Network frailty and the geometry of herd immunity

The spread of infectious disease through communities depends fundamentally on the underlying patterns of contacts between individuals. Generally, the more contacts one individual has, the more vulnerable they are to infection during an epidemic. Thus, outbreaks disproportionately impact the most highly connected demographics. Epidemics can then lead, through immunization or removal of individuals, to sparser networks that are more resistant to future transmission of a given disease. Using several classes of contact networks-Poisson, scale-free and small-world-we characterize the structural evolution of a network due to an epidemic in terms of frailty (the degree to which highly connected individuals are more vulnerable to infection) and interference (the extent to which the epidemic cuts off connectivity among the susceptible population that remains following an epidemic). The evolution of the susceptible network over the course of an epidemic differs among the classes of networks; frailty, relative to interference, accounts for an increasing component of network evolution on networks with greater variance in contacts. The result is that immunization due to prior epidemics can provide greater community protection than random vaccination on networks with heterogeneous contact patterns, while the reverse is true for highly structured populations.     

Susceptible-infected-recovered epidemics in dynamic contact networks

Contact patterns in populations fundamentally influence the spread of infectious diseases. Current mathematical methods for epidemiological forecasting on networks largely assume that contacts between individuals are fixed, at least for the duration of an outbreak. In reality, contact patterns may be quite fluid, with individuals frequently making and breaking social or sexual relationships. Here, we develop a mathematical approach to predicting disease transmission on dynamic networks in which each individual has a characteristic behaviour (typical contact number), but the identities of their contacts change in time. We show that dynamic contact patterns shape epidemiological dynamics in ways that cannot be adequately captured in static network models or mass-action models. Our new model interpolates smoothly between static network models and mass-action models using a mixing parameter, thereby providing a bridge between disparate classes of epidemiological models. Using epidemiological and sexual contact data from an Atlanta high school, we demonstrate the application of this method for forecasting and controlling sexually transmitted disease outbreaks.     

Network-based analysis of stochastic SIR epidemic models with random and proportionate mixing

In this paper, we outline the theory of epidemic percolation networks and their use in the analysis of stochastic susceptible-infectious-removed (SIR) epidemic models on undirected contact networks. We then show how the same theory can be used to analyze stochastic SIR models with random and proportionate mixing. The epidemic percolation networks for these models are purely directed because undirected edges disappear in the limit of a large population. In a series of simulations, we show that epidemic percolation networks accurately predict the mean outbreak size and probability and final size of an epidemic for a variety of epidemic models in homogeneous and heterogeneous populations. Finally, we show that epidemic percolation networks can be used to re-derive classical results from several different areas of infectious disease epidemiology. In an Appendix, we show that an epidemic percolation network can be defined for any time-homogeneous stochastic SIR model in a closed population and prove that the distribution of outbreak sizes given the infection of any given node in the SIR model is identical to the distribution of its out-component sizes in the corresponding probability space of epidemic percolation networks. We conclude that the theory of percolation on semi-directed networks provides a very general framework for the analysis of stochastic SIR models in closed populations.     

Epidemic threshold and network structure: The interplay of probability of transmission and of persistence in small-size directed networks

A growing number of studies are investigating the effect of contact structure on the dynamics of epidemics in large-scale complex networks. Whether findings thus obtained apply also to networks of small size, and thus to many real-world biological applications, is still an open question. We use numerical simulations of disease spread in directed networks of 100 individual nodes with a constant number of links. We show that, no matter the type of network structure (local, small-world, random and scale-free), there is a linear threshold determined by the probability of infection transmission between connected nodes and the probability of infection persistence in an infected node. The threshold is significantly lower for scale-free networks compared to local, random and small-world ones only if super-connected nodes have a higher number of links both to and from other nodes. The starting point, the node at which the epidemic starts, does not affect the threshold conditions, but has a marked influence on the final size of the epidemic in all kinds of network. There is evidence that contact structure has an influence on the average final size of an epidemic across all starting nodes, with significantly lower values in scale-free networks at equilibrium. Simulations in scale-free networks show a distinctive time-series pattern, which, if found in a real epidemic, can be used to infer the underlying network structure. The findings have relevance also for meta-population ecology and species conservation.     

