The death of an epidemic

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LECTURE 2 Equilibrium Stability Analysis & Next Generation Method The death of an epidemic In SIR equations, let s divide equation for dx/dt by dz/ dt:!! dx/dz = - (β X Y/N)/(γY)!!! = - R 0 X/N Integrate with respect to Z X(t) = X(0) e Z(t) R 0 /N When epidemic is over, by definition, we have X( ), Y( ) (=0), and Z( ) X( ) = N Z( ) = X(0) e Z( ) R 0 /N

The death of an epidemic So, N Z( ) - X(0) e Z( ) R 0 /N = 0 Solve this numerically ( transcendental equation) Epidemic(dies(out(because( there(are(too(few(infectives,( not(because(of(too(few( susceptibles Kermack(&(McKendrick((1927) Simple Epidemics β 1/γ R₀ Measles 886 yr ¹ 0.019 yr 17 Influenza 180 yr ¹ 0.011 yr 2 Chickenpox 315 yr ¹ 0.022 yr 7 Rubella 200 yr ¹ 0.025 yr 5

Contact)Rate Frequency- or Density-Dependent Transmission? Assumed contact rate, κ, constant: mixing is independent of population size: frequency-dependent transmission. Reasonable? If we assume contact rate to be κn (increases with crowding ), then transmission rate is dx/dt = -βxy Called density-dependent transmission κn κ Popula'on)Size Does it Matter? Again, pathogen invasion if dy/dt > 0 If initially everyone susceptible (X=N), $$ $ βny γy>0 Y(βN - γ) > 0 In this case, we define R 0 = βn/γ, so need R 0 >1! Hence, for any particular β and γ, there s now a threshold population density required for invasion

Incorporating virulence Assume infectious individuals die at rate α dy dt =... Y Y Transmission & R 0 Density Dependent β=0.0426, γ=24, α=18, μ=0.02 N T = 1000 Frequency Dependent β=426, γ=24, α=18, μ=0.02 No invasion threshold 10000 = 0.0426; 1/ = 15d 10000 10000 = 426; 1/ = 15d = 426; 1/ = 15d Population Size 5000 Infected R 0 Population Size 10 0 5000 5000 11 10 9 Infected R 0 0 N T 0 0 100 200 300 400 500 600 700 800 900 1000 0 Time (years) 1 0 0 100 200 300 400 500 600 700 800 900 1000 0 100 200 300 400 500 600 700 800 900 1000 Time Time (years) (years) FD transmission pathogen can wipe out host

What should we do? If population size doesn t change, FD & DD equivalent (β FD = N x β DD ) Otherwise: Frequency-dependence generally more appropriate in large populations with heterogenous mixing, STDs, vector-borne pathogens Density-dependence representative of wildlife & livestock diseases (especially with smaller population sizes) LONG-TERM DYNAMICS So far, looked at start and end of a simple epidemic In other settings, would like to know systems dynamics in the long run Use equilibrium analysis

STDS AND SIS MODEL Simple model for a non-immunising infection, that is only cleared through treatment X Y System reduced to a single state variable What is R 0 here? Recall that N=X+Y, so we can rewrite this system as dy dt = (N Y ) Y N Y dy dt = Y (1 Y N ) Y EQUILIBRIUM ANALYSIS Can study properties of model at equilibrium (setting rates of change = 0) Setting dy/dt =0, we get $$ β(n-y)y/n - γy = 0,! So Y(β(N-Y)/N - γ) = 0 Satisfied whenever Y=0 or Y=N - Nγ/β = N(1-1/R0 ) Eqm points are: 0 and N(1-1/R 0) So, under what circumstances do we see each state?

STABILITY ANALYSIS So, we have two equilibria one where pathogen persists and one where it is absent What are conditions that determine when we observe one or other? For answer to this question, we need to carry out linear stability analysis Basic idea is to start at an equilibrium point and introduce a slight change (a perturbation ) and establish whether this perturbation grows (unstable) or decays (stable) EQUILIBRIUM STABILITY Stable Unstable Neutrally Stable To determine stability properties of equilibria, we need to calculate dominant eigenvalue To#determine#stability#proper1es#of#equilibria,#we# need#to#calculate#the# dominant#eigenvalue

