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Moniz M, Soares P, Nunes B, Leite A. Is a tiered restrictions system an effective intervention for COVID-19 control? Results from Portugal, November-December 2020. BMC Public Health 2024; 24:956. [PMID: 38575989 PMCID: PMC10993531 DOI: 10.1186/s12889-024-18369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND In November 2020, similar to other European countries, Portugal implemented a tiered restrictions system to control the COVID-19 pandemic. We aimed to compare the COVID-19 growth rate across tiers to assess the effect of a tiered restrictions system in Portugal, using models with different times between tiers assessment. Our hypothesis was that being in a higher tier brings a faster deceleration in the growth rate than being in a lower tier. METHODS The national database of notified COVID-19 cases and publicly available data were used to analyse the effect of the tiered restrictions system on the COVID-19 incidence growth rate. The tiers were based on the European Centre for Disease Control risk classification: moderate, high, very and extremely high. We used a generalised mixed-effects regression model to estimate the growth rate ratio (GRR) for each tier, comparing the growth rates of higher tiers using moderate tier as reference. Three models were fitted using different times between tiers assessment, separated by 14 days. RESULTS We included 156 034 cases. Very high tier was the most frequent combination in all the three moments assessed (21.2%), and almost 50% of the municipalities never changed tier during the study period. Immediately after the tiers implementation, a reduction was identified in the municipalities in high tier (GRR high tier: 0.90 [95%CI: 0.79; 1.02]) and very high tier (GRR very high tier: 0.68 [95%CI: 0.61; 0.77]), however with some imprecision in the 95% confidence interval for the high tier. A reduction in very high tier growth rate was identified two weeks (GRR: 0.79 [95%CI: 0.71; 0.88]) and four weeks (GRR: 0.77 [95%CI: 0.74; 0.82]) after the implementation, compared to moderate tier. In high tier, a reduction was also identified in both times, although smaller. CONCLUSIONS We observed a reduction in the growth rate in very high tier after the tiered restriction system was implemented, but we also observed a lag between tiered restriction system implementation and the onset of consequent effects. This could suggest the importance of early implementation of stricter measures for pandemic control. Thus, studies analysing a broader period of time are needed.
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Affiliation(s)
- Marta Moniz
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal.
| | - Patrícia Soares
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Centre for Vectors and Infectious Diseases Research, National Institute of Health Doutor Ricardo Jorge, Águas de Moura, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Baltazar Nunes
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Andreia Leite
- Public Health Research Center, Comprehensive Health Research Center, NOVA National School of Public Health, NOVA University Lisbon, CHRC, Lisbon, Portugal
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
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Faucher B, Sabbatini CE, Czuppon P, Kraemer MUG, Lemey P, Colizza V, Blanquart F, Boëlle PY, Poletto C. Drivers and impact of the early silent invasion of SARS-CoV-2 Alpha. Nat Commun 2024; 15:2152. [PMID: 38461311 PMCID: PMC10925057 DOI: 10.1038/s41467-024-46345-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
SARS-CoV-2 variants of concern (VOCs) circulated cryptically before being identified as a threat, delaying interventions. Here we studied the drivers of such silent spread and its epidemic impact to inform future response planning. We focused on Alpha spread out of the UK. We integrated spatio-temporal records of international mobility, local epidemic growth and genomic surveillance into a Bayesian framework to reconstruct the first three months after Alpha emergence. We found that silent circulation lasted from days to months and decreased with the logarithm of sequencing coverage. Social restrictions in some countries likely delayed the establishment of local transmission, mitigating the negative consequences of late detection. Revisiting the initial spread of Alpha supports local mitigation at the destination in case of emerging events.