Modeling epidemic spread with awareness and heterogeneous transmission rates in networks

During an epidemic outbreak in a human population, susceptibility to infection can be reduced by raising awareness of the disease. In this paper, we investigate the effects of three forms of awareness (i.e., contact, local, and global) on the spread of a disease in a random network. Connectivity-correlated transmission rates are assumed. By using the mean-field theory and numerical simulation, we show that both local and contact awareness can raise the epidemic thresholds while the global awareness cannot, which mirrors the recent results of Wu et al. The obtained results point out that individual behaviors in the presence of an infectious disease has a great influence on the epidemic dynamics. Our method enriches mean-field analysis in epidemic models.     

OutbreakFlow: Model-based Bayesian inference of disease outbreak dynamics with invertible neural networks and its application to the COVID-19 pandemics in Germany

Mathematical models in epidemiology are an indispensable tool to determine the dynamics and important characteristics of infectious diseases. Apart from their scientific merit, these models are often used to inform political decisions and interventional measures during an ongoing outbreak. However, reliably inferring the epidemical dynamics by connecting complex models to real data is still hard and requires either laborious manual parameter fitting or expensive optimization methods which have to be repeated from scratch for every application of a given model. In this work, we address this problem with a novel combination of epidemiological modeling with specialized neural networks. Our approach entails two computational phases: In an initial training phase, a mathematical model describing the epidemic is used as a coach for a neural network, which acquires global knowledge about the full range of possible disease dynamics. In the subsequent inference phase, the trained neural network processes the observed data of an actual outbreak and infers the parameters of the model in order to realistically reproduce the observed dynamics and reliably predict future progression. With its flexible framework, our simulation-based approach is applicable to a variety of epidemiological models. Moreover, since our method is fully Bayesian, it is designed to incorporate all available prior knowledge about plausible parameter values and returns complete joint posterior distributions over these parameters. Application of our method to the early Covid-19 outbreak phase in Germany demonstrates that we are able to obtain reliable probabilistic estimates for important disease characteristics, such as generation time, fraction of undetected infections, likelihood of transmission before symptom onset, and reporting delays using a very moderate amount of real-world observations.     

Modelling disease spread and control in networks: implications for plant sciences

Networks are ubiquitous in natural, technological and social systems. They are of increasing relevance for improved understanding and control of infectious diseases of plants, animals and humans, given the interconnectedness of today's world. Recent modelling work on disease development in complex networks shows: the relative rapidity of pathogen spread in scale-free compared with random networks, unless there is high local clustering; the theoretical absence of an epidemic threshold in scale-free networks of infinite size, which implies that diseases with low infection rates can spread in them, but the emergence of a threshold when realistic features are added to networks (e.g. finite size, household structure or deactivation of links); and the influence on epidemic dynamics of asymmetrical interactions. Models suggest that control of pathogens spreading in scale-free networks should focus on highly connected individuals rather than on mass random immunization. A growing number of empirical applications of network theory in human medicine and animal disease ecology confirm the potential of the approach, and suggest that network thinking could also benefit plant epidemiology and forest pathology, particularly in human-modified pathosystems linked by commercial transport of plant and disease propagules. Potential consequences for the study and management of plant and tree diseases are discussed.     

Predicting epidemics on directed contact networks

Contact network epidemiology is an approach to modeling the spread of infectious diseases that explicitly considers patterns of person-to-person contacts within a community. Contacts can be asymmetric, with a person more likely to infect one of their contacts than to become infected by that contact. This is true for some sexually transmitted diseases that are more easily caught by women than men during heterosexual encounters; and for severe infectious diseases that cause an average person to seek medical attention and thereby potentially infect health care workers (HCWs) who would not, in turn, have an opportunity to infect that average person. Here we use methods from percolation theory to develop a mathematical framework for predicting disease transmission through semi-directed contact networks in which some contacts are undirected-the probability of transmission is symmetric between individuals-and others are directed-transmission is possible only in one direction. We find that the probability of an epidemic and the expected fraction of a population infected during an epidemic can be different in semi-directed networks, in contrast to the routine assumption that these two quantities are equal. We furthermore demonstrate that these methods more accurately predict the vulnerability of HCWs and the efficacy of various hospital-based containment strategies during outbreaks of severe respiratory diseases.     

