Planning horizon affects prophylactic decision-making and epidemic dynamics

Modeling COVID-19 Transmission Dynamics With Self-Learning Population Behavioral Change

Many regions observed recurrent outbreaks of COVID-19 cases after relaxing social distancing measures. It suggests that maintaining sufficient social distancing is important for limiting the spread of COVID-19. The change of population behavior responding to the social distancing measures becomes an important factor for the pandemic prediction. In this paper, we develop a SEAIR model for studying the dynamics of COVID-19 transmission with population behavioral change. In our model, the population is divided into several groups with their own social behavior in response to the delayed information about the number of the infected population. The transmission rate depends on the behavioral changes of all the population groups, forming a feedback loop to affect the COVID-19 dynamics. Based on the data of Hong Kong, our simulations demonstrate how the perceived cost after infection and the information delay affect the level and the time period of the COVID-19 waves.

Risk of disease and willingness to vaccinate in the United States: A population-based survey

BACKGROUND

Vaccination complacency occurs when perceived risks of vaccine-preventable diseases are sufficiently low so that vaccination is no longer perceived as a necessary precaution. Disease outbreaks can once again increase perceptions of risk, thereby decrease vaccine complacency, and in turn decrease vaccine hesitancy. It is not well understood, however, how change in perceived risk translates into change in vaccine hesitancy. We advance the concept of vaccine propensity, which relates a change in willingness to vaccinate with a change in perceived risk of infection-holding fixed other considerations such as vaccine confidence and convenience.

METHODS AND FINDINGS

We used an original survey instrument that presents 7 vaccine-preventable "new" diseases to gather demographically diverse sample data from the United States in 2018 (N = 2,411). Our survey was conducted online between January 25, 2018, and February 2, 2018, and was structured in 3 parts. First, we collected information concerning the places participants live and visit in a typical week. Second, participants were presented with one of 7 hypothetical disease outbreaks and asked how they would respond. Third, we collected sociodemographic information. The survey was designed to match population parameters in the US on 5 major dimensions: age, sex, income, race, and census region. We also were able to closely match education. The aggregate demographic details for study participants were a mean age of 43.80 years, 47% male and 53% female, 38.5% with a college degree, and 24% nonwhite. We found an overall change of at least 30% in proportion willing to vaccinate as risk of infection increases. When considering morbidity information, the proportion willing to vaccinate went from 0.476 (0.449-0.503) at 0 local cases of disease to 0.871 (0.852-0.888) at 100 local cases (upper and lower 95% confidence intervals). When considering mortality information, the proportion went from 0.526 (0.494-0.557) at 0 local cases of disease to 0.916 (0.897-0.931) at 100 local cases. In addition, we ffound that the risk of mortality invokes a larger proportion willing to vaccinate than mere morbidity (P = 0.0002), that older populations are more willing than younger (P<0.0001), that the highest income bracket (>$90,000) is more willing than all others (P = 0.0001), that men are more willing than women (P = 0.0011), and that the proportion willing to vaccinate is related to both ideology and the level of risk (P = 0.004). Limitations of this study include that it does not consider how other factors (such as social influence) interact with local case counts in people's vaccine decision-making, it cannot determine whether different degrees of severity in morbidity or mortality failed to be statistically significant because of survey design or because participants use heuristically driven decision-making that glosses over degrees, and the study does not capture the part of the US that is not online.

CONCLUSIONS

In this study, we found that different degrees of risk (in terms of local cases of disease) correspond with different proportions of populations willing to vaccinate. We also identified several sociodemographic aspects of vaccine propensity. Understanding how vaccine propensity is affected by sociodemographic factors is invaluable for predicting where outbreaks are more likely to occur and their expected size, even with the resulting cascade of changing vaccination rates and the respective feedback on potential outbreaks.

The Timing and Nature of Behavioural Responses Affect the Course of an Epidemic

During an epidemic, the interplay of disease and opinion dynamics can lead to outcomes that are different from those predicted based on disease dynamics alone. Opinions and the behaviours they elicit are complex, so modelling them requires a measure of abstraction and simplification. Here, we develop a differential equation model that couples SIR-type disease dynamics with opinion dynamics. We assume a spectrum of opinions that change based on current levels of infection as well as interactions that to some extent amplify the opinions of like-minded individuals. Susceptibility to infection is based on the level of prophylaxis (disease avoidance) that an opinion engenders. In this setting, we observe how the severity of an epidemic is influenced by the distribution of opinions at disease introduction, the relative rates of opinion and disease dynamics, and the amount of opinion amplification. Some insight is gained by considering how the effective reproduction number is influenced by the combination of opinion and disease dynamics.