Traditional contact tracing tests the direct contacts of those who test positive. But, by the time an infected individual is tested, the infection starting from the person may have infected a chain of individuals. Hence, why should the testing stop at direct contacts, and not test secondary, tertiary contacts or even contacts further down? One deterrent in testing long chains of individuals right away may be that it substantially increases the testing load, or does it? We investigate the costs and benefits of such multi-hop contact tracing for different number of hops. Considering diverse contact networks, we show that the cost–benefit trade-off can be characterized in terms of a single measurable attribute, the initial epidemic growth rate . Once this growth rate crosses a threshold, multi-hop contact tracing substantially reduces the outbreak size compared with traditional tracing. Multi-hop even incurs a lower cost compared with the traditional tracing for a large range of values of the growth rate. The cost–benefit trade-offs can be classified into three phases depending on the value of the growth rate. The need for choosing a larger number of hops becomes greater as the growth rate increases or the environment becomes less conducive toward containing the disease.
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This content will become publicly available on July 13, 2024
Capturing COVID-19 spread and interplay with multi-hop contact tracing intervention
A preemptive multi-hop contact tracing scheme that tracks not only the direct contacts of those who tested positive for COVID-19, but also secondary or tertiary contacts has been proposed and deployed in practice with some success. We propose a mathematical methodology for evaluating this preemptive contact tracing strategy that combines the contact tracing dynamics and the virus transmission mechanism in a single framework using microscopic Markov Chain approach (MMCA). We perform Monte Carlo (MC) simulations to validate our model and show that the output of our model provides a reasonable match with the result of MC simulations. Utilizing the formulation under a human contact network generated from real-world data, we show that the cost-benefit tradeoff can be significantly enhanced through an implementation of the multi-hop contact tracing as compared to traditional contact tracing. We further shed light on the mechanisms behind the effectiveness of the multi-hop testing strategy using the framework. We show that our mathematical framework allows significantly faster computation of key attributes for multi-hop contact tracing as compared to MC simulations. This in turn enables the investigation of these attributes for large contact networks, and constitutes a significant strength of our approach as the contact networks that arise in practice are typically large.
more » « less- Award ID(s):
- 2047482
- NSF-PAR ID:
- 10500182
- Editor(s):
- Dovrolis, Constantine
- Publisher / Repository:
- ncbi.nlm.nih.gov
- Date Published:
- Journal Name:
- PLOS ONE
- Volume:
- 18
- Issue:
- 7
- ISSN:
- 1932-6203
- Page Range / eLocation ID:
- e0288394
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Efficient contact tracing and isolation is an effective strategy to control epidemics. It was used effectively during the Ebola epidemic and successfully implemented in several parts of the world during the ongoing COVID-19 pandemic. An important consideration in contact tracing is the budget on the number of individuals asked to quarantine -- the budget is limited for socioeconomic reasons. In this paper, we present a Markov Decision Process (MDP) framework to formulate the problem of using contact tracing to reduce the size of an outbreak while asking a limited number of people to quarantine. We formulate each step of the MDP as a combinatorial problem, MinExposed, which we demonstrate is NP-Hard; as a result, we develop an LP-based approximation algorithm. Though this algorithm directly solves MinExposed, it is often impractical in the real world due to information constraints. To this end, we develop a greedy approach based on insights from the analysis of the previous algorithm, which we show is more interpretable. A key feature of the greedy algorithm is that it does not need complete information of the underlying social contact network. This makes the heuristic implementable in practice and is an important consideration. Finally, we carry out experiments on simulations of the MDP run on real-world networks, and show how the algorithms can help in bending the epidemic curve while limiting the number of isolated individuals. Our experimental results demonstrate that the greedy algorithm and its variants are especially effective, robust, and practical in a variety of realistic scenarios, such as when the contact graph and specific transmission probabilities are not known. All code can be found in our GitHub repository: this https URL.more » « less
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Efficient contact tracing and isolation is an effective strategy to control epidemics, as seen in the Ebola epidemic and COVID-19 pandemic. An important consideration in contact tracing is the budget on the number of individuals asked to quarantine—the budget is limited for socioeconomic reasons (e.g., having a limited number of contact tracers). Here, we present a Markov Decision Process (MDP) framework to formulate the problem of using contact tracing to reduce the size of an outbreak while limiting the number of people quarantined. We formulate each step of the MDP as a combinatorial problem, MinExposed, which we demonstrate is NP-Hard. Next, we develop two approximation algorithms, one based on rounding the solutions of a linear program and another (greedy algorithm) based on choosing nodes with a high (weighted) degree. A key feature of the greedy algorithm is that it does not need complete information of the underlying social contact network, making it implementable in practice. Using simulations over realistic networks, we show how the algorithms can help in bending the epidemic curve with a limited number of isolated individuals.more » « less
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Background: Short-term forecasts of infectious disease burden can contribute to situational awareness and aid capacity planning. Based on best practice in other fields and recent insights in infectious disease epidemiology, one can maximise the predictive performance of such forecasts if multiple models are combined into an ensemble. Here, we report on the performance of ensembles in predicting COVID-19 cases and deaths across Europe between 08 March 2021 and 07 March 2022.
