Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.

A key parameter in epidemiological modeling which characterizes the spread of an infectious disease is the generation time, or more generally the distribution of infectiousness as a function of time since infection. There is increasing evidence supporting a prolonged viral shedding window for COVID-...

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Main Authors: Burcu Tepekule, Anthony Hauser, Viacheslav N Kachalov, Sara Andresen, Thomas Scheier, Peter W Schreiber, Huldrych F Günthard, Roger D Kouyos
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS Computational Biology
Online Access:https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008609&type=printable
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author Burcu Tepekule
Anthony Hauser
Viacheslav N Kachalov
Sara Andresen
Thomas Scheier
Peter W Schreiber
Huldrych F Günthard
Roger D Kouyos
author_facet Burcu Tepekule
Anthony Hauser
Viacheslav N Kachalov
Sara Andresen
Thomas Scheier
Peter W Schreiber
Huldrych F Günthard
Roger D Kouyos
author_sort Burcu Tepekule
collection DOAJ
description A key parameter in epidemiological modeling which characterizes the spread of an infectious disease is the generation time, or more generally the distribution of infectiousness as a function of time since infection. There is increasing evidence supporting a prolonged viral shedding window for COVID-19, but the transmissibility in this phase is unclear. Based on this, we develop a generalized Susceptible-Exposed-Infected-Resistant (SEIR) model including an additional compartment of chronically infected individuals who can stay infectious for a longer duration than the reported generation time, but with infectivity reduced to varying degrees. Using the incidence and fatality data from different countries, we first show that such an assumption also yields a plausible model in explaining the data observed prior to the easing of the lockdown measures (relaxation). We then test the predictive power of this model for different durations and levels of prolonged infectiousness using the incidence data after the introduction of relaxation in Switzerland, and compare it with a model without the chronically infected population to represent the models conventionally used. We show that in case of a gradual easing on the lockdown measures, the predictions of the model including the chronically infected population vary considerably from those obtained under a model in which prolonged infectiousness is not taken into account. Although the existence of a chronically infected population still remains largely hypothetical, we believe that our results provide tentative evidence to consider a chronically infected population as an alternative modeling approach to better interpret the transmission dynamics of COVID-19.
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spelling doaj-art-bb8d99f4d80b4b2fb33932662eaad2aa2025-08-20T02:55:13ZengPublic Library of Science (PLoS)PLoS Computational Biology1553-734X1553-73582021-01-01171e100860910.1371/journal.pcbi.1008609Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.Burcu TepekuleAnthony HauserViacheslav N KachalovSara AndresenThomas ScheierPeter W SchreiberHuldrych F GünthardRoger D KouyosA key parameter in epidemiological modeling which characterizes the spread of an infectious disease is the generation time, or more generally the distribution of infectiousness as a function of time since infection. There is increasing evidence supporting a prolonged viral shedding window for COVID-19, but the transmissibility in this phase is unclear. Based on this, we develop a generalized Susceptible-Exposed-Infected-Resistant (SEIR) model including an additional compartment of chronically infected individuals who can stay infectious for a longer duration than the reported generation time, but with infectivity reduced to varying degrees. Using the incidence and fatality data from different countries, we first show that such an assumption also yields a plausible model in explaining the data observed prior to the easing of the lockdown measures (relaxation). We then test the predictive power of this model for different durations and levels of prolonged infectiousness using the incidence data after the introduction of relaxation in Switzerland, and compare it with a model without the chronically infected population to represent the models conventionally used. We show that in case of a gradual easing on the lockdown measures, the predictions of the model including the chronically infected population vary considerably from those obtained under a model in which prolonged infectiousness is not taken into account. Although the existence of a chronically infected population still remains largely hypothetical, we believe that our results provide tentative evidence to consider a chronically infected population as an alternative modeling approach to better interpret the transmission dynamics of COVID-19.https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008609&type=printable
spellingShingle Burcu Tepekule
Anthony Hauser
Viacheslav N Kachalov
Sara Andresen
Thomas Scheier
Peter W Schreiber
Huldrych F Günthard
Roger D Kouyos
Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
PLoS Computational Biology
title Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
title_full Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
title_fullStr Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
title_full_unstemmed Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
title_short Assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on COVID-19.
title_sort assessing the potential impact of transmission during prolonged viral shedding on the effect of lockdown relaxation on covid 19
url https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008609&type=printable
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