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...

Full description

Saved in:
Bibliographic Details
Main Authors: Kris V Parag, Christl A Donnelly, Rahul Jha, Robin N Thompson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-11-01
Series:PLoS Computational Biology
Online Access:https://journals.plos.org/ploscompbiol/article/file?id=10.1371/journal.pcbi.1008478&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850163055833382912
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
work_keys_str_mv AT krisvparag anexactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT christladonnelly anexactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT rahuljha anexactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT robinnthompson anexactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT krisvparag exactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT christladonnelly exactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT rahuljha exactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime
AT robinnthompson exactmethodforquantifyingthereliabilityofendofepidemicdeclarationsinrealtime