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Affiliation(s)
- Benjamin Faucher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Peter Czuppon
- Institute for Evolution and Biodiversity, University of Münster, Münster, 48149, Germany
| | - Moritz U G Kraemer
- Department of Biology, University of Oxford, Oxford, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
- Department of Biology, Georgetown University, Washington, DC, USA
| | - François Blanquart
- Center for Interdisciplinary Research in Biology, CNRS, Collège de France, PSL Research University, Paris, 75005, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France
| | - Chiara Poletto
- Department of Molecular Medicine, University of Padova, 35121, Padova, Italy.
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Pouquet M, Decarreaux D, Di Domenico L, Sabbatini CE, Prévot-Monsacre P, Fourié T, Villarroel PMS, Priet S, Blanché H, Sebaoun JM, Deleuze JF, Turbelin C, Rossignol L, Werner A, Kochert F, Grosgogeat B, Rabiega P, Laupie J, Abraham N, Noël H, van der Werf S, Colizza V, Carrat F, Charrel R, de Lamballerie X, Blanchon T, Falchi A. SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave. Sci Rep 2024; 14:5418. [PMID: 38443618 PMCID: PMC10914718 DOI: 10.1038/s41598-024-55477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5-36.0) for GPs, 28.7% (95% CI 24.4-33.0) for pediatricians, 25.2% (95% CI 20.6-31.0) for dentists, and 25.5% (95% CI 18.2-34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01-5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14-2.05), South-East (aPR = 1.57; CI 95% 1.19-2.08), North-East (aPR = 1.81; CI 95% 1.38-2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22-1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.
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Affiliation(s)
- Marie Pouquet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France.
| | - Dorine Decarreaux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Pol Prévot-Monsacre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Toscane Fourié
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | - Stephane Priet
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | | | | | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Andréas Werner
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Brigitte Grosgogeat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
- Service d'Odontologie, Hospices Civils de Lyon, 69007, Lyon, France
| | | | - Julien Laupie
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
| | | | - Harold Noël
- Infectious Diseases Division, Santé Publique France, 94410, Saint Maurice, France
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Molecular Genetics of RNA Viruses Unit, 75015, Paris, France
- Institut Pasteur, Université Paris Cité, National Reference Center for Respiratory Viruses, 75015, Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Département de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, 75012, Paris, France
| | - Remi Charrel
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
- LE Service de Prévention du Risque Infectieux (LESPRI), CLIN AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Xavier de Lamballerie
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
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Espinosa O, Mora L, Sanabria C, Ramos A, Rincón D, Bejarano V, Rodríguez J, Barrera N, Álvarez-Moreno C, Cortés J, Saavedra C, Robayo A, Franco OH. Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review. Syst Rev 2024; 13:30. [PMID: 38229123 PMCID: PMC10790449 DOI: 10.1186/s13643-023-02411-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The interaction between modelers and policymakers is becoming more common due to the increase in computing speed seen in recent decades. The recent pandemic caused by the SARS-CoV-2 virus was no exception. Thus, this study aims to identify and assess epidemiological mathematical models of SARS-CoV-2 applied to real-world data, including immunization for coronavirus 2019 (COVID-19). METHODOLOGY PubMed, JSTOR, medRxiv, LILACS, EconLit, and other databases were searched for studies employing epidemiological mathematical models of SARS-CoV-2 applied to real-world data. We summarized the information qualitatively, and each article included was assessed for bias risk using the Joanna Briggs Institute (JBI) and PROBAST checklist tool. The PROSPERO registration number is CRD42022344542. FINDINGS In total, 5646 articles were retrieved, of which 411 were included. Most of the information was published in 2021. The countries with the highest number of studies were the United States, Canada, China, and the United Kingdom; no studies were found in low-income countries. The SEIR model (susceptible, exposed, infectious, and recovered) was the most frequently used approach, followed by agent-based modeling. Moreover, the most commonly used software were R, Matlab, and Python, with the most recurring health outcomes being death and recovery. According to the JBI assessment, 61.4% of articles were considered to have a low risk of bias. INTERPRETATION The utilization of mathematical models increased following the onset of the SARS-CoV-2 pandemic. Stakeholders have begun to incorporate these analytical tools more extensively into public policy, enabling the construction of various scenarios for public health. This contribution adds value to informed decision-making. Therefore, understanding their advancements, strengths, and limitations is essential.