Methods: We used open-source tools to develop a public European COVID-19 Forecast Hub. We invited groups globally to contribute weekly forecasts for COVID-19 cases and deaths reported by a standardised source for 32 countries over the next 1–4 weeks. Teams submitted forecasts from March 2021 using standardised quantiles of the predictive distribution. Each week we created an ensemble forecast, where each predictive quantile was calculated as the equally-weighted average (initially the mean and then from 26th July the median) of all individual models’ predictive quantiles. We measured the performance of each model using the relative Weighted Interval Score (WIS), comparing models’ forecast accuracy relative to all other models. We retrospectively explored alternative methods for ensemble forecasts, including weighted averages based on models’ past predictive performance.
Results: Over 52 weeks, we collected forecasts from 48 unique models. We evaluated 29 models’ forecast scores in comparison to the ensemble model. We found a weekly ensemble had a consistently strong performance across countries over time. Across all horizons and locations, the ensemble performed better on relative WIS than 83% of participating models’ forecasts of incident cases (with a total N=886 predictions from 23 unique models), and 91% of participating models’ forecasts of deaths (N=763 predictions from 20 models). Across a 1–4 week time horizon, ensemble performance declined with longer forecast periods when forecasting cases, but remained stable over 4 weeks for incident death forecasts. In every forecast across 32 countries, the ensemble outperformed most contributing models when forecasting either cases or deaths, frequently outperforming all of its individual component models. Among several choices of ensemble methods we found that the most influential and best choice was to use a median average of models instead of using the mean, regardless of methods of weighting component forecast models.
Conclusions: Our results support the use of combining forecasts from individual models into an ensemble in order to improve predictive performance across epidemiological targets and populations during infectious disease epidemics. Our findings further suggest that median ensemble methods yield better predictive performance more than ones based on means. Our findings also highlight that forecast consumers should place more weight on incident death forecasts than incident case forecasts at forecast horizons greater than 2 weeks.
Funding: AA, BH, BL, LWa, MMa, PP, SV funded by National Institutes of Health (NIH) Grant 1R01GM109718, NSF BIG DATA Grant IIS-1633028, NSF Grant No.: OAC-1916805, NSF Expeditions in Computing Grant CCF-1918656, CCF-1917819, NSF RAPID CNS-2028004, NSF RAPID OAC-2027541, US Centers for Disease Control and Prevention 75D30119C05935, a grant from Google, University of Virginia Strategic Investment Fund award number SIF160, Defense Threat Reduction Agency (DTRA) under Contract No. HDTRA1-19-D-0007, and respectively Virginia Dept of Health Grant VDH-21-501-0141, VDH-21-501-0143, VDH-21-501-0147, VDH-21-501-0145, VDH-21-501-0146, VDH-21-501-0142, VDH-21-501-0148. AF, AMa, GL funded by SMIGE - Modelli statistici inferenziali per governare l'epidemia, FISR 2020-Covid-19 I Fase, FISR2020IP-00156, Codice Progetto: PRJ-0695. AM, BK, FD, FR, JK, JN, JZ, KN, MG, MR, MS, RB funded by Ministry of Science and Higher Education of Poland with grant 28/WFSN/2021 to the University of Warsaw. BRe, CPe, JLAz funded by Ministerio de Sanidad/ISCIII. BT, PG funded by PERISCOPE European H2020 project, contract number 101016233. CP, DL, EA, MC, SA funded by European Commission - Directorate-General for Communications Networks, Content and Technology through the contract LC-01485746, and Ministerio de Ciencia, Innovacion y Universidades and FEDER, with the project PGC2018-095456-B-I00. DE., MGu funded by Spanish Ministry of Health / REACT-UE (FEDER). DO, GF, IMi, LC funded by Laboratory Directed Research and Development program of Los Alamos National Laboratory (LANL) under project number 20200700ER. DS, ELR, GG, NGR, NW, YW funded by National Institutes of General Medical Sciences (R35GM119582; the content is solely the responsibility of the authors and does not necessarily represent the official views of NIGMS or the National Institutes of Health). FB, FP funded by InPresa, Lombardy Region, Italy. HG, KS funded by European Centre for Disease Prevention and Control. IV funded by Agencia de Qualitat i Avaluacio Sanitaries de Catalunya (AQuAS) through contract 2021-021OE. JDe, SMo, VP funded by Netzwerk Universitatsmedizin (NUM) project egePan (01KX2021). JPB, SH, TH funded by Federal Ministry of Education and Research (BMBF; grant 05M18SIA). KH, MSc, YKh funded by Project SaxoCOV, funded by the German Free State of Saxony. Presentation of data, model results and simulations also funded by the NFDI4Health Task Force COVID-19 (
https://www.nfdi4health.de/task-force-covid-19-2 ) within the framework of a DFG-project (LO-342/17-1). LP, VE funded by Mathematical and Statistical modelling project (MUNI/A/1615/2020), Online platform for real-time monitoring, analysis and management of epidemic situations (MUNI/11/02202001/2020); VE also supported by RECETOX research infrastructure (Ministry of Education, Youth and Sports of the Czech Republic: LM2018121), the CETOCOEN EXCELLENCE (CZ.02.1.01/0.0/0.0/17-043/0009632), RECETOX RI project (CZ.02.1.01/0.0/0.0/16-013/0001761). NIB funded by Health Protection Research Unit (grant code NIHR200908). SAb, SF funded by Wellcome Trust (210758/Z/18/Z).