LINEAR STABILITY ANALYSIS: 1-D CASE Assume we have a single state variable dy dt = f(y ) So, at equilibrium point Y*, f(y*)=0 Now, we re interested in knowing what happens if we slightly perturb equilibrium Let Y = Y* + y (y<<y*), substitute in ODE d(y + y) dt = dy dt = f(y + y) LINEAR STABILITY ANALYSIS: 1-D CASE f(n*+n) can be expressed as a Taylor expansion dy dt = f(y )+yf 0 (Y )+y 2 f 00 (Y )+... Note: f means derivative of f with respect to Y We end up with a linear ODE, solution to which is y(t) =y(0)e f 0 (Y )t f (N*) is eigenvalue -- from now on, we ll call it Λ Our perturbation, y(t), will 1. Grow exponentially if Λ >0 (equilibrium Unstable) 2. Decay exponentially if Λ <0 (equilibrium Stable)

TAYLOR EXPANSION f(y*+y) f(y*) f(y) f (Y*) { y f(y*) + y f (Y*) +... Y* Y*+y y SIS MODEL System is in equilibrium as long as!y* = 0 (or X* = N)... ie DFE!or Y* = N(1-γ/β) = N(1-1/R0) f(y )= Y (1 f 0 (Y )= df (Y ) dy Y N ) Y = 2 Y N

SIS MODEL f 0 (Y )= 2 Y N So, when Y*=0, f (0) = β-γ <0 if γ>β or R0<1 When Y*=N(1-γ/β), f (Y*) = -β+γ <0 if β>γ or R0>1 STABILITY ANALYSIS Let s do this in general terms For a system containing n state variables, we have "Now, we perturb equilibrium (Ni = Ni * +xi, xi<<ni * ), Taylor expand fi() and ignore higher order terms (xi 2, xixj etc) "Growth of perturbations (xi, i=1,n) given by linear set of ODEs Keeling & Rohani (2008) pp30-31 Excellent texts: Strang (1986) & Kreyszig (2010)

ADDING A LATENT PERIOD: SEIR MODEL Incorporating a latent period takes into account transition from infected but not yet infectious to infectious Note:'S'+'E'+'I'+'R'=1 SEIR MODEL In qualitative ways, this addition makes little difference System still possesses two equilibria: DFE (1,0,0) and an endemic equilibrium "Expression'for'R 0 'is'now

INVASION PHASE: SIR Consider Jacobian for SIR model, evaluated at disease free equilibrium "We worked out that two eigenvalues are Λ 1,2 =-µ "Third is Λ 3 =β-(µ+γ) = (R 0 1)(µ+γ) "So, initial dynamics of I class are driven by this largest eigenvalue (Λ 3 )' and (assume µ is small) are given by INVASION PHASE: SEIR If we do exactly same thing for SEIR model (straightforward but more involved), we get I SEIR I(0) e 1 2 ( + )+ p 4(R 0 1) +( + ) 2 "This seems pretty unwieldy. Let s see what happens if we assume γ=σ I SEIR I(0) e (p R 0 1) t "So, in comparison with SIR model, invasion speed in SEIR model scales with R₀

THE INVASION PHASE: SEIR DERIVING EXPRESSION FOR R 0 1. Examine eigenvalues at disease-free equilibrium Show system has two eigenvalues, Λ=-µ and Λ=(γ+µ) (β/(γ+µ)-1) As long as β/(γ+µ)>1, disease-free equilibrium is unstable and pathogen successfully invades 2. Use next generation method or Spectral Radius method (see Diekmann et al. 1990; J. Math. Biol. and Heffernan et al. 2005; J. R. Soc. Interface)

NEXT GENERATION METHOD Useful when host population can be split into disjoint categories (representing epidemiological complexities) Establishes # of transmissions generated by typical infected in susceptible population Denote x = {x 1, x 2,, x n } represent n infected host compartments Denote y = {y 1, y 2,, y m } represent m other host compartments NEXT GENERATION METHOD dx i dt = F i(x, y) V i (x, y) dy j dt = G j(x, y) i=1,...,&n j=1,...,&m F i = rate at which new infecteds enter compartment i V i = transfer of individuals out of and into ith compartment

ASSUMPTIONS I. Fi(0,y) = Vi(0,y) = 0 y>0 (no new infections if no infecteds) II. Fi(x,y) 0 xi 0 and yi 0 (no new infections if no infecteds) III. Vi(0,y) 0 yi 0 (if compartment empty, can only have inflow) IV. i Vi(x,y) 0 xi 0 and yi 0 (sum is net outflow) V. System y = G(0,y) has unique asymptotically stable equilibrium, y* SIR MODEL ds = µ dt SI µs di = dt SI I µi dr dt = I µr Here, n=1, m=2, x=i, y = (S,R) F 1 = SI V 1 =(µ + )I G 1 = µ SI µs G 2 = I µr

