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Background Human behavioral responses to changes in risks are often delayed. Methods for estimating these delayed responses either rely on rigid assumptions about the delay distribution (e.g., Erlang distribution), producing a poor fit, or yield period-specific estimates (e.g., estimates from the Autoregressive Distributed Lag (ARDL) model) that are difficult to integrate into simulation models. We propose a hybrid ARDL–Erlang approach that yields an interpretable summary of behavioral responses suitable for incorporation into simulation models. Method We apply the ARDL–Erlang approach to estimate the effect of COVID-19 deaths on mobility across US counties from October 2020 to July 2021. A standard panel autoregressive distributed lag (ARDL) model first estimates the effect of past deaths and past mobility on current mobility. The ARDL model is then transformed into an Infinite Distributed Lag (IDL) model consisting of only past deaths. The coefficients of the past deaths are aggregated into an overall effect and fit to an Erlang distribution, summarized by average delay length and shape parameter. Results Our results show that on the national level, a one-standard-deviation permanent increase in weekly deaths per 100,000 population (log-transformed) is associated with a 0.46-standard-deviation decrease in human mobility in the long run, where the delay distribution follows a first-order Erlang distribution, and the average delay length is about 3.2 weeks. However, there is much heterogeneity across states, with first- to third-order Erlang delays and 2 to 18 weeks of average delay providing a theoretically cogent summary of how mobility followed changes in deaths during the first year and a half of the pandemic. Conclusion This study provides a novel approach to estimating delayed human responses to health risks using a hybrid ARDL-Erlang model. Our findings highlight significant variability in the impact and timing of responses across states, underscoring the need for tailored public health policies. This study can also serve as guidelines and an example for identifying delayed human behavior in other settings. 

ABSTRACT Estimating parameters and their credible intervals for complex system dynamics models is challenging but critical to continuous model improvement and reliable communication with an increasing fraction of audiences. The purpose of this study is to integrate Amortized Bayesian Inference (ABI) methods with system dynamics. Utilizing Neural Posterior Estimation (NPE), we train neural networks using synthetic data (pairs of ground truth parameters and outcome time series) to estimate parameters of system dynamics models. We apply this method to two example models: a simple Random Walk model and a moderately complex SEIRb model. We show that the trained neural networks can output the posterior for parameters instantly given new unseen time series data. Our analysis highlights the potential of ABI to facilitate a principled, scalable, and likelihood‐free inference workflow that enhance the integration of models of complex systems with data. Accompanying code streamlines application to diverse system dynamics models. 

In the first two years of the COVID-19 pandemic, per capita mortality varied by more than a hundredfold across countries, despite most implementing similar nonpharmaceutical interventions. Factors such as policy stringency, gross domestic product, and age distribution explain only a small fraction of mortality variation. To address this puzzle, we built on a previously validated pandemic model in which perceived risk altered societal responses affecting SARS-CoV-2 transmission. Using data from more than 100 countries, we found that a key factor explaining heterogeneous death rates was not the policy responses themselves but rather variation in responsiveness. Responsiveness measures how sensitive communities are to evolving mortality risks and how readily they adopt nonpharmaceutical interventions in response, to curb transmission. We further found that responsiveness correlated with two cultural constructs across countries: uncertainty avoidance and power distance. Our findings show that more responsive adoption of similar policies saves many lives, with important implications for the design and implementation of responses to future outbreaks.