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Affiliation(s)
- Oscar Espinosa
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Laura Mora
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Cristian Sanabria
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Antonio Ramos
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Duván Rincón
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Valeria Bejarano
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Jhonathan Rodríguez
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Nicolás Barrera
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | | | - Jorge Cortés
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Carlos Saavedra
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Adriana Robayo
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Oscar H Franco
- University Medical Center Utrecht, Utrecht University & Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA
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Sabbatini CE, Pullano G, Di Domenico L, Rubrichi S, Bansal S, Colizza V. The impact of spatial connectivity on NPIs effectiveness. BMC Infect Dis 2024; 24:21. [PMID: 38166649 PMCID: PMC10763474 DOI: 10.1186/s12879-023-08900-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND France implemented a combination of non-pharmaceutical interventions (NPIs) to manage the COVID-19 pandemic between September 2020 and June 2021. These included a lockdown in the fall 2020 - the second since the start of the pandemic - to counteract the second wave, followed by a long period of nighttime curfew, and by a third lockdown in the spring 2021 against the Alpha wave. Interventions have so far been evaluated in isolation, neglecting the spatial connectivity between regions through mobility that may impact NPI effectiveness. METHODS Focusing on September 2020-June 2021, we developed a regionally-based epidemic metapopulation model informed by observed mobility fluxes from daily mobile phone data and fitted the model to regional hospital admissions. The model integrated data on vaccination and variants spread. Scenarios were designed to assess the impact of the Alpha variant, characterized by increased transmissibility and risk of hospitalization, of the vaccination campaign and alternative policy decisions. RESULTS The spatial model better captured the heterogeneity observed in the regional dynamics, compared to models neglecting inter-regional mobility. The third lockdown was similarly effective to the second lockdown after discounting for immunity, Alpha, and seasonality (51% vs 52% median regional reduction in the reproductive number R0, respectively). The 6pm nighttime curfew with bars and restaurants closed, implemented in January 2021, substantially reduced COVID-19 transmission. It initially led to 49% median regional reduction of R0, decreasing to 43% reduction by March 2021. In absence of vaccination, implemented interventions would have been insufficient against the Alpha wave. Counterfactual scenarios proposing a sequence of lockdowns in a stop-and-go fashion would have reduced hospitalizations and restriction days for low enough thresholds triggering and lifting restrictions. CONCLUSIONS Spatial connectivity induced by mobility impacted the effectiveness of interventions especially in regions with higher mobility rates. Early evening curfew with gastronomy sector closed allowed authorities to delay the third wave. Stop-and-go lockdowns could have substantially lowered both healthcare and societal burdens if implemented early enough, compared to the observed application of lockdown-curfew-lockdown, but likely at the expense of several labor sectors. These findings contribute to characterize the effectiveness of implemented strategies and improve pandemic preparedness.
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Affiliation(s)
- Chiara E Sabbatini
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Giulia Pullano
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Stefania Rubrichi
- Orange Labs, Sociology and Economics of Networks and Services (SENSE), Chatillon, France
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.
