Time-optimal control strategies in SIR epidemic models

A non-standard finite-difference-method for a non-autonomous epidemiological model: analysis, parameter identification and applications

In this work, we propose a new non-standard finite-difference-method for the numerical solution of the time-continuous non-autonomous susceptible-infected-recovered model. For our time-discrete numerical solution algorithm, we prove preservation of non-negativity and show that the unique time-discrete solution converges linearly towards the time-continuous unique solution. In addition to that, we introduce a parameter identification algorithm for the susceptible-infected-recovered model. Finally, we provide two numerical examples to stress our theoretical findings.

A simple planning problem for COVID-19 lockdown: a dynamic programming approach

A large number of recent studies consider a compartmental SIR model to study optimal control policies aimed at containing the diffusion of COVID-19 while minimizing the economic costs of preventive measures. Such problems are non-convex and standard results need not to hold. We use a Dynamic Programming approach and prove some continuity properties of the value function of the associated optimization problem. We study the corresponding Hamilton-Jacobi-Bellman equation and show that the value function solves it in the viscosity sense. Finally, we discuss some optimality conditions. Our paper represents a first contribution towards a complete analysis of non-convex dynamic optimization problems, within a Dynamic Programming approach.

Reframing Optimal Control Problems for Infectious Disease Management in Low-Income Countries

Optimal control theory can be a useful tool to identify the best strategies for the management of infectious diseases. In most of the applications to disease control with ordinary differential equations, the objective functional to be optimized is formulated in monetary terms as the sum of intervention costs and the cost associated with the burden of disease. We present alternate formulations that express epidemiological outcomes via health metrics and reframe the problem to include features such as budget constraints and epidemiological targets. These alternate formulations are illustrated with a compartmental cholera model. The alternate formulations permit us to better explore the sensitivity of the optimal control solutions to changes in available budget or the desired epidemiological target. We also discuss some limitations of comprehensive cost assessment in epidemiology.

Optimal reduced-mixing for an SIS infectious-disease model

Which reduced-mixing strategy maximizes economic output during a disease outbreak? To answer this question, we formulate an optimal-control problem that maximizes the difference between revenue, due to healthy individuals, and medical costs, associated with infective individuals, for SIS disease dynamics. The control variable is the level of mixing in the population, which influences both revenue and the spread of the disease. Using Pontryagin's maximum principle, we find a closed-form solution for our problem. We explore an example of our problem with parameters for the transmission of Staphylococcus aureus in dairy cows, and we perform sensitivity analyses to determine how model parameters affect optimal strategies. We find that less mixing is preferable when the transmission rate is high, the per-capita recovery rate is low, or when the revenue parameter is much smaller than the cost parameter.

Highly coordinated nationwide massive travel restrictions are central to effective mitigation and control of COVID-19 outbreaks in China

COVID-19, the disease caused by the novel coronavirus 2019, has caused grave woes across the globe since it was first reported in the epicentre of Wuhan, Hubei, China, in December 2019. The spread of COVID-19 in China has been successfully curtailed by massive travel restrictions that rendered more than 900 million people housebound for more than two months since the lockdown of Wuhan, and elsewhere, on 23 January 2020. Here, we assess the impact of China’s massive lockdowns and travel restrictions reflected by the changes in mobility patterns across and within provinces, before and during the lockdown period. We calibrate movement flow between provinces with an epidemiological compartment model to quantify the effectiveness of lockdowns and reductions in disease transmission. Our analysis demonstrates that the onset and phase of local community transmission in other provinces depends on the cumulative population outflow received from the epicentre Hubei. Moreover, we show that synchronous lockdowns and consequent reduced mobility lag a certain time to elicit an actual impact on suppressing the spread. Such highly coordinated nationwide lockdowns, applied via a top-down approach along with high levels of compliance from the bottom up, are central to mitigating and controlling early-stage outbreaks and averting a massive health crisis.