The impacts of network topology on disease spread

Individuals in a population susceptible to a disease may be represented as vertices in a network, with the edges that connect vertices representing social and/or spatial contact between individuals. Networks, which explicitly included six different patterns of connection between vertices, were created. Both scale-free networks and random graphs showed a different response in path level to increasing levels of clustering than regular lattices. Clustering promoted short path lengths in all network types, but randomly assembled networks displayed a logarithmic relationship between degree and path length; whereas this response was linear in regular lattices. In all cases, small-world models, generated by rewiring the connections of a regular lattice, displayed properties, which spanned the gap between random and regular networks.Simulation of a disease in these networks showed a strong response to connectance pattern, even when the number of edges and vertices were approximately equal. Epidemic spread was fastest, and reached the largest size, in scale-free networks, then in random graphs. Regular lattices were the slowest to be infected, and rewired lattices were intermediate between these two extremes. Scale-free networks displayed the capacity to produce an epidemic even at a likelihood of infection, which was too low to produce an epidemic for the other network types. The interaction between the statistical properties of the network and the results of epidemic spread provides a useful tool for assessing the risk of disease spread in more realistic networks.     

Disease spread in small-size directed networks: Epidemic threshold, correlation between links to and from nodes, and clustering

Network epidemiology has mainly focused on large-scale complex networks. It is unclear whether findings of these investigations also apply to networks of small size. This knowledge gap is of relevance for many biological applications, including meta-communities, plant–pollinator interactions and the spread of the oomycete pathogen Phytophthora ramorum in networks of plant nurseries. Moreover, many small-size biological networks are inherently asymmetrical and thus cannot be realistically modelled with undirected networks. We modelled disease spread and establishment in directed networks of 100 and 500 nodes at four levels of connectance in six network structures (local, small-world, random, one-way, uncorrelated, and two-way scale-free networks). The model was based on the probability of infection persistence in a node and of infection transmission between connected nodes. Regardless of the size of the network, the epidemic threshold did not depend on the starting node of infection but was negatively related to the correlation coefficient between in- and out-degree for all structures, unless networks were sparsely connected. In this case clustering played a significant role. For small-size scale-free directed networks to have a lower epidemic threshold than other network structures, there needs to be a positive correlation between number of links to and from nodes. When this correlation is negative (one-way scale-free networks), the epidemic threshold for small-size networks can be higher than in non-scale-free networks. Clustering does not necessarily have an influence on the epidemic threshold if connectance is kept constant. Analyses of the influence of the clustering on the epidemic threshold in directed networks can also be spurious if they do not consider simultaneously the effect of the correlation coefficient between in- and out-degree.     

Epidemic growth rate and household reproduction number in communities of households,schools and workplaces

In this paper we present a novel and coherent modelling framework for the characterisation of the real-time growth rate in SIR models of epidemic spread in populations with social structures of increasing complexity. Known results about homogeneous mixing and multitype models are included in the framework, which is then extended to models with households and models with households and schools/workplaces. Efficient methods for the exact computation of the real-time growth rate are presented for the standard SIR model with constant infection and recovery rates (Markovian case). Approximate methods are described for a large class of models with time-varying infection rates (non-Markovian case). The quality of the approximation is assessed via comparison with results from individual-based stochastic simulations. The methodology is then applied to the case of influenza in models with households and schools/workplaces, to provide an estimate of a household-to-household reproduction number and thus asses the effort required to prevent an outbreak by targeting control policies at the level of households. The results highlight the risk of underestimating such effort when the additional presence of schools/workplaces is neglected. Our framework increases the applicability of models of epidemic spread in socially structured population by linking earlier theoretical results, mainly focused on time-independent key epidemiological parameters (e.g. reproduction numbers, critical vaccination coverage, epidemic final size) to new results on the epidemic dynamics.     

Epidemic Spread on Weighted Networks

The contact structure between hosts shapes disease spread. Most network-based models used in epidemiology tend to ignore heterogeneity in the weighting of contacts between two individuals. However, this assumption is known to be at odds with the data for many networks (e.g. sexual contact networks) and to have a critical influence on epidemics'' behavior. One of the reasons why models usually ignore heterogeneity in transmission is that we currently lack tools to analyze weighted networks, such that most studies rely on numerical simulations. Here, we present a novel framework to estimate key epidemiological variables, such as the rate of early epidemic expansion () and the basic reproductive ratio (), from joint probability distributions of number of partners (contacts) and number of interaction events through which contacts are weighted. These distributions are much easier to infer than the exact shape of the network, which makes the approach widely applicable. The framework also allows for a derivation of the full time course of epidemic prevalence and contact behaviour, which we validate with numerical simulations on networks. Overall, incorporating more realistic contact networks into epidemiological models can improve our understanding of the emergence and spread of infectious diseases.     

