# Reporting delays and right-truncation of line list data

If you are unfamiliar with the {simulist} package or the `sim_linelist()` function Get Started vignette is a great place to start.

This vignette covers reporting delays in line list data, how to use {simulist} to produce line list data with a delay between symptom onset and reporting, explains right truncation in outbreak data sets and shows how to use the `truncate_linelist()` function in {simulist} to augment a simulated line list to resemble real-time outbreak data.

## Reporting delays

Reporting delays in line list data during an infectious disease outbreak refer to the time lag between when an event (e.g., infection, symptom onset, or hospitalisation) occurs and when it is officially recorded or reported. These delays can arise from factors like diagnostic testing turnaround times, administrative processing, or delayed healthcare-seeking behaviour. In line list data sets, these delays are captured as separate times/dates for different event types, such as the dates of symptom onset, specimen collection, laboratory confirmation, or case reporting. For each case, the delay is the difference between these times/dates, allowing researchers to quantify and adjust for reporting delays when analysing outbreak dynamics. Accurate recording of these dates is crucial for reconstructing the epidemic curve and assessing the timeliness of public health responses.

In {simulist}, `sim_linelist()` outputs a line list with a date of reporting (`$date_reporting` column), which by default will be identical to the date of symptom onset (`$date_onset`). However, it is possible to parameterise a reporting delay that can be used by `sim_linelist()` to simulate a delay between symptom onset and reporting. In {simulist} we assume that the reporting delay is the delay between symptom onset and it being reported, it does not reflect reporting of hospitalisation or outcome times.

    library(simulist)
    library(epiparameter)
    library(tidyr)
    library(dplyr)
    #>
    #> Attaching package: 'dplyr'
    #> The following objects are masked from 'package:stats':
    #>
    #>     filter, lag
    #> The following objects are masked from 'package:base':
    #>
    #>     intersect, setdiff, setequal, union
    library(ggplot2)
    library(incidence2)
    #> Loading required package: grates

First we load the required delay distributions using the {epiparameter} package.

    contact_distribution <- epiparameter(
      disease = "COVID-19",
      epi_name = "contact distribution",
      prob_distribution = create_prob_distribution(
        prob_distribution = "pois",
        prob_distribution_params = c(mean = 2)
      )
    )
    #> Citation cannot be created as author, year, journal or title is missing

    infectious_period <- epiparameter(
      disease = "COVID-19",
      epi_name = "infectious period",
      prob_distribution = create_prob_distribution(
        prob_distribution = "gamma",
        prob_distribution_params = c(shape = 3, scale = 2)
      )
    )
    #> Citation cannot be created as author, year, journal or title is missing

    onset_to_hosp <- epiparameter(
      disease = "COVID-19",
      epi_name = "onset to hospitalisation",
      prob_distribution = create_prob_distribution(
        prob_distribution = "lnorm",
        prob_distribution_params = c(meanlog = 1, sdlog = 0.5)
      )
    )
    #> Citation cannot be created as author, year, journal or title is missing

    # get onset to death from {epiparameter} database
    onset_to_death <- epiparameter_db(
      disease = "COVID-19",
      epi_name = "onset to death",
      single_epiparameter = TRUE
    )
    #> Using Linton N, Kobayashi T, Yang Y, Hayashi K, Akhmetzhanov A, Jung S, Yuan
    #> B, Kinoshita R, Nishiura H (2020). "Incubation Period and Other
    #> Epidemiological Characteristics of 2019 Novel Coronavirus Infections
    #> with Right Truncation: A Statistical Analysis of Publicly Available
    #> Case Data." _Journal of Clinical Medicine_. doi:10.3390/jcm9020538
    #> <https://doi.org/10.3390/jcm9020538>..
    #> To retrieve the citation use the 'get_citation' function

Setting the seed ensures we have the same output each time the vignette is rendered. When using {simulist}, setting the seed is not required unless you need to simulate the same line list multiple times.

    set.seed(123)

Using a simple line list simulation without specifying a reporting delay will produce reporting times identical to symptom onset times:

    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death
    )
    identical(linelist$date_onset, linelist$date_reporting)
    #> [1] TRUE

The reporting delay can be specified as a (random) number generating function to the `reporting_delay` argument in `sim_linelist()`.