A nonlinear optimal control method against the spreading of epidemics

To define a vaccination policy and antiviral treatment against the spreading of viral infections a nonlinear optimal (H-infinity) control approach is proposed. Actually, because of the scarcity of the resources for treating infectious diseases in terms of vaccines, antiviral drugs and other medical facilities, there is need to implement optimal control against the epidemics deployment. In this approach, the state-space model of the epidemics dynamics undergoes first approximate linearization around a temporary operating point which is recomputed at each time-step of the control method. The linearization is based on Taylor series expansion and on the computation of the associated Jacobian matrices. Next, an optimal (H-infinity) feedback controller is developed for the approximately linearized model of the epidemics. To compute the controller’s feedback gains an algebraic Riccati equation is solved at each iteration of the control algorithm. Furthermore, the global asymptotic stability properties of the control scheme are proven through Lyapunov stability analysis. This paper’s results confirm that optimal control of the infectious disease dynamics allows for eliminating its spreading while also keeping moderate the consumption of the related medication, that is vaccines and antiviral drugs.

Effects of Vaccination Efficacy on Wealth Distribution in Kinetic Epidemic Models

The spread of the COVID-19 pandemic has highlighted the close link between economics and health in the context of emergency management. A widespread vaccination campaign is considered the main tool to contain the economic consequences. This paper will focus, at the level of wealth distribution modeling, on the economic improvements induced by the vaccination campaign in terms of its effectiveness rate. The economic trend during the pandemic is evaluated, resorting to a mathematical model joining a classical compartmental model including vaccinated individuals with a kinetic model of wealth distribution based on binary wealth exchanges. The interplay between wealth exchanges and the progress of the infectious disease is realized by assuming, on the one hand, that individuals in different compartments act differently in the economic process and, on the other hand, that the epidemic affects risk in economic transactions. Using the mathematical tools of kinetic theory, it is possible to identify the equilibrium states of the system and the formation of inequalities due to the pandemic in the wealth distribution of the population. Numerical experiments highlight the importance of the vaccination campaign and its positive effects in reducing economic inequalities in the multi-agent society.

Current forecast of COVID-19 in Mexico: A Bayesian and machine learning approaches

The COVID-19 pandemic has been widely spread and affected millions of people and caused hundreds of deaths worldwide, especially in patients with comorbilities and COVID-19. This manuscript aims to present models to predict, firstly, the number of coronavirus cases and secondly, the hospital care demand and mortality based on COVID-19 patients who have been diagnosed with other diseases. For the first part, I present a projection of the spread of coronavirus in Mexico, which is based on a contact tracing model using Bayesian inference. I investigate the health profile of individuals diagnosed with coronavirus to predict their type of patient care (inpatient or outpatient) and survival. Specifically, I analyze the comorbidity associated with coronavirus using Machine Learning. I have implemented two classifiers: I use the first classifier to predict the type of care procedure that a person diagnosed with coronavirus presenting chronic diseases will obtain (i.e. outpatient or hospitalised), in this way I estimate the hospital care demand; I use the second classifier to predict the survival or mortality of the patient (i.e. survived or deceased). I present two techniques to deal with these kinds of unbalanced datasets related to outpatient/hospitalised and survived/deceased cases (which occur in general for these types of coronavirus datasets) to obtain a better performance for the classification.

Highly coordinated nationwide massive travel restrictions are central to effective mitigation and control of COVID-19 outbreaks in China

