which was subsequently used to numerically solve the model partial differential equations. Upon discussing how to adapt the 0D model to this spatial setting, we show that these models bear significant potential towards capturing both the well-mixed, zero-dimensional description and the spatial expansion of the pandemic in the two regions. Veins of potential refinement of the model assumptions towards future work are also explored.

Lockdown measures and their impact on single- and two-age-structured epidemic model for the COVID-19 outbreak in Mexico.

The role of lockdown measures in mitigating COVID-19 in Mexico is investigated using a comprehensive nonlinear ODE model. The model includes both asymptomatic and presymptomatic populations with the latter leading to sickness (with recovery, hospitalization and death as possible outcomes). We consider situations involving the application of social-distancing and other intervention measures in the time series of interest. We find optimal parametric fits to the time series of deaths (only), as well as to the time series of deaths and cumulative infections. We discuss the merits and disadvantages of each approach, we interpret the parameters of the model and assess the realistic nature of the parameters resulting from the optimization procedure. Importantly, we explore a model involving two sub-populations (younger and older than a specific age), to more accurately reflect the observed impact as concerns symptoms and behavior in different age groups. For definiteness and to separate people that are (typically) in the active workforce, our partition of population is with respect to members younger vs. older than the age of 65. The basic reproduction number of the model is computed for both the single- and the two-population variant. Finally, we consider what would be the impact of partial lockdown (involving only the older population) and full lockdown (involving the entire population) on the number of deaths and cumulative infections.

Easing COVID-19 lockdown measures while protecting the older restricts the deaths to the level of the full lockdown.

Guided by a rigorous mathematical result, we have earlier introduced a numerical algorithm, which using as input the cumulative number of deaths caused by COVID-19, can estimate the effect of easing of the lockdown conditions. Applying this algorithm to data from Greece, we extend it to the case of two subpopulations, namely, those consisting of individuals below and above 40 years of age. After supplementing the Greek data for deaths with the data for the number of individuals reported to be infected by SARS-CoV-2, we estimated the effect on deaths and infections in the case that the easing of the lockdown measures is different for these two subpopulations. We found that if the lockdown measures are partially eased only for the young subpopulation, then the effect on deaths and infections is small. However, if the easing is substantial for the older population, this effect may be catastrophic.

A quantitative framework for exploring exit strategies from the COVID-19 lockdown.

Following the highly restrictive measures adopted by many countries for combating the current pandemic, the number of individuals infected by SARS-CoV-2 and the associated number of deaths steadily decreased. This fact, together with the impossibility of maintaining the lockdown indefinitely, raises the crucial question of whether it is possible to design an exit strategy based on quantitative analysis. Guided by rigorous mathematical results, we show that this is indeed possible: we present a robust numerical algorithm which can compute the cumulative number of deaths that will occur as a result of increasing the number of contacts by a given multiple, using as input only the most reliable of all data available during the lockdown, namely the cumulative number of deaths.