In this example we assume the reporting delays are distributed according to a lognormal distribution with parameters: `meanlog = 1` and `sdlog = 1` (or a mean of approximately 4.5 days and standard deviation of 5.9 days).

    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death,
      reporting_delay = function(x) rlnorm(n = x, meanlog = 1, sdlog = 1)
    )
    head(linelist)
    #>   id            case_name case_type sex age date_onset date_reporting
    #> 1  1       Yoonus al-Azam suspected   m  51 2023-01-01     2023-01-07
    #> 2  2       Kristina Clark confirmed   f  53 2023-01-04     2023-01-06
    #> 3  3         Karen Meehan confirmed   f  16 2023-01-05     2023-01-20
    #> 4  4 Ritika Brandenburger suspected   f  41 2023-01-05     2023-01-09
    #> 5  5       Steven Kaliski confirmed   m   4 2023-01-04     2023-01-09
    #> 6  6          Keely Atene suspected   f  68 2023-01-05     2023-01-12
    #>   date_admission   outcome date_outcome date_first_contact date_last_contact
    #> 1     2023-01-03      died   2023-01-26               <NA>              <NA>
    #> 2           <NA> recovered         <NA>         2022-12-28        2023-01-03
    #> 3           <NA> recovered         <NA>         2022-12-29        2023-01-06
    #> 4           <NA> recovered         <NA>         2022-12-31        2023-01-05
    #> 5           <NA> recovered         <NA>         2023-01-02        2023-01-05
    #> 6           <NA> recovered         <NA>         2023-01-02        2023-01-06
    #>   ct_value
    #> 1       NA
    #> 2     26.1
    #> 3     26.6
    #> 4       NA
    #> 5     25.0
    #> 6       NA

Here from the first 6 rows of the line list you can see differences between the `$date_onset` column and the `$date_reporting` column.

    tidy_linelist <- linelist %>%
      pivot_longer(
        cols = c("date_onset", "date_reporting", "date_admission", "date_outcome")
      ) %>%
      mutate(ordering_value = ifelse(name == "date_onset", value, NA)) %>% # nolint consecutive_mutate_linter
      mutate(case_name = reorder(case_name, ordering_value, min, na.rm = TRUE)) # nolint consecutive_mutate_linter

    ggplot(data = tidy_linelist) +
      geom_line(
        mapping = aes(x = value, y = case_name),
        linewidth = 0.25
      ) +
      geom_point(
        mapping = aes(
          x = value,
          y = case_name,
          shape = name,
          col = name
        ), size = 2
      ) +
      scale_x_date(name = "Event date", date_breaks = "week") +
      scale_y_discrete(name = "Case name") +
      scale_color_brewer(
        palette = "Set1",
        name = "Event type",
        labels = c("Date Admission", "Date Onset", "Date Outcome", "Date Reporting")
      ) +
      scale_shape_manual(
        name = "Event type",
        labels = c(
          "Date Admission", "Date Onset", "Date Outcome", "Date Reporting"
        ),
        values = c(15, 16, 17, 18)
      ) +
      theme_bw() +
      theme(legend.position = "bottom", axis.text.y = element_text(size = 4))
    #> Warning: Removed 1519 rows containing missing values or values outside the scale range
    #> (`geom_line()`).
    #> Warning: Removed 1519 rows containing missing values or values outside the scale range
    #> (`geom_point()`).

<img src=“/tmp/RtmpbTSW6h/Rbuild1864d1f2d4375/simulist/vignettes/reporting-delays-truncation_files/figure-html/plot-linelist-events-1.png” alt=“A dot plot with the event dates in the line list plotted a points on the figure, connected by horizontal lines. One row in the dot plot corresponds to one case (i.e. one row in the line list). The y-axis label is”Case name”, and the x-axis label is “Event date”. The event types are “Date admission” (red square), “Date Onset” (blue circle), “Date Outcome” (green triangle), and “Date Reporting” (purple diamond). The plot shows the distribution of delay times between each event for each individual in the line list, with the y-axis order by earliest date of symptom onset at the bottom.” />

If we plot the difference between the date of symptom onset and reporting then, as expected, the distribution is roughly lognormally distributed.

    ggplot(data = linelist) +
      geom_histogram(
        mapping = aes(x = as.numeric(date_reporting - date_onset)),
        binwidth = 2
      ) +
      scale_x_continuous(
        name = paste0(
          "Reporting delay (",
          attr(linelist$date_reporting - linelist$date_onset, "units"),
          ")"
        )
      ) +
      theme_bw() +
      theme(axis.title.y = element_blank())

If instead of a variable reporting delay you want to simulate a fixed reporting delay, for example, the date of reporting is always 5 days after the date of symptom onset, then a different function can be supplied. One option is to set the parameter that controls the variance of the probability distribution to zero (in the case of the lognormal distribution, setting `sdlog = 0`), but a simpler and more readable option would be to give a number generating function that always returned 5.

