A network-based explanation of why most COVID-19 infection curves are linear

Proc Natl Acad Sci U S A. 2020 Sep 15;117(37):22684-22689. doi: 10.1073/pnas.2010398117. Epub 2020 Aug 24.

Abstract

Many countries have passed their first COVID-19 epidemic peak. Traditional epidemiological models describe this as a result of nonpharmaceutical interventions pushing the growth rate below the recovery rate. In this phase of the pandemic many countries showed an almost linear growth of confirmed cases for extended time periods. This new containment regime is hard to explain by traditional models where either infection numbers grow explosively until herd immunity is reached or the epidemic is completely suppressed. Here we offer an explanation of this puzzling observation based on the structure of contact networks. We show that for any given transmission rate there exists a critical number of social contacts, [Formula: see text], below which linear growth and low infection prevalence must occur. Above [Formula: see text] traditional epidemiological dynamics take place, e.g., as in susceptible-infected-recovered (SIR) models. When calibrating our model to empirical estimates of the transmission rate and the number of days being contagious, we find [Formula: see text] Assuming realistic contact networks with a degree of about 5, and assuming that lockdown measures would reduce that to household size (about 2.5), we reproduce actual infection curves with remarkable precision, without fitting or fine-tuning of parameters. In particular, we compare the United States and Austria, as examples for one country that initially did not impose measures and one that responded with a severe lockdown early on. Our findings question the applicability of standard compartmental models to describe the COVID-19 containment phase. The probability to observe linear growth in these is practically zero.

Keywords: COVID-19; compartmental epidemiological model; mean-field (well mixed) approximation; network theory; social contact networks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basic Reproduction Number
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / transmission
  • Humans
  • Models, Statistical*
  • Pandemics / prevention & control
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / transmission
  • Quarantine / statistics & numerical data