The COVID-19, the disease caused by the novel coronavirus 2019 (SARS-CoV-2), has caused graving woes across the globe since first reported in the epicenter Wuhan, Hubei, China, December 2019. The spread of COVID-19 in China has been successfully curtailed by massive travel restrictions that put more than 900 million people housebound for more than two months since the lockdown of Wuhan on 23 January 2020 when other provinces in China followed suit. Here, we assess the impact of China's massive lockdowns and travel restrictions reflected by the changes in mobility patterns before and during the lockdown period. We quantify the synchrony of mobility patterns across provinces and within provinces. Using these mobility data, we calibrate movement flow between provinces in combination with an epidemiological compartment model to quantify the effectiveness of lockdowns and reductions in disease transmission. Our analysis demonstrates that the onset and phase of local community transmission in other provinces depends on the cumulative population outflow received from the epicenter Hubei. As such, infections can propagate further into other interconnected places both near and far, thereby necessitating synchronous lockdowns. Moreover, our data-driven modeling analysis shows that lockdowns and consequently reduced mobility lag a certain time to elicit an actual impact on slowing down the spreading and ultimately putting the epidemic under check. In spite of the vastly heterogeneous demographics and epidemiological characteristics across China, mobility data shows that massive travel restrictions have been applied consistently via a top-down approach along with high levels of compliance from the bottom up.

Optimal control of the SIR model with constrained policy, with an application to COVID-19

This article considers the optimal control of the SIR model with both transmission and treatment uncertainty. It follows the model presented in Gatto and Schellhorn (2021). We make four significant improvements on the latter paper. First, we prove the existence of a solution to the model. Second, our interpretation of the control is more realistic: while in Gatto and Schellhorn (2021) the control α is the proportion of the population that takes a basic dose of treatment, so that α>1 occurs only if some patients take more than a basic dose, in our paper, α is constrained between zero and one, and represents thus the proportion of the population undergoing treatment. Third, we provide a complete solution for the moderate infection regime (with constant treatment). Finally, we give a thorough interpretation of the control in the moderate infection regime, while Gatto and Schellhorn (2021) focused on the interpretation of the low infection regime. Finally, we compare the efficiency of our control to curb the COVID-19 epidemic to other types of control.

Time Optimal Control Studies on COVID-19 Incorporating Adverse Events of the Antiviral Drugs

COVID -19 pandemic has resulted in more than 257 million infections and 5.15 million deaths worldwide. Several drug interventions targeting multiple stages of the pathogenesis of COVID -19 can significantly reduce induced infection and thus mortality. In this study, we first develop SIV model at within-host level by incorporating the intercellular time delay and analyzing the stability of equilibrium points. The model dynamics admits a disease-free equilibrium and an infected equilibrium with their stability based on the value of the basic reproduction number R 0. We then formulate an optimal control problem with antiviral drugs and second-line drugs as control measures and study their roles in reducing the number of infected cells and viral load. The comparative study conducted in the optimal control problem suggests that if the first-line antiviral drugs show adverse effects, considering these drugs in reduced amounts along with the second-line drugs would be very effective in reducing the number of infected cells and viral load in a COVID-19 infected patient. Later, we formulate a time-optimal control problem with the goal of driving the system from any initial state to the desired infection-free equilibrium state in finite minimal time. Using Pontryagin’s Minimum Principle, it is shown that the optimal control strategy is of the bang-bang type, with the possibility of switching between two extreme values of the optimal controls. Numerically, it is shown that the desired infection-free state is achieved in a shorter time when the higher values of the optimal controls. The results of this study may be very helpful to researchers, epidemiologists, clinicians and physicians working in this field.

Safety-Critical Control of Compartmental Epidemiological Models With Measurement Delays

We introduce a methodology to guarantee safety against the spread of infectious diseases by viewing epidemiological models as control systems and human interventions (such as quarantining or social distancing) as control input. We consider a generalized compartmental model that represents the form of the most popular epidemiological models and we design safety-critical controllers that formally guarantee safe evolution with respect to keeping certain populations of interest under prescribed safe limits. Furthermore, we discuss how measurement delays originated from incubation period and testing delays affect safety and how delays can be compensated via predictor feedback. We demonstrate our results by synthesizing active intervention policies that bound the number of infections, hospitalizations and deaths for epidemiological models capturing the spread of COVID-19 in the USA.

Optimal control-based vaccination and testing strategies for COVID-19

BACKGROUND AND OBJECTIVE

Assuming the availability of a limited amount of effective COVID-19 rapid tests, the effects of various vaccination strategies on SARS-CoV-2 virus transmission are compared for different vaccination scenarios characterized by distinct limitations associated with vaccine supply and administration.

