skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Accurately summarizing an outbreak using epidemiological models takes time
Recent outbreaks of Mpox and Ebola, and worrying waves of COVID-19, influenza and respiratory syncytial virus, have all led to a sharp increase in the use of epidemiological models to estimate key epidemiological parameters. The feasibility of this estimation task is known as the practical identifiability (PI) problem. Here, we investigate the PI of eight commonly reported statistics of the classic susceptible–infectious–recovered model using a new measure that shows how much a researcher can expect to learn in a model-based Bayesian analysis of prevalence data. Our findings show that the basic reproductive number and final outbreak size are often poorly identified, with learning exceeding that of individual model parameters only in the early stages of an outbreak. The peak intensity, peak timing and initial growth rate are better identified, being in expectation over 20 times more probable having seen the data by the time the underlying outbreak peaks. We then test PI for a variety of true parameter combinations and find that PI is especially problematic in slow-growing or less-severe outbreaks. These results add to the growing body of literature questioning the reliability of inferences from epidemiological models when limited data are available.  more » « less
Award ID(s):
2019470
PAR ID:
10516506
Author(s) / Creator(s):
; ;
Publisher / Repository:
Royal Society Open Science
Date Published:
Journal Name:
Royal Society Open Science
Volume:
10
Issue:
9
ISSN:
2054-5703
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Multinational epidemics of emerging infectious diseases are increasingly common, due to anthropogenic pressure on ecosystems and the growing connectivity of human populations. Early and efficient vaccination can contain outbreaks and prevent mass mortality, but optimal vaccine stockpiling strategies are dependent on pathogen characteristics, reservoir ecology, and epidemic dynamics. Here, we model major regional outbreaks of Nipah virus and Middle East respiratory syndrome, and use these to develop a generalized framework for estimating vaccine stockpile needs based on spillover geography, spatially-heterogeneous healthcare capacity and spatially-distributed human mobility networks. Because outbreak sizes were highly skewed, we found that most outbreaks were readily contained (median stockpile estimate for MERS-CoV: 2,089 doses; Nipah: 1,882 doses), but the maximum estimated stockpile need in a highly unlikely large outbreak scenario was 2–3 orders of magnitude higher (MERS-CoV: ~87,000 doses; Nipah ~ 1.1 million doses). Sensitivity analysis revealed that stockpile needs were more dependent on basic epidemiological parameters (i.e., death and recovery rate) and healthcare availability than any uncertainty related to vaccine efficacy or deployment strategy. Our results highlight the value of descriptive epidemiology for real-world modeling applications, and suggest that stockpile allocation should consider ecological, epidemiological, and social dimensions of risk. 
    more » « less
  2. Social and spatial structures of host populations play important roles in pathogen transmission. For environmentally transmitted pathogens, the host space use interacts with both the host social structure and the pathogen’s environmental persistence (which determines the time-lag across which two hosts can transmit). Together, these factors shape the epidemiological dynamics of environmentally transmitted pathogens. While the importance of both social and spatial structures and environmental pathogen persistence has long been recognized in epidemiology, they are often considered separately. A better understanding of how these factors interact to determine disease dynamics is required for developing robust surveillance and management strategies. Here, we use a simple agent-based model where we vary host mobility (spatial), host gregariousness (social) and pathogen decay (environmental persistence), each from low to high levels to uncover how they affect epidemiological dynamics. By comparing epidemic peak, time to epidemic peak and final epidemic size, we show that longer infectious periods, higher group mobility, larger group size and longer pathogen persistence lead to larger, faster growing outbreaks, and explore how these processes interact to determine epidemiological outcomes such as the epidemic peak and the final epidemic size. We identify general principles that can be used for planning surveillance and control for wildlife host–pathogen systems with environmental transmission across a range of spatial behaviour, social structure and pathogen decay rates. This article is part of the theme issue ‘The spatial–social interface: a theoretical and empirical integration’. 
    more » « less
  3. Evaluating public health interventions during disease outbreaks requires an understanding of the spatial patterns underlying epidemiological processes. In this study, we explore how Large Language Models (LLMs) can leverage spatial understanding and contextual reasoning to support spatially-disaggregated epidemiological simulations. We present an approach in which a system dynamics model queries an LLM at key decision points to determine appropriate mitigation strategies, informed by local profiles and the current outbreak status, and incorporates these strategies into the simulations. Through a series of experiments with COVID-19 data from San Diego County, we show how different LLMs perform in tasks requiring spatial adaptation of mitigation strategies, and how incorporating connectivity information through Retrieval-Augmented Generation (RAG) enhances the performance of these customizations. The results reveal significant differences among LLMs in their ability to account for spatial structure and optimize mitigation strategies accordingly. This highlights the importance of selecting the right model and enhancing it with relevant contextual information for effective public health interventions. 
    more » « less
  4. Evaluating public health interventions during disease outbreaks requires an understanding of the spatial patterns underlying epidemiological processes. In this study, we explore how Large Language Models (LLMs) can leverage spatial understanding and contextual reasoning to support spatially-disaggregated epidemiological simulations. We present an approach in which a system dynamics model queries an LLM at key decision points to determine appropriate mitigation strategies, informed by local profiles and the current outbreak status, and incorporates these strategies into the simulations. Through a series of experiments with COVID-19 data from San Diego County, we show how different LLMs perform in tasks requiring spatial adaptation of mitigation strategies, and how incorporating connectivity information through Retrieval-Augmented Generation (RAG) enhances the performance of these customizations. The results reveal significant differences among LLMs in their ability to account for spatial structure and optimize mitigation strategies accordingly. This highlights the importance of selecting the right model and enhancing it with relevant contextual information for effective public health interventions. 
    more » « less
  5. An important part of infectious disease management is predicting factors that influence disease outbreaks, such asR, the number of secondary infections arising from an infected individual. EstimatingRis particularly challenging for environmentally transmitted pathogens given time lags between cases and subsequent infections. Here, we calculatedRforBacillus anthracisinfections arising from anthrax carcass sites in Etosha National Park, Namibia. Combining host behavioural data, pathogen concentrations and simulation models, we show thatRis spatially and temporally variable, driven by spore concentrations at death, host visitation rates and early preference for foraging at infectious sites. While spores were detected up to a decade after death, most secondary infections occurred within 2 years. Transmission simulations under scenarios combining site infectiousness and host exposure risk under different environmental conditions led to dramatically different outbreak dynamics, from pathogen extinction (R< 1) to explosive outbreaks (R> 10). These transmission heterogeneities may explain variation in anthrax outbreak dynamics observed globally, and more generally, the critical importance of environmental variation underlying host–pathogen interactions. Notably, our approach allowed us to estimate the lethal dose of a highly virulent pathogen non-invasively from observational studies and epidemiological data, useful when experiments on wildlife are undesirable or impractical. 
    more » « less