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He M, Tang B, Xiao Y, Tang S. Transmission dynamics informed neural network with application to COVID-19 infections. Comput Biol Med 2023; 165:107431. [PMID: 37696183 DOI: 10.1016/j.compbiomed.2023.107431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
Since the end of 2019 the COVID-19 repeatedly surges with most countries/territories experiencing multiple waves, and mechanism-based epidemic models played important roles in understanding the transmission mechanism of multiple epidemic waves. However, capturing temporal changes of the transmissibility of COVID-19 during the multiple waves keeps ill-posed problem for traditional mechanism-based epidemic compartment models, because that the transmission rate is usually assumed to be specific piecewise functions and more parameters are added to the model once multiple epidemic waves involved, which poses a huge challenge to parameter estimation. Meanwhile, data-driven deep neural networks fail to discover the driving factors of repeated outbreaks and lack interpretability. In this study, aiming at developing a data-driven method to project time-dependent parameters but also merging the advantage of mechanism-based models, we propose a transmission dynamics informed neural network (TDINN) by encoding the SEIRD compartment model into deep neural networks. We show that the proposed TDINN algorithm performs very well when fitting the COVID-19 epidemic data with multiple waves, where the epidemics in the United States, Italy, South Africa, and Kenya, and several outbreaks the Omicron variant in China are taken as examples. In addition, the numerical simulation shows that the trained TDINN can also perform as a predictive model to capture the future development of COVID-19 epidemic. We find that the transmission rate inferred by the TDINN frequently fluctuates, and a feedback loop between the epidemic shifting and the changes of transmissibility drives the occurrence of multiple waves. We observe a long response delay to the implementation of control interventions in the four countries, while the decline of the transmission rate in the outbreaks in China usually happens once the implementation of control interventions. The further simulation show that 17 days' delay of the response to the implementation of control interventions lead to a roughly four-fold increase in daily reported cases in one epidemic wave in Italy, which suggest that a rapid response to policies that strengthen control interventions can be effective in flattening the epidemic curve or avoiding subsequent epidemic waves. We observe that the transmission rate in the outbreaks in China is already decreasing before enhancing control interventions, providing the evidence that the increasing of the epidemics can drive self-conscious behavioural changes to protect against infections.
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Affiliation(s)
- Mengqi He
- School of Mathematics and Statistics, Shaanxi Normal University, Xi'an, China
| | - Biao Tang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China.
| | - Yanni Xiao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
| | - Sanyi Tang
- School of Mathematics and Statistics, Shaanxi Normal University, Xi'an, China
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Peano A, Politano G, Gianino MM. Determinants of COVID-19 vaccination worldwide: WORLDCOV, a retrospective observational study. Front Public Health 2023; 11:1128612. [PMID: 37719735 PMCID: PMC10501313 DOI: 10.3389/fpubh.2023.1128612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/19/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The COVID-19 pandemic has resulted in numerous deaths, great suffering, and significant changes in people's lives worldwide. The introduction of the vaccines was a light in the darkness, but after 18 months, a great disparity in vaccination coverage between countries has been observed. As disparities in vaccination coverage have become a global public health issue, this study aimed to analyze several variables to identify possible determinants of COVID-19 vaccination. Methods An ecological study was conducted using pooled secondary data sourced from institutional sites. A total of 205 countries and territories worldwide were included. A total of 16 variables from different fields were considered to establish possible determinants of COVID-19 vaccination: sociodemographic, cultural, infrastructural, economic and political variables, and health system performance indicators. The percentage of the population vaccinated with at least one dose and the total doses administered per 100 residents on 15 June 2022 were identified as indicators of vaccine coverage and outcomes. Raw and adjusted values for delivered vaccine doses in the multivariate GLM were determined using R. The tested hypothesis (i.e., variables as determinants of COVID-19 vaccination) was formulated before data collection. The study protocol was registered with the grant number NCT05471635. Results GDP per capita [odds = 1.401 (1.299-1.511) CI 95%], access to electricity [odds = 1.625 (1.559-1.694) CI 95%], political stability, absence of violence/terrorism [odds = 1.334 (1.284-1.387) CI 95%], and civil liberties [odds = 0.888 (0.863-0.914) CI 95%] were strong determinants of COVID-19 vaccination. Several other variables displayed a statistically significant association with outcomes, although the associations were stronger for total doses administered per 100 residents. There was a substantial overlap between raw outcomes and their adjusted counterparts. Discussion This pioneering study is the first to analyze the association between several different categories of indicators and COVID-19 vaccination coverage in a wide complex setting, identifying strong determinants of vaccination coverage. Political decision-makers should consider these findings when organizing mass vaccination campaigns in a pandemic context to reduce inequalities between nations and to achieve a common good from a public health perspective.