LINEARIZATION General system dx i dt = F i(x, y) V i (x, y) dy j dt = G j(x, y) can decouple x-system from y-system when close to disease-free equilibrium, y* where F and V are n x n matrices: i=1,...,&n j=1,...,&m dx dt =(F V )x F ij = @F i @x j (0,y ) V ij = @V i @x j (0,y ) NEXT GENERATION METHOD dx dt =(F V )x If F=0 (no new infections), x = x(0)e -Vt. Expected number of secondary cases produced by an initial case is Z 1 Z 1 Fe Vt x(0)dt = F e Vt dt x(0) = FV 1 x(0) 0 0 Next Generation Matrix, K=FV -1. Entry Kij represents expected number of secondary cases in compartment i by an individual in compartment j

NEXT GENERATION METHOD Next generation operator (FV -1 ) gives rate at which individuals in compartment j generate new infections in compartment i times average length of time individual spends in single visit to compartment j R o is given by dominant eigenvalue (or spectral radius, ρ) of FV -1, ie R0 = ρ(fv -1 ) = ρ(k) SIR MODEL ds = µ dt SI µs di = dt SI I µi dr dt = I µr Here, n=1, m=2, x=i, y = (S,R) F 1 = SI V 1 =(µ + )I G 1 = µ SI µs G 2 = I µr F = @F 1 @I = V = @V 1 @I = µ + Hence, R 0 = (µ + )

NEXT GENERATION METHOD SEIR equations (again): n=2 We deal with these two infected compartments How do we use Next Generation Method to work out R 0 for this model? NEXT GENERATION METHOD Write down matrix F, which defines rate of new infections in different compartments, differentiated with respect to E and I and evaluated at disease-free equilibrium F = F 1 = F 2 =0 SI @( SI) @E @( SI) @I 0 0 F = 0 S 0 0 = 0 00

NEXT GENERATION METHOD Now, we write a new matrix V that defines rate of transfer of infectives from one compartment to another V 1 =(µ + )E V 2 =(µ + )I E V = µ+ 0 µ+ NEXT GENERATION METHOD Recall that inverse of is So, we get: FV 1 = 0 00 µ+ (µ+ )(µ+ ) 0 (µ+ )(µ+ ) µ+ (µ+ )(µ+ )

NEXT GENERATION METHOD FV 1 = (µ+ )(µ+ ) (µ+ ) (µ+ )(µ+ ) 0 0 This is Next Generation Operator. R0 given by largest eigenvalue of this matrix: FV 1 = (µ+ )(µ+ ) 0 0 (µ+ ) (µ+ )(µ+ ) Check: σ, R 0 = β/(µ+γ) as for SIR model LECTURE SUMMARY Linear Stability Analysis SIR/SEIR endemic eqm stable if R 0 > 1 Approach to eqm via damped oscillations Period given by 2π (AG) Adding latent period, SEIR model Affects speed of epidemic take-off Next Generation Method to derive expression for R 0 for any model

CLASS CHALLENGE: HIV PROGRESSION Model'needs'to' consider'infec<vity'of' different'stages'and' respec<ve'dura<ons Fauci et al. 1995; Ann Intern Med CLASS CHALLENGE: HIV PROGRESSION Transmission rate β P β A 1/δ P 1/δ A Time since infection Equations: ds dt =! (! PI P +! A I A )S di P = (! P I P +! A I A )S!! P I P dt di A =! P I P!! A I A dt Show: R 0 =! P " P +! A " A

HINT: YOU LL NEED TO KNOW a 11 a 12 a 21 a 22 = a 11 a 22! a 12 a 21! # " a 11 a 12 a 21 a 22 $ & % '1! 1 a 22 'a = 12 a 11 a 22 ' a 12 a 21 # " 'a 21 a 11 $ & % SOLUTION! F = # "! P! A 0 0 $ " & V = % $ #! P 0!! P! A % ' & V!1 = 1 "! A! P! P! A $ # 0! P % ' &

SOLUTION C TD " FV!1 = $ # # % FV!1 = % % $! P! A 0 0 " $ % $ ' $ & $ # 1 " P 0 1 1 " A " A! P " P +! A " A! "! A " A 0!" % ' ' ' ' & & ( ( = 0 ( ' R 0 =! P " P +! A " A