An exact method for quantifying the reliability of end-of-epidemic declarations in real time.
We derive and validate a novel and analytic method for estimating the probability that an epidemic has been eliminated (i.e. that no future local cases will emerge) in real time. When this probability crosses 0.95 an outbreak can be declared over with 95% confidence. Our method is easy to compute, o...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-11-01
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| Series: | PLoS Computational Biology |
| Online Access: | https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008478&type=printable |
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| author | Kris V Parag Christl A Donnelly Rahul Jha Robin N Thompson |
| author_facet | Kris V Parag Christl A Donnelly Rahul Jha Robin N Thompson |
| author_sort | Kris V Parag |
| collection | DOAJ |
| description | We derive and validate a novel and analytic method for estimating the probability that an epidemic has been eliminated (i.e. that no future local cases will emerge) in real time. When this probability crosses 0.95 an outbreak can be declared over with 95% confidence. Our method is easy to compute, only requires knowledge of the incidence curve and the serial interval distribution, and evaluates the statistical lifetime of the outbreak of interest. Using this approach, we show how the time-varying under-reporting of infected cases will artificially inflate the inferred probability of elimination, leading to premature (false-positive) end-of-epidemic declarations. Contrastingly, we prove that incorrectly identifying imported cases as local will deceptively decrease this probability, resulting in delayed (false-negative) declarations. Failing to sustain intensive surveillance during the later phases of an epidemic can therefore substantially mislead policymakers on when it is safe to remove travel bans or relax quarantine and social distancing advisories. World Health Organisation guidelines recommend fixed (though disease-specific) waiting times for end-of-epidemic declarations that cannot accommodate these variations. Consequently, there is an unequivocal need for more active and specialised metrics for reliably identifying the conclusion of an epidemic. |
| format | Article |
| id | doaj-art-e6ca317185c241df83814de1ef182bd0 |
| institution | OA Journals |
| issn | 1553-734X 1553-7358 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Computational Biology |
| spelling | doaj-art-e6ca317185c241df83814de1ef182bd02025-08-20T02:22:24ZengPublic Library of Science (PLoS)PLoS Computational Biology1553-734X1553-73582020-11-011611e100847810.1371/journal.pcbi.1008478An exact method for quantifying the reliability of end-of-epidemic declarations in real time.Kris V ParagChristl A DonnellyRahul JhaRobin N ThompsonWe derive and validate a novel and analytic method for estimating the probability that an epidemic has been eliminated (i.e. that no future local cases will emerge) in real time. When this probability crosses 0.95 an outbreak can be declared over with 95% confidence. Our method is easy to compute, only requires knowledge of the incidence curve and the serial interval distribution, and evaluates the statistical lifetime of the outbreak of interest. Using this approach, we show how the time-varying under-reporting of infected cases will artificially inflate the inferred probability of elimination, leading to premature (false-positive) end-of-epidemic declarations. Contrastingly, we prove that incorrectly identifying imported cases as local will deceptively decrease this probability, resulting in delayed (false-negative) declarations. Failing to sustain intensive surveillance during the later phases of an epidemic can therefore substantially mislead policymakers on when it is safe to remove travel bans or relax quarantine and social distancing advisories. World Health Organisation guidelines recommend fixed (though disease-specific) waiting times for end-of-epidemic declarations that cannot accommodate these variations. Consequently, there is an unequivocal need for more active and specialised metrics for reliably identifying the conclusion of an epidemic.https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008478&type=printable |
| spellingShingle | Kris V Parag Christl A Donnelly Rahul Jha Robin N Thompson An exact method for quantifying the reliability of end-of-epidemic declarations in real time. PLoS Computational Biology |
| title | An exact method for quantifying the reliability of end-of-epidemic declarations in real time. |
| title_full | An exact method for quantifying the reliability of end-of-epidemic declarations in real time. |
| title_fullStr | An exact method for quantifying the reliability of end-of-epidemic declarations in real time. |
| title_full_unstemmed | An exact method for quantifying the reliability of end-of-epidemic declarations in real time. |
| title_short | An exact method for quantifying the reliability of end-of-epidemic declarations in real time. |
| title_sort | exact method for quantifying the reliability of end of epidemic declarations in real time |
| url | https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008478&type=printable |
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