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Affiliation(s)
- Alberto Peano
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Polytechnic of Turin, Turin, Italy
| | - Maria Michela Gianino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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8
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De Domenico M. Prevalence of long COVID decreases for increasing COVID-19 vaccine uptake. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001917. [PMID: 37342998 PMCID: PMC10284420 DOI: 10.1371/journal.pgph.0001917] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/24/2023] [Indexed: 06/23/2023]
Abstract
Long COVID is a post-COVID-19 condition characterized by persistent symptoms that can develop after SARS-CoV-2 infection. Estimating and comparing its prevalence across countries is difficult, hindering the quantitative assessment of massive vaccination campaigns as a preventive measure. By integrating epidemiological, demographic and vaccination data, we first reconcile the estimates of long COVID prevalence in the U.K. and the U.S., and estimate a 7-fold yearly increase in the global median prevalence between 2020 and 2022. Second, we estimate that vaccines against COVID-19 decrease the prevalence of long COVID among U.S. adults by 20.9% (95% CI: -32.0%, -9.9%) and, from the analysis of 158 countries, by -15.7% (95% CI: -18.0%, -13.4%) among all who had COVID-19. Our population-level analysis complements the current knowledge from patients data and highlights how aggregated data from fully operational epidemic surveillance and monitoring can inform about the potential impact of long COVID on national and global public health in the next future.
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Affiliation(s)
- Manlio De Domenico
- Department of Physics and Astronomy “Galileo Galilei”, University of Padova, Padova, Italy
- Padua Center for Network Medicine, Padova, Italy
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9
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Klamser PP, d’Andrea V, Di Lauro F, Zachariae A, Bontorin S, Di Nardo A, Hall M, Maier BF, Ferretti L, Brockmann D, De Domenico M. Enhancing global preparedness during an ongoing pandemic from partial and noisy data. PNAS NEXUS 2023; 2:pgad192. [PMID: 37351112 PMCID: PMC10282504 DOI: 10.1093/pnasnexus/pgad192] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023]
Abstract
As the coronavirus disease 2019 spread globally, emerging variants such as B.1.1.529 quickly became dominant worldwide. Sustained community transmission favors the proliferation of mutated sub-lineages with pandemic potential, due to cross-national mobility flows, which are responsible for consecutive cases surge worldwide. We show that, in the early stages of an emerging variant, integrating data from national genomic surveillance and global human mobility with large-scale epidemic modeling allows to quantify its pandemic potential, providing quantifiable indicators for pro-active policy interventions. We validate our framework on worldwide spreading variants and gain insights about the pandemic potential of BA.5, BA.2.75, and other sub- and lineages. We combine the different sources of information in a simple estimate of the pandemic delay and show that only in combination, the pandemic potentials of the lineages are correctly assessed relative to each other. Compared to a country-level epidemic intelligence, our scalable integrated approach, that is pandemic intelligence, permits to enhance global preparedness to contrast the pandemic of respiratory pathogens such as SARS-CoV-2.
