ID Control 1 - Practice

Overview

This app links the reproductive number and ID control. Read about the model in the “Model” tab. Then do the tasks described in the “What to do” tab. Before going through this app, you should go through the ‘Reproductive Number’ apps first.

This app assumes that you have worked through the reproductive number apps.

Learning Objectives

The Model

Model Overview

For this app, we’ll use the same basic compartmental SIR model as for the ‘Reproductive Number 2’ app. We allow for 3 different stages/compartments:

In addition to specifying the compartments of a model, we need to specify the dynamics determining the changes for each compartment. Broadly speaking, some processes increase the number of individuals in a given compartment/stage and other processes that lead to a reduction. Those processes are sometimes called inflows and outflows.

For our system, we specify the following processes/flows:

Model Implementation

The flow diagram and the set of equations which are used to implement this model are as follows:

Flow diagram for this model.

Flow diagram for this model.

\[\dot S =n - b SI - mS + wR\] \[\dot I = b S I - g I - mI\] \[\dot R = g I - mR - wR\] \[S_{v} = (1-ef)S(0)\] \[R(0) = efS(0)\]

Vaccination Implementation

The model includes the process of vaccinating individuals. It is modeled in a fairly simple way. Before the simulation starts, it is assumed that a fraction f of susceptibles are vaccinated. The vaccine protects those vaccinated with efficacy e. Those protected individuals move into the R compartment, the remainder stay in S. Thus, the simulation is started with values for susceptibles and recovered following vaccination given by \(S_{v} = (1 - fe) S\) and \(R = feS\). As an example, for a perfect vaccine (\(e=1\)) given to half the population (\(f=0.5\)) the initial number of susceptibles is reduced by half.

Note the unfortunate fact that the recovered compartment uses the same letter as the reproductive number, and the starting value for the R compartment, R(0) looks similar to the basic reproductive number. This is common notation and I therefore use it here too. Just be careful to make sure you know which quantity is discussed.

What to do

The tasks below are described in a way that assumes everything is in units of MONTHS (rate parameters, therefore, have units of inverse months). If any quantity is not given in those units, you need to convert it first (e.g. if it says a year, you need to convert it to 12 months).

Task 1

Knowing the reproductive number, R, is important for control strategies, e.g. for vaccine campaigns. You learned in the reproductive number apps that for R=1 an outbreak switches from growth to decline (often called the threshold value). Let’s say you have an ID that enters a new population where everyone is susceptible. That ID has R0=4. Would you expect to see an outbreak? Why? Now let’s assume that we protected half the population through a (100% effective) vaccine. What is the new value for R, i.e. how many people are being infected on average by an infected person after we vaccinated? Is that new value of R low enough to prevent the outbreak? What is the minimum percentage of the population you would need to be able to protect/vaccinate to achieve an R such that no outbreak can occur?

Record

Task 2

Let’s test the vaccination idea with the computer simulation. Set the simulation with 1000 susceptibles and 1 infected, simulation time 24 months, g=5, no births, deaths or waning immunity. Choose the value for b such that R0=4. Run the simulation for 0% vaccination coverage to confirm things happen as you expect. Use the final size equation for R0 to make sure it gives you a value of approximately 4.

Record

Task 3

Now set 50% vaccination coverage at 100% vaccine efficacy (f=0.5 and e=1). This changes the effective number of susceptible, as described in the Model section. What is the value of the effective R after vaccination? Run a simulation, use final size equation to confirm the expected R value.

Record

Task 4

Now run the simulation at the vaccination level you determined above to be enough to prevent an outbreak. Make sure the simulation results and your theoretical reasoning agree.

Record

Task 5

Most vaccines are not perfect. For the model settings above (R=4), what percentage of the population would you need to vaccinate to prevent an outbreak if the vaccine efficacy/effectiveness was 75% (e=0.75)? Confirm with the simulation. What happens to your ability to prevent an outbreak if the vaccine efficacy was was 65% or less?

Record

Task 6

Other useful interventions are quarantine or isolation, types of social distancing. Isolation is usually the term applied to reduction of contacts of an infected/infectious individual, quarantine to possibly exposed but likely still susceptible individuals (though that terminololgy can vary). In our model, we can’t distinguish between interventions that target susceptibles or infected, both could reduce the transmission rate. Targeting susceptibles before they become infected is of course preferable, but there are usually many more of those, so targeting infected is often easier. Interventions that reduce contact and transmission/infection risk for both groups are of course best. Consider the scenario as in task 2, but now with b=0.015. If we were able to reduce contacts and thus transmission by half, what would R0 be (and would that prevent an outbreak)? Test with the simulation.

Record

Task 7

If we want to completely prevent an outbreak, what value do we need to reduce R0 to? To achieve this, by what percentage do we need to reduce transmission? Express this reduction as a percent of the original value (e.g. reducing transmission from 0.1 to 0.06 is a (0.1-0.06)/0.1*100 = 40% reduction). Confirm with the model.

Record

Task 8

Keep exploring. The model allows for births and deaths and waning immunity. We haven’t explored that here, but you might want to. One limitation of the model is that it only allows vaccination at the start of the simulation, so any births will always be un-vaccinated. If one wanted a more realistic model, e.g. one that can mimick vaccination of children, one would want to modify the model to allow ongoing vaccination of a fraction of those entering the susceptible compartment.

Record

Further Information

References

Vynnycky, Emilia, and Richard White. 2010. An Introduction to Infectious Disease Modelling. Oxford University Press.
Wallinga, J, and M Lipsitch. 2007. “How Generation Intervals Shape the Relationship Between Growth Rates and Reproductive Numbers.” Proceedings. Biological Sciences / The Royal Society 274 (1609): 599–604.