Comparison of Contact Patterns Relevant for Transmission of Respiratory Pathogens in Thailand and the Netherlands Using Respondent-Driven Sampling

Understanding infection dynamics of respiratory diseases requires the identification and quantification of behavioural, social and environmental factors that permit the transmission of these infections between humans. Little empirical information is available about contact patterns within real-world social networks, let alone on differences in these contact networks between populations that differ considerably on a socio-cultural level. Here we compared contact network data that were collected in the Netherlands and Thailand using a similar online respondent-driven method. By asking participants to recruit contact persons we studied network links relevant for the transmission of respiratory infections. We studied correlations between recruiter and recruited contacts to investigate mixing patterns in the observed social network components. In both countries, mixing patterns were assortative by demographic variables and random by total numbers of contacts. However, in Thailand participants reported overall more contacts which resulted in higher effective contact rates. Our findings provide new insights on numbers of contacts and mixing patterns in two different populations. These data could be used to improve parameterisation of mathematical models used to design control strategies. Although the spread of infections through populations depends on more factors, found similarities suggest that spread may be similar in the Netherlands and Thailand.     

Revealing mechanisms of infectious disease spread through empirical contact networks

The spread of pathogens fundamentally depends on the underlying contacts between individuals. Modeling the dynamics of infectious disease spread through contact networks, however, can be challenging due to limited knowledge of how an infectious disease spreads and its transmission rate. We developed a novel statistical tool, INoDS (Identifying contact Networks of infectious Disease Spread) that estimates the transmission rate of an infectious disease outbreak, establishes epidemiological relevance of a contact network in explaining the observed pattern of infectious disease spread and enables model comparison between different contact network hypotheses. We show that our tool is robust to incomplete data and can be easily applied to datasets where infection timings of individuals are unknown. We tested the reliability of INoDS using simulation experiments of disease spread on a synthetic contact network and find that it is robust to incomplete data and is reliable under different settings of network dynamics and disease contagiousness compared with previous approaches. We demonstrate the applicability of our method in two host-pathogen systems: Crithidia bombi in bumblebee colonies and Salmonella in wild Australian sleepy lizard populations. INoDS thus provides a novel and reliable statistical tool for identifying transmission pathways of infectious disease spread. In addition, application of INoDS extends to understanding the spread of novel or emerging infectious disease, an alternative approach to laboratory transmission experiments, and overcoming common data-collection constraints.     

The number of links to and from the starting node as a predictor of epidemic size in small-size directed networks

Much recent modelling is focusing on epidemics in large-scale complex networks. Whether or not findings of these investigations also apply to networks of small size is still an open question. This is an important gap for many biological applications, including the spread of the oomycete pathogen Phytophthora ramorum in networks of plant nurseries. We use numerical simulations of disease spread and establishment in directed networks of 100 individual nodes at four levels of connectivity. Factors governing epidemic spread are network structure (local, small-world, random, scale-free) and the probabilities of infection persistence in a node and of infection transmission between connected nodes. Epidemic final size at equilibrium varies widely depending on the starting node of infection, although the latter does not affect the threshold condition for spread. The number of links from (out-degree) but not the number of links to (in-degree) the starting node of the epidemic explains a substantial amount of variation in final epidemic size at equilibrium irrespective of the structure of the network. The proportion of variance in epidemic size explained by the out-degree of the starting node increases with the level of connectivity. Targeting highly connected nodes is thus likely to make disease control more effective also in case of small-size populations, a result of relevance not just for the horticultural trade, but for epidemiology in general.     