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Affiliation(s)
- Pascal P Klamser
- Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
- Department of Biology, Institute for Theoretical Biology, Humboldt-University of Berlin, Philippstr. 13, 10115 Berlin, Germany
| | - Valeria d’Andrea
- Fondazione Bruno Kessler, Via Sommarive 18, 38123, Povo (TN), Italy
| | - Francesco Di Lauro
- Big Data Institute, University of Oxford, Old Road Campus, OX3 7LF Oxford, UK
| | - Adrian Zachariae
- Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
- Department of Biology, Institute for Theoretical Biology, Humboldt-University of Berlin, Philippstr. 13, 10115 Berlin, Germany
| | - Sebastiano Bontorin
- Fondazione Bruno Kessler, Via Sommarive 18, 38123, Povo (TN), Italy
- Department of Physics, University of Trento, Via Sommarive 14, 38123 Povo (TN), Italy
| | | | - Matthew Hall
- Big Data Institute, University of Oxford, Old Road Campus, OX3 7LF Oxford, UK
| | - Benjamin F Maier
- Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
- Department of Biology, Institute for Theoretical Biology, Humboldt-University of Berlin, Philippstr. 13, 10115 Berlin, Germany
| | - Luca Ferretti
- Big Data Institute, University of Oxford, Old Road Campus, OX3 7LF Oxford, UK
| | - Dirk Brockmann
- Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
- Department of Biology, Institute for Theoretical Biology, Humboldt-University of Berlin, Philippstr. 13, 10115 Berlin, Germany
| | - Manlio De Domenico
- Department of Physics and Astronomy, G. Galilei, University of Padua, Via Francesco Marzolo 8, 35131 Padua, Italy
- Padua Center for Network Medicine, University of Padua, Via Francesco Marzolo 8, 35131 Padua, Italy
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10
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Paireau J, Charpignon ML, Larrieu S, Calba C, Hozé N, Boëlle PY, Thiebaut R, Prague M, Cauchemez S. Impact of non-pharmaceutical interventions, weather, vaccination, and variants on COVID-19 transmission across departments in France. BMC Infect Dis 2023; 23:190. [PMID: 36997873 PMCID: PMC10061408 DOI: 10.1186/s12879-023-08106-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Multiple factors shape the temporal dynamics of the COVID-19 pandemic. Quantifying their relative contributions is key to guide future control strategies. Our objective was to disentangle the individual effects of non-pharmaceutical interventions (NPIs), weather, vaccination, and variants of concern (VOC) on local SARS-CoV-2 transmission. METHODS We developed a log-linear model for the weekly reproduction number (R) of hospital admissions in 92 French metropolitan departments. We leveraged (i) the homogeneity in data collection and NPI definitions across departments, (ii) the spatial heterogeneity in the timing of NPIs, and (iii) an extensive observation period (14 months) covering different weather conditions, VOC proportions, and vaccine coverage levels. FINDINGS Three lockdowns reduced R by 72.7% (95% CI 71.3-74.1), 70.4% (69.2-71.6) and 60.7% (56.4-64.5), respectively. Curfews implemented at 6/7 pm and 8/9 pm reduced R by 34.3% (27.9-40.2) and 18.9% (12.04-25.3), respectively. School closures reduced R by only 4.9% (2.0-7.8). We estimated that vaccination of the entire population would have reduced R by 71.7% (56.4-81.6), whereas the emergence of VOC (mainly Alpha during the study period) increased transmission by 44.6% (36.1-53.6) compared with the historical variant. Winter weather conditions (lower temperature and absolute humidity) increased R by 42.2% (37.3-47.3) compared to summer weather conditions. Additionally, we explored counterfactual scenarios (absence of VOC or vaccination) to assess their impact on hospital admissions. INTERPRETATION Our study demonstrates the strong effectiveness of NPIs and vaccination and quantifies the role of weather while adjusting for other confounders. It highlights the importance of retrospective evaluation of interventions to inform future decision-making.
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Affiliation(s)
- Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France.
- Infectious Diseases Department, Santé Publique France, Saint Maurice, France.
