In “Estimating dates of origin and end of COVID-19 epidemics”, Bénéteau et al. develop and apply a mathematical modeling approach to estimate the date of the origin of the SARS-CoV-2 epidemic in France. They also assess how long strict control measures need to last to ensure that the prevalence of the virus remains below key public health thresholds. This problem is challenging because the numbers of infected individuals in both tails of the epidemic are low, which can lead to errors when deterministic models are used. To achieve their goals, the authors developed a discrete stochastic model. The model is non-Markovian, meaning that individual infection histories influence the dynamics. The model also accounts for heterogeneity in the timing between infection and transmission and includes stochasticity as well as consideration of superspreader events. By comparing the outputs of their model with several alternative models, Bénéteau et al. were able to assess the importance of stochasticity, individual heterogeneity, and non-Markovian effects on the estimates of the dates of origin and end of the epidemic, using France as a test case. Some limitations of the study, which the authors acknowledge, are that the time from infection to death remains largely unknown, a lack of data on the heterogeneity of transmission among individuals, and the assumption that only a single infected individual caused the epidemic. Despite the acknowledged limitations of the work, the results suggest that cases may be detected long before the detection of an epidemic wave. Also, the approach may be helpful for informing public health decisions such as the necessary duration of strict lockdowns and for assessing the risks of epidemic rebound as restrictions are lifted. In particular, the authors found that estimates of the end of the epidemic following lockdowns are more sensitive to the assumptions of the models used than estimates of its beginning. In summary, this model adds to a valuable suite of tools to support decision-making in response to disease epidemics.

References

Bénéteau T, Elie B, Sofonea MT, Alizon S (2021) Estimating dates of origin and end of COVID-19 epidemics. medRxiv, 2021.01.19.21250080, ver. 3 peer-reviewed and recommended by Peer Community in Mathematical and Computational Biology. https://doi.org/10.1101/2021.01.19.21250080

This study [1] used Bayesian models of the number of deaths through time across different regions of France to explore the effects of lockdown and other events (i.e., holding elections) on the dynamics of the SARS-CoV-2 epidemic. The models accurately predicted the number of deaths 2 to 3 weeks in advance, and results were similar to other recent models using different structure and input data. Viral reproduction numbers were not found to be different between weekends and week days, and there was no evidence that holding elections affected the number of deaths directly. However, exploring different scenarios of the timing of the lockdown showed that this had a substantial impact on the number of deaths. This is an interesting and important paper that can inform adaptive management strategies for controlling the spread of this virus, not just in France, but in other geographic areas. For example, the results found that there was a lag period between a change in management strategies (lockdown, social distancing, and the relaxing of controls) and the observed change in mortality. Also, there was a large variation in the impact of mitigation measures on the viral reproduction number depending on region, with lockdown being slightly more effective in denser regions. The authors provide an extensive amount of additional data and code as supplemental material, which increase the value of this contribution to the rapidly growing literature on SARS-CoV-2.

References

[1] Duchemin, L., Veber, P. and Boussau, B. (2020) Bayesian investigation of SARS-CoV-2-related mortality in France. medRxiv 2020.06.09.20126862, ver. 5 peer-reviewed and recommended by PCI Mathematical & Computational Biology. doi: 10.1101/2020.06.09.20126862