We once again simulate to produce a line list with a fixed reporting delay.

    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death,
      reporting_delay = function(x) rep(5, times = x)
    )
    head(linelist)
    #>   id          case_name case_type sex age date_onset date_reporting
    #> 1  1       Caleb Froome confirmed   m  47 2023-01-01     2023-01-06
    #> 2  2    Zubair el-Kalil  probable   m  41 2023-01-07     2023-01-12
    #> 3  3   Cameron Williams  probable   m  79 2023-01-09     2023-01-14
    #> 4  4      Aiyana Garcia confirmed   f  70 2023-01-10     2023-01-15
    #> 5  6 Miguel Line-Torres suspected   m  50 2023-01-10     2023-01-15
    #> 6  7       Teagan Dixon confirmed   f  80 2023-01-10     2023-01-15
    #>   date_admission   outcome date_outcome date_first_contact date_last_contact
    #> 1     2023-01-05      died   2023-01-26               <NA>              <NA>
    #> 2           <NA> recovered         <NA>         2022-12-26        2023-01-02
    #> 3           <NA> recovered         <NA>         2023-01-03        2023-01-11
    #> 4           <NA> recovered         <NA>         2023-01-03        2023-01-10
    #> 5           <NA> recovered         <NA>         2023-01-07        2023-01-11
    #> 6     2023-01-13      died   2023-01-30         2023-01-05        2023-01-10
    #>   ct_value
    #> 1     23.6
    #> 2       NA
    #> 3       NA
    #> 4     28.2
    #> 5       NA
    #> 6     26.9
    linelist$date_reporting - linelist$date_onset
    #> Time differences in days
    #>   [1] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #>  [38] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #>  [75] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [112] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [149] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [186] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [223] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [260] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [297] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [334] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [371] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [408] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [445] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [482] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
    #> [519] 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

## Truncation

Right truncation in infectious disease data occurs when only individuals who have experienced a specific event by a certain time can be included in the linelist. This leads to an underestimate of recent cases or death, and is especially relevant for ongoing outbreaks where recent cases might not have been recorded. It can also happen if cases are no longer recorded after a certain point in time.

Right-truncated outbreak data, in particular line list data, can give the impression that the incidence is decreasing (\(R\) < 1), however this can be an artefact resulting from the fact the data is right-truncated, and the outbreak can be stable or growing.

By default {simulist} simulates an outbreak from start to finish. Therefore, the line list or contact data contain all cases and outcomes. In order to get data that is more representative of ongoing outbreak dynamics where recent cases are not yet recorded and may be revised upwards in the future the `truncate_linelist()` function can be applied.

Re-simulating a simple line list using `sim_linelist()` with a lognormal reporting delay with `meanlog = 2` and `sdlog = 0.5`.

    # set seed to produce small line list
    set.seed(3)
    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death,
      reporting_delay = function(x) rlnorm(n = x, meanlog = 2, sdlog = 0.5)
    )

    # first 6 rows of linelist
    head(linelist)
    #>   id          case_name case_type sex age date_onset date_reporting
    #> 1  1 Daiveante Labarrie confirmed   m  59 2023-01-01     2023-01-05
    #> 2  2       Phayd Garcia confirmed   m   3 2023-01-07     2023-01-13
    #> 3  3  Jenifer Castaneda suspected   f  53 2023-01-01     2023-01-07
    #> 4  8      Asya Woolfolk confirmed   f  42 2023-01-14     2023-01-25
    #> 5  9 Amaani el-Abdullah  probable   f  73 2023-01-03     2023-01-08
    #> 6 10       Bella Nguyen confirmed   f  89 2023-01-03     2023-01-11
    #>   date_admission   outcome date_outcome date_first_contact date_last_contact
    #> 1     2023-01-05 recovered         <NA>               <NA>              <NA>
    #> 2           <NA> recovered         <NA>         2022-12-27        2023-01-06
    #> 3           <NA> recovered         <NA>         2023-01-01        2023-01-04
    #> 4           <NA> recovered         <NA>         2023-01-07        2023-01-11
    #> 5           <NA> recovered         <NA>         2022-12-25        2023-01-04
    #> 6           <NA> recovered         <NA>         2022-12-30        2023-01-02
    #>   ct_value
    #> 1     22.3
    #> 2     27.4
    #> 3       NA
    #> 4     28.0
    #> 5       NA
    #> 6     26.9