METHODS

The vaccination strategies are defined by solving optimal control problems of a compartmental epidemic model in which the daily vaccination rate and the daily testing rate for the identification and isolation of asymptomatic subjects are the control variables. Different kinds of algebraic constraints are considered, representing different vaccination scenarios in which the total amount of vaccines available during the time period under consideration is limited or the number of daily available vaccines is limited. These optimal control problems are numerically solved by means of a direct transcription technique, which allows both equality and inequality constraints to be straightforwardly included in the formulation of the optimal control problems.

RESULTS

Several numerical experiments are conducted, in which the objective functional to be minimized is a combination of the number of symptomatic and asymptomatic infectious subjects with the cost of vaccination of susceptible subjects and testing of asymptomatic infectious subjects. The results confirm the hypothesis that the implementation of early control measures significantly reduces the number of symptomatic infected subjects, which is a key aspect for the resilience of the healthcare system. The sensitivity analysis of the solutions to the weighting parameters of the objective functional reveals that it is possible to obtain a vaccination strategy that allows vaccination supplies to be saved while keeping the same number of symptomatic infected subjects. Furthermore, it indicates that if the vaccination plan is not supported by a sufficient rate of testing, the number of symptomatic infected subjects could increase. Finally, the sensitivity analysis shows that a significant reduction in the efficacy of the vaccines could also lead to a relevant increase in the number of symptomatic infected subjects.

CONCLUSIONS

The numerical experiments show that the proposed approach, which is based on optimal control of compartmental epidemic models, provides healthcare systems with a suitable method for scheduling vaccination plans and testing policies to control the spread of the SARS-CoV-2 virus.

Threshold dynamics and optimal control on an age-structured SIRS epidemic model with vaccination

We consider a vaccination control into a age-structured susceptible-infective-recovered-susceptible (SIRS) model and study the global stability of the endemic equilibrium by the iterative method. The basic reproduction number $ R_0 $ is obtained. It is shown that if $ R_0 < 1 $, then the disease-free equilibrium is globally asymptotically stable, if $ R_0 > 1 $, then the disease-free and endemic equilibrium coexist simultaneously, and the global asymptotic stability of endemic equilibrium is also shown. Additionally, the Hamilton-Jacobi-Bellman (HJB) equation is given by employing the Bellman's principle of optimality. Through proving the existence of viscosity solution for HJB equation, we obtain the optimal vaccination control strategy. Finally, numerical simulations are performed to illustrate the corresponding analytical results.

On the optimal control of SIR model with Erlang-distributed infectious period: isolation strategies

Mathematical models are formal and simplified representations of the knowledge related to a phenomenon. In classical epidemic models, a major simplification consists in assuming that the infectious period is exponentially distributed, then implying that the chance of recovery is independent on the time since infection. Here, we first attempt to investigate the consequences of relaxing this assumption on the performances of time-variant disease control strategies by using optimal control theory. In the framework of a basic susceptible–infected–removed (SIR) model, an Erlang distribution of the infectious period is considered and optimal isolation strategies are searched for. The objective functional to be minimized takes into account the cost of the isolation efforts per time unit and the sanitary costs due to the incidence of the epidemic outbreak. Applying the Pontryagin’s minimum principle, we prove that the optimal control problem admits only bang–bang solutions with at most two switches. In particular, the optimal strategy could be postponing the starting intervention time with respect to the beginning of the outbreak. Finally, by means of numerical simulations, we show how the shape of the optimal solutions is affected by the different distributions of the infectious period, by the relative weight of the two cost components, and by the initial conditions.

Modelling lockdown measures in epidemic outbreaks using selective socio-economic containment with uncertainty

After the introduction of drastic containment measures aimed at stopping the epidemic contagion from SARS-CoV2, many governments have adopted a strategy based on a periodic relaxation of such measures in the face of a severe economic crisis caused by lockdowns. Assessing the impact of such openings in relation to the risk of a resumption of the spread of the disease is an extremely difficult problem due to the many unknowns concerning the actual number of people infected, the actual reproduction number and infection fatality rate of the disease. In this work, starting from a SEIRD compartmental model with a social structure based on the age of individuals and stochastic inputs that account for data uncertainty, the effects of containment measures are introduced via an optimal control problem dependent on specific social activities, such as home, work, school, etc. Through a short time horizon approximation, we derive models with multiple feedback controls depending on social activities that allow us to assess the impact of selective relaxation of containment measures in the presence of uncertain data. After analyzing the effects of the various controls, results from different scenarios concerning the first wave of the epidemic in some major countries, including Germany, France, Italy, Spain, the United Kingdom and the United States, are presented and discussed. Specific contact patterns in the home, work, school and other locations have been considered for each country. Numerical simulations show that a careful strategy of progressive relaxation of containment measures, such as that adopted by some governments, may be able to keep the epidemic under control by restarting various productive activities.

Control with uncertain data of socially structured compartmental epidemic models

The adoption of containment measures to reduce the amplitude of the epidemic peak is a key aspect in tackling the rapid spread of an epidemic. Classical compartmental models must be modified and studied to correctly describe the effects of forced external actions to reduce the impact of the disease. The importance of social structure, such as the age dependence that proved essential in the recent COVID-19 pandemic, must be considered, and in addition, the available data are often incomplete and heterogeneous, so a high degree of uncertainty must be incorporated into the model from the beginning. In this work we address these aspects, through an optimal control formulation of a socially structured epidemic model in presence of uncertain data. After the introduction of the optimal control problem, we formulate an instantaneous approximation of the control that allows us to derive new feedback controlled compartmental models capable of describing the epidemic peak reduction. The need for long-term interventions shows that alternative actions based on the social structure of the system can be as effective as the more expensive global strategy. The timing and intensity of interventions, however, is particularly relevant in the case of uncertain parameters on the actual number of infected people. Simulations related to data from the first wave of the recent COVID-19 outbreak in Italy are presented and discussed.

Optimal control of the SIR model in the presence of transmission and treatment uncertainty

The COVID-19 pandemic illustrates the importance of treatment-related decision making in populations. This article considers the case where the transmission rate of the disease as well as the efficiency of treatments is subject to uncertainty. We consider two different regimes, or submodels, of the stochastic SIR model, where the population consists of three groups: susceptible, infected and recovered and dead. In the first regime the proportion of infected is very low, and the proportion of susceptible is very close to 100the proportion of infected is moderate, but not negligible. We show that the first regime corresponds almost exactly to a well-known problem in finance, the problem of portfolio and consumption decisions under mean-reverting returns (Wachter, JFQA 2002), for which the optimal control has an analytical solution. We develop a perturbative solution for the second problem. To our knowledge, this paper represents one of the first attempts to develop analytical/perturbative solutions, as opposed to numerical solutions to stochastic SIR models.

Application of Optimal Control of Infectious Diseases in a Model-Free Scenario

Optimal control for infectious diseases has received increasing attention over the past few decades. In general, a combination of cost state variables and control effort have been applied as cost indices. Many important results have been reported. Nevertheless, it seems that the interpretation of the optimal control law for an epidemic system has received less attention. In this paper, we have applied Pontryagin's maximum principle to develop an optimal control law to minimize the number of infected individuals and the vaccination rate. We have adopted the compartmental model SIR to test our technique. We have shown that the proposed control law can give some insights to develop a control strategy in a model-free scenario. Numerical examples show a reduction of 50% in the number of infected individuals when compared with constant vaccination. There is not always a prior knowledge of the number of susceptible, infected, and recovered individuals required to formulate and solve the optimal control problem. In a model-free scenario, a strategy based on the analytic function is proposed, where prior knowledge of the scenario is not necessary. This insight can also be useful after the development of a vaccine to COVID-19, since it shows that a fast and general cover of vaccine worldwide can minimize the number of infected, and consequently the number of deaths. The considered approach is capable of eradicating the disease faster than a constant vaccination control method.