| | - Marie-Laure Charpignon
- Institute for Data, Systems, and Society (IDSS), Cambridge, MA, USA
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
- University of Bordeaux, Inria Bordeaux Sud-Ouest, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR1219, Bordeaux, France
| | - Sophie Larrieu
- Regions Department, Regional Office Nouvelle-Aquitaine, Santé publique France, Bordeaux, France
| | - Clémentine Calba
- Regions Department, Regional Office Provence-Alps-French Riviera and Corsica, Santé Publique France, Marseille, France
| | - Nathanaël Hozé
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Rodolphe Thiebaut
- University of Bordeaux, Inria Bordeaux Sud-Ouest, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR1219, Bordeaux, France
| | - Mélanie Prague
- University of Bordeaux, Inria Bordeaux Sud-Ouest, Inserm, Bordeaux Population Health Research Center, SISTM Team, UMR1219, Bordeaux, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France
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11
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Bonacina F, Boëlle PY, Colizza V, Lopez O, Thomas M, Poletto C. Global patterns and drivers of influenza decline during the COVID-19 pandemic. Int J Infect Dis 2023; 128:132-139. [PMID: 36608787 PMCID: PMC9809002 DOI: 10.1016/j.ijid.2022.12.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The influenza circulation reportedly declined during the COVID-19 pandemic in many countries. The occurrence of this change has not been studied worldwide nor its potential drivers. METHODS The change in the proportion of positive influenza samples reported by country and trimester was computed relative to the 2014-2019 period using the FluNet database. Random forests were used to determine predictors of change from demographical, weather, pandemic preparedness, COVID-19 incidence, and pandemic response characteristics. Regression trees were used to classify observations according to these predictors. RESULTS During the COVID-19 pandemic, the influenza decline relative to prepandemic levels was global but heterogeneous across space and time. It was more than 50% for 311 of 376 trimesters-countries and even more than 99% for 135. COVID-19 incidence and pandemic preparedness were the two most important predictors of the decline. Europe and North America initially showed limited decline despite high COVID-19 restrictions; however, there was a strong decline afterward in most temperate countries, where pandemic preparedness, COVID-19 incidence, and social restrictions were high; the decline was limited in countries where these factors were low. The "zero-COVID" countries experienced the greatest decline. CONCLUSION Our findings set the stage for interpreting the resurgence of influenza worldwide.
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Affiliation(s)
- Francesco Bonacina
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Tokyo Tech World Research Hub Initiative (WRHI), Tokyo Institute of Technology, Tokyo, Japan
| | - Olivier Lopez
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Maud Thomas
- Sorbonne Université, CNRS, Laboratoire de Probabilités, Statistique et Modélisation, F-75013 Paris, France
| | - Chiara Poletto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012 Paris, France; Department of Molecular Medicine, University of Padova, 35121 Padova, Italy.
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12
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Sacco PL, Valle F, De Domenico M. Proactive vs. reactive country responses to the COVID-19 pandemic shock. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001345. [PMID: 36962977 PMCID: PMC10021818 DOI: 10.1371/journal.pgph.0001345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/08/2022] [Indexed: 01/25/2023]
Abstract
The infection caused by SARS-CoV-2, responsible for the COVID-19 pandemic, is characterized by an infectious period with either asymptomatic or pre-symptomatic phases, leading to a rapid surge of mild and severe cases putting national health systems under serious stress. To avoid their collapse, and in the absence of pharmacological treatments, during the early pandemic phase countries worldwide were forced to adopt strategies, from elimination to mitigation, based on non-pharmacological interventions which, in turn, overloaded social, educational and economic systems. To date, the heterogeneity and incompleteness of data sources does not allow to quantify the multifaceted impact of the pandemic at country level and, consequently, to compare the effectiveness of country responses. Here, we tackle this challenge from a complex systems perspective, proposing a model to evaluate the impact of systemic failures in response to the pandemic shock. We use health, behavioral and economic indicators for 44 countries to build a shock index quantifying responses in terms of robustness and resilience, highlighting the crucial advantage of proactive policy and decision making styles over reactive ones, which can be game-changing during the emerging of a new variant of concern.