The truncation time is the time/date at which we want to take a snapshot of the line list and see what it would have looked like on that day (i.e. real-time during the outbreak). By default `truncate_linelist()` will truncate from 14 days before the end of the outbreak (defined as the maximum date in the line list).

Here we define the time between the latest, or user-specified date, and the time point at which data is truncated as the truncation point.

In the plot below we show the truncation time as a vertical line. If the date of reporting falls after the truncation time, then the case is removed from the line list, if it falls before the date of reporting but after the hospital admission and/or outcome date they are set to `NA`.

    tidy_linelist <- linelist %>%
      pivot_longer(
        cols = c("date_onset", "date_reporting", "date_admission", "date_outcome")
      ) %>%
      mutate(ordering_value = ifelse(name == "date_onset", value, NA)) %>% # nolint consecutive_mutate_linter
      mutate(case_name = reorder(case_name, ordering_value, min, na.rm = TRUE)) # nolint consecutive_mutate_linter

    truncation_day <- 14
    trunc_date <- max(tidy_linelist$value, na.rm = TRUE) - truncation_day

    ggplot(data = tidy_linelist) +
      geom_line(
        mapping = aes(x = value, y = case_name),
        linewidth = 0.25
      ) +
      geom_point(
        mapping = aes(
          x = value,
          y = case_name,
          shape = name,
          col = name
        ),
        size = 2
      ) +
      geom_vline(xintercept = trunc_date, linetype = 2) +
      scale_x_date(name = "Event date", date_breaks = "2 week") +
      scale_y_discrete(name = "Case name") +
      scale_color_brewer(
        palette = "Set1",
        name = "Event type",
        labels = c("Date Admission", "Date Onset", "Date Outcome", "Date Reporting")
      ) +
      scale_shape_manual(
        name = "Event type",
        labels = c(
          "Date Admission", "Date Onset", "Date Outcome", "Date Reporting"
        ),
        values = c(15, 16, 17, 18)
      ) +
      theme_bw() +
      theme(legend.position = "bottom", axis.text.y = element_text(size = 4))
    #> Warning: Removed 22 rows containing missing values or values outside the scale range
    #> (`geom_line()`).
    #> Warning: Removed 22 rows containing missing values or values outside the scale range
    #> (`geom_point()`).

<img src=“/tmp/RtmpbTSW6h/Rbuild1864d1f2d4375/simulist/vignettes/reporting-delays-truncation_files/figure-html/plot-linelist-events-trunc-1.png” alt=“A dot plot with the event dates in the line list plotted a points on the figure, connected by horizontal lines. One row in the dot plot corresponds to one case (i.e. one row in the line list). The y-axis label is”Case name”, and the x-axis label is “Event date”. The event types are “Date admission” (red square), “Date Onset” (blue circle), “Date Outcome” (green triangle), and “Date Reporting” (purple diamond). The plot shows the distribution of delay times between each event for each individual in the line list, with the y-axis order by earliest date of symptom onset at the bottom. There is a vertical dashed line showing when the truncation day is.” />

In this example several cases are removed as the reporting date occurs after the truncation time.

    linelist_trunc <- truncate_linelist(linelist = linelist)

`truncate_linelist()` assumes the event which is pertinent to the truncation of the data is the date of reporting (`$date_reporting`), as this is likely the date the case was first input into the line list, even if this date is before the date of hospital admission (`$date_admission`) or date of outcome (`$date_outcome`).

Right-truncating line list date using {simulist} removes individuals (rows) when the sampled truncation time is less recent than the reporting date. For cases where the rows are kept because the truncation time is more recent than the truncation event, but there are subsequent events, such as date of hospitalisation, that are more recent than the truncation time, these events dates are set to `NA`. The reasoning being that these events are assumed to have not been reported yet.