Optimal Immunity Control and Final Size Minimization by Social Distancing for the SIR Epidemic Model

The aim of this article is to understand how to apply partial or total containment to SIR epidemic model during a given finite time interval in order to minimize the epidemic final size, that is the cumulative number of cases infected during the complete course of an epidemic. The existence and uniqueness of an optimal strategy are proved for this infinite-horizon problem, and a full characterization of the solution is provided. The best policy consists in applying the maximal allowed social distancing effort until the end of the interval, starting at a date that is not always the closest date and may be found by a simple algorithm. Both theoretical results and numerical simulations demonstrate that it leads to a significant decrease in the epidemic final size. We show that in any case the optimal intervention has to begin before the number of susceptible cases has crossed the herd immunity level, and that its limit is always smaller than this threshold. This problem is also shown to be equivalent to the minimum containment time necessary to stop at a given distance after this threshold value.

Piecewise-constant optimal control strategies for controlling the outbreak of COVID-19 in the Irish population

We introduce a deterministic SEIR model and fit it to epidemiological data for the COVID-19 outbreak in Ireland. We couple the model to economic considerations - we formulate an optimal control problem in which the cost to the economy of the various non-pharmaceutical interventions is minimized, subject to hospital admissions never exceeding a threshold value corresponding to health-service capacity. Within the framework of the model, the optimal strategy of disease control is revealed to be one of disease suppression, rather than disease mitigation.

Safety-Critical Control of Active Interventions for COVID-19 Mitigation

The world has recently undergone the most ambitious mitigation effort in a century, consisting of wide-spread quarantines aimed at preventing the spread of COVID-19. The use of influential epidemiological models of COVID-19 helped to encourage decision makers to take drastic non-pharmaceutical interventions. Yet, inherent in these models are often assumptions that the active interventions are static, e.g., that social distancing is enforced until infections are minimized, which can lead to inaccurate predictions that are ever evolving as new data is assimilated. We present a methodology to dynamically guide the active intervention by shifting the focus from viewing epidemiological models as systems that evolve in autonomous fashion to control systems with an "input" that can be varied in time in order to change the evolution of the system. We show that a safety-critical control approach to COVID-19 mitigation gives active intervention policies that formally guarantee the safe evolution of compartmental epidemiological models. This perspective is applied to current US data on cases while taking into account reduction of mobility, and we find that it accurately describes the current trends when time delays associated with incubation and testing are incorporated. Optimal active intervention policies are synthesized to determine future mitigations necessary to bound infections, hospitalizations, and death, both at national and state levels. We therefore provide means in which to model and modulate active interventions with a view toward the phased reopenings that are currently beginning across the US and the world in a decentralized fashion. This framework can be converted into public policies, accounting for the fractured landscape of COVID-19 mitigation in a safety-critical fashion.

A new modelling of the COVID 19 pandemic

А model of coronavirus incidence is proposed. Process of disease development is represented as analogue of first- and second order phase transition in physical systems. The model is very simple in terms of the data necessary for the calculations. To verify the proposed model, only data on the current incidence rate are required. However, the determination coefficient of model R2 is very high and exceeds 0.95 for most countries. The model permits the accurate prediction of the pandemics dynamics at intervals of up to 10 days. The ADL(autoregressive distributed lag)-model was introduced in addition to the phase transition model to describe the development of the disease at the exponential phase.The ADL-model allows describing nonmonotonic changes in relative infection over the time, and providing to governments and health care decision makers the possibility to predict the outcomes of their decisions on public health.