The spread of infectious diseases in spatially structured populations: an invasory pair approximation

The invasion of new species and the spread of emergent infectious diseases in spatially structured populations has stimulated the study of explicit spatial models such as cellular automata, network models and lattice models. However, the analytic intractability of these models calls for the development of tractable mathematical approximations that can capture the dynamics of discrete, spatially-structured populations. Here we explore moment closure approximations for the invasion of an SIS epidemic on a regular lattice. We use moment closure methods to derive an expression for the basic reproductive number, R(0), in a lattice population. On lattices, R(0) should be bounded above by the number of neighbors per individual. However, we show that conventional pair approximations actually predict unbounded growth in R(0) with increasing transmission rates. To correct this problem, we propose an 'invasory' pair approximation which yields a relatively simple expression for R(0) that remains bounded above, and also predicts R(0) values from lattice model simulations more accurately than conventional pair and triple approximations. The invasory pair approximation is applicable to any spatial model, since it takes into account characteristics of invasions that are common to all spatially structured populations.     

EpiFire: An open source C++ library and application for contact network epidemiology

ABSTRACT: BACKGROUND: Contact network models have become increasingly common in epidemiology, but we lack a flexible programming framework for the generation and analysis of epidemiological contact networks and for the simulation of disease transmission through such networks. RESULTS: Here we present EpiFire, an applications programming interface and graphical user interface implemented in C++, which includes a fast and efficient library for generating, analyzing and manipulating networks. Network-based percolation and chain-binomial simulations of susceptible-infected-recovered disease transmission, as well as traditional non-network mass-action simulations, can be performed using EpiFire. CONCLUSIONS: EpiFire provides an open-source programming interface for the rapid development of network models with a focus in contact network epidemiology. EpiFire also provides a point-and-click interface for generating networks, conducting epidemic simulations, and creating figures. This interface is particularly useful as a pedagogical tool.     

Effects of behavioral changes in a smallpox attack model

The impact of individual and community behavioral changes in response to an outbreak of a disease with high mortality is often not appreciated. Response strategies to a smallpox bioterrorist attack have focused on interventions such as isolation of infectives, contact tracing, quarantine of contacts, ring vaccination, and mass vaccination. We formulate and analyze a mathematical model in which some individuals lower their daily contact activity rates once an epidemic has been identified in a community. Transmission parameters are estimated from data and an expression is derived for the effective reproduction number. We use computer simulations to analyze the effects of behavior change alone and in combination with other control measures. We demonstrate that the spread of the disease is highly sensitive to how rapidly people reduce their contact activity rates and to the precautions that the population takes to reduce the transmission of the disease. Even gradual and mild behavioral changes can have a dramatic impact in slowing an epidemic. When behavioral changes are combined with other interventions, the epidemic is shortened and the number of smallpox cases is reduced. We conclude that for simulations of a smallpox outbreak to be useful, they must consider the impact of behavioral changes. This is especially true if the model predictions are being used to guide public health policy.     

Disease contact tracing in random and clustered networks

The efficacy of contact tracing, be it between individuals (e.g. sexually transmitted diseases or severe acute respiratory syndrome) or between groups of individuals (e.g. foot-and-mouth disease; FMD), is difficult to evaluate without precise knowledge of the underlying contact structure; i.e. who is connected to whom? Motivated by the 2001 FMD epidemic in the UK, we determine, using stochastic simulations and deterministic 'moment closure' models of disease transmission on networks of premises (nodes), network and disease properties that are important for contact tracing efficiency. For random networks with a high average number of connections per node, little clustering of connections and short latency periods, contact tracing is typically ineffective. In this case, isolation of infected nodes is the dominant factor in determining disease epidemic size and duration. If the latency period is longer and the average number of connections per node small, or if the network is spatially clustered, then the contact tracing performs better and an overall reduction in the proportion of nodes that are removed during an epidemic is observed.     

The effect of contact heterogeneity and multiple routes of transmission on final epidemic size

Heterogeneity in the number of potentially infectious contacts amongst members of a population increases the basic reproduction ratio (R(0)) and markedly alters disease dynamics compared to traditional mean-field models. Most models describing transmission on contact networks only account for one specific route of transmission. However, for many infectious diseases multiple routes of transmission exist. The model presented here captures transmission through a well defined network of contacts, complemented by mean-field type transmission amongst the nodes of the network that accounts for alternative routes of transmission. The impact of these combined transmission mechanisms on the final epidemic size is investigated analytically. The analytic predictions for the purely mean-field case and the transmission through the network-only case are confirmed by individual-based network simulations. There is a critical transmission potential above which an increased contribution of the mean-field type transmission increases the final epidemic size while an increased contribution of the transmission through the network decreases it. Below the critical transmission potential the opposite effect is observed.