The `truncate_linelist()` function can also be used to reflect if the reporting of cases during an outbreak stopped on a given date.

It is also possible to specify the truncation time as the number of days, weeks, months or years since the start of the outbreak. Here we right-truncate the line list 3 months since the start of the outbreak.

    linelist_trunc <- truncate_linelist(
      linelist = linelist,
      truncation_day = 3,
      unit = "months",
      direction = "forward"
    )

## Truncate to emulate different stages of outbreak

It is not possible to simulate a line list with `sim_linelist()` that is mid-way through an outbreak1. This can make it difficult to generate outbreak data sets that resemble early outbreak dynamics where incidence is increasing, or mid-outbreak, or late in an outbreak as the disease approaches extinction. These types of data sets are useful for testing outbreak analytics method that are applied in real-time outbreak scenarios.

The `truncate_linelist()` function enables converting a complete line list from `sim_linelist()` into a within-outbreak line list.

We can simulate another outbreak, this time with more cases, and plot the complete line list by aggregating to daily incidence using the {incidence2} package.

For a full overview of how to visualise outbreak data simulated with {simulist} see the Visualising simulated data vignette.

    # set seed to produce single wave outbreak
    set.seed(3)
    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death,
      outbreak_size = c(500, 5000)
    )

    # create incidence object
    weekly_inci <- incidence(
      x = linelist,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    plot(weekly_inci)

By looking at the outbreak, we can pick three points to truncate: 1) early in the outbreak when the epicurve is growing (1st February 2023, epiweek 5), 2) in the middle of the outbreak (15th March 2023, epiweek 11), and 3) late in the outbreak when the number of cases is declining and the end of the outbreak is near (1st May 2023, epiweek 18).

We can specify a `<Date>` object to the `truncation_day` argument in `truncate_linelist()` to specify the date we want to apply the right truncation to.

    linelist_early <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-02-01")
    )
    inci_early <- incidence(
      x = linelist_early,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    linelist_mid <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-03-15")
    )
    inci_mid <- incidence(
      x = linelist_mid,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    linelist_late <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-05-01")
    )
    inci_late <- incidence(
      x = linelist_late,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

Next we repeat this procedure of creating data sets for early, mid, and late in the outbreak. For this example we will use a reporting delay to illustrate the issue of under-reporting of recent cases when there is a time delay between symptom onset and reporting.

    # set seed to produce single wave outbreak
    set.seed(3)
    linelist <- sim_linelist(
      contact_distribution = contact_distribution,
      infectious_period = infectious_period,
      prob_infection = 0.5,
      onset_to_hosp = onset_to_hosp,
      onset_to_death = onset_to_death,
      reporting_delay = function(x) rlnorm(n = x, meanlog = 2, sdlog = 0.5),
      outbreak_size = c(500, 5000)
    )

    linelist_early <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-02-01")
    )
    inci_early <- incidence(
      x = linelist_early,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    linelist_mid <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-03-15")
    )
    inci_mid <- incidence(
      x = linelist_mid,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    linelist_late <- truncate_linelist(
      linelist = linelist,
      truncation_day = as.Date("2023-05-01")
    )
    inci_late <- incidence(
      x = linelist_late,
      date_index = "date_onset",
      interval = "epiweek",
      complete_dates = TRUE
    )

    plot(inci_early) +
      ggtitle("Early") +
      theme(plot.title = element_text(size = 25, hjust = 0.5))
    plot(inci_mid) +
      ggtitle("Mid") +
      theme(plot.title = element_text(size = 25, hjust = 0.5))
    plot(inci_late) +
      ggtitle("Late") +
      theme(plot.title = element_text(size = 25, hjust = 0.5))

Comparing the two sets of the three plots you can see how in the latter applying right truncation gives the impression that cases are declining.

These truncated line lists can be used to test methods that estimate the real-time reproduction number such as {EpiNow2} or {epinowcast}.

1. `sim_linelist()` simulates an outbreak to extinction except in cases where the number of infected individuals exceeds the maximum outbreak size specified in the `outbreak_size` argument in `sim_linelist()`, which by default is 10^{4} where the line list returned is an ongoing outbreak.↩︎