Optimal quarantine control of an infectious outbreak

This paper studies the optimal control of an infectious spread based on common epidemic models with permanent immunity and no vaccine availability. Assuming limited isolation control and capacity constraints on the number of infections, an optimal quarantine control strategy that balances between the total number of infections and the overall isolation effort is derived from necessary optimality conditions. The specific optimal policy is then obtained by optimizing the switching times of this generalized strategy. In the case of a newly emerged disease, these results can be used in a data-driven receding horizon manner to improve actions as more data becomes available. The proposed approach is applied to publicly available data from the outbreak of SARS-CoV-2 in Germany. In particular, for minimizing the total number of infections or the number of isolated individuals, the simulations indicate that a sufficiently delayed and controlled release of the lock-down are optimal for overcoming the outbreak. The approach can support public health authorities to plan quarantine control policies.

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions

When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple "flattening of the curve". Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.

An optimal predictive control strategy for COVID-19 (SARS-CoV-2) social distancing policies in Brazil

This paper formulates a Model Predictive Control (MPC) policy to mitigate the COVID-19 contagion in Brazil, designed as optimal On-Off social isolation strategy. The proposed optimization algorithm is able to determine the time and duration of social distancing policies in the country. The achieved results are based on data from the period between March and May of 2020, regarding the cumulative number of infections and deaths due to the SARS-CoV-2 virus. This dataset is assumably largely sub-notified due to the absence of mass testing in Brazil. Thus, the MPC is based on a SIR model which is identified using an uncertainty-weighted Least-Squares criterion. Furthermore, this model includes an additional dynamic variable that mimics the response of the population to the social distancing policies determined by the government, which affect the COVID-19 transmission rate. The proposed control method is set within a mixed-logical formalism, since the decision variable is forcefully binary (existence or the absence of social distance policy). A dwell-time constraint is included to avoid too frequent shifts between these two inputs. The achieved simulation results illustrate how such optimal control method would operate in practice, pointing out that no social distancing should be relaxed before mid August 2020. If relaxations are necessary, they should not be performed before this date and should be in small periods, no longer than 25 days. This paradigm would proceed roughly until January/2021. The results also indicate a possible second peak of infections, which has a forecast to the beginning of October. This peak can be reduced if the periods of days with relaxed social isolation measures are shortened.

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions

When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple "flattening of the curve". Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.

Optimal control of epidemic size and duration with limited resources

The total number of infections (epidemic size) and the time needed for the infection to go extinct (epidemic duration) represent two of the main indicators for the severity of infectious disease epidemics in human and livestock. However, few attempts have been made to address the problem of minimizing at the same time the epidemic size and duration from a theoretical point of view by using optimal control theory. Here, we investigate the multi-objective optimal control problem aiming to minimize, through either vaccination or isolation, a suitable combination of epidemic size and duration when both maximum control effort and total amount of resources available during the entire epidemic period are limited. Application of Pontryagin's Maximum Principle to a Susceptible-Infected-Removed epidemic model, shows that, when the resources are not sufficient to maintain the maximum control effort for the entire duration of the epidemic, the optimal vaccination control admits only bang-bang solutions with one or two switches, while the optimal isolation control admits only bang-bang solutions with one switch. We also find that, especially when the maximum control effort is low, there may exist a trade-off between the minimization of the two objectives. Consideration of this conflict among objectives can be crucial in successfully tackling real-world problems, where different stakeholders with potentially different objectives are involved. Finally, the particular case of the minimum time optimal control problem with limited resources is discussed.

Global dynamics of deterministic and stochastic epidemic systems with nonmonotone incidence rate

This paper is devoted to studying the dynamics of a susceptible-infective-latent-infective (SILI) epidemic model that is subject to the combined effects of environmental noise and intervention strategy. We extend the classical SILI epidemic model from a deterministic framework to a stochastic one. For the deterministic case, the global stability analysis of the solution is carried out in terms of the basic reproduction number. For the stochastic case, sufficient conditions for the extinction of diseases are obtained. Then, the existence of stationary distribution and asymptotic behavior of the solution are further studied to illustrate the cycling phenomena of recurrent diseases. Numerical simulations are conducted to verify these analytical results. It is shown that both stochastic noise and intervention strategy contribute to the control of diseases.