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Affiliation(s)
- Pier Luigi Sacco
- DiSFiPEQ, University of Chieti-Pescara, Pescara, Italy
- metaLAB (at) Harvard, Cambridge, Massachusetts, United States of America
| | | | - Manlio De Domenico
- Department of Physics and Astronomy “Galileo Galilei”, University of Padova, Padova, Italy
- Padua Center for Network Medicine, Padova, Italy
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13
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Akhmetzhanov AR, Cheng HY, Linton NM, Ponce L, Jian SW, Lin HH. Transmission Dynamics and Effectiveness of Control Measures during COVID-19 Surge, Taiwan, April-August 2021. Emerg Infect Dis 2022; 28:2051-2059. [PMID: 36104202 PMCID: PMC9514361 DOI: 10.3201/eid2810.220456] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
An unprecedented surge of COVID-19 cases in Taiwan in May 2021 led the government to implement strict nationwide control measures beginning May 15. During the surge, the government was able to bring the epidemic under control without a complete lockdown despite the cumulative case count reaching >14,400 and >780 deaths. We investigated the effectiveness of the public health and social measures instituted by the Taiwan government by quantifying the change in the effective reproduction number, which is a summary measure of the ability of the pathogen to spread through the population. The control measures that were instituted reduced the effective reproduction number from 2.0-3.3 to 0.6-0.7. This decrease was correlated with changes in mobility patterns in Taiwan, demonstrating that public compliance, active case finding, and contact tracing were effective measures in preventing further spread of the disease.
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14
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Piroddi C. Non-pharmaceutical Interventions and Social Distancing as Intersubjective Care and Collective Protection. Asian Bioeth Rev 2022; 14:379-395. [PMID: 35990569 PMCID: PMC9375195 DOI: 10.1007/s41649-022-00212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022] Open
Abstract
The paper discusses non-pharmaceutical interventions (NPIs) as a collective form of protection that, in terms of health justice, benefits groups at risk, allowing them to engage in social life and activities during health crises. More specifically, the paper asserts that NPIs that realize social distancing are justifiable insofar as they are constitutive of a type of social protection that allows everyone, especially social disadvantaged agents, to access the public health sphere and other fundamental social spheres, such as the family and civil society.
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15
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Mancastroppa M, Guizzo A, Castellano C, Vezzani A, Burioni R. Sideward contact tracing and the control of epidemics in large gatherings. J R Soc Interface 2022; 19:20220048. [PMID: 35537473 PMCID: PMC9090492 DOI: 10.1098/rsif.2022.0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Effective contact tracing is crucial to containing epidemic spreading without disrupting societal activities, especially during a pandemic. Large gatherings play a key role, potentially favouring superspreading events. However, the effects of tracing in large groups have not been fully assessed so far. We show that in addition to forward tracing, which reconstructs to whom the disease spreads, and backward tracing, which searches from whom the disease spreads, a third 'sideward' tracing is always present, when tracing gatherings. This is an indirect tracing that detects infected asymptomatic individuals, even if they have been neither directly infected by nor directly transmitted the infection to the index case. We analyse this effect in a model of epidemic spreading for SARS-CoV-2, within the framework of simplicial activity-driven temporal networks. We determine the contribution of the three tracing mechanisms to the suppression of epidemic spreading, showing that sideward tracing induces a non-monotonic behaviour in the tracing efficiency, as a function of the size of the gatherings. Based on our results, we suggest an optimal choice for the sizes of the gatherings to be traced and we test the strategy on an empirical dataset of gatherings on a university campus.
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Affiliation(s)
- Marco Mancastroppa
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università degli Studi di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy.,INFN, Sezione di Milano Bicocca, Gruppo Collegato di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy
| | - Andrea Guizzo
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università degli Studi di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy.,INFN, Sezione di Milano Bicocca, Gruppo Collegato di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy
| | - Claudio Castellano
- Istituto dei Sistemi Complessi (ISC-CNR), Via dei Taurini 19, I-00185 Roma, Italy
| | - Alessandro Vezzani
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università degli Studi di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy.,INFN, Sezione di Milano Bicocca, Gruppo Collegato di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy.,Istituto dei Materiali per l'Elettronica ed il Magnetismo (IMEM-CNR), Parco Area delle Scienze, 37/A 43124 Parma, Italy
| | - Raffaella Burioni
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università degli Studi di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy.,INFN, Sezione di Milano Bicocca, Gruppo Collegato di Parma, Parco Area delle Scienze, 7/A 43124 Parma, Italy
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