The COVID-19 pandemic has highlighted the need for control measures that reduce the epidemic peak ("flattening the curve"). Here we derive the optimal time-limited intervention for reducing peak epidemic prevalence in the standard Susceptible-Infectious-Recovered (SIR) model. We show that alternative, more practical interventions can perform nearly as well as the provably optimal strategy. However, none of these strategies are robust to implementation errors: mistiming the start of the intervention by even a single week can be enormously costly, for realistic epidemic parameters. Sustained control measures, though less efficient than optimal and near-optimal time-limited interventions, can be used in combination with time-limited strategies to mitigate the catastrophic risks of mistiming .
In the absence of drugs and vaccines, policymakers use non-pharmaceutical interventions such as social distancing to decrease rates of disease-causing contact, with the aim of reducing or delaying the epidemic peak. These measures carry social and economic costs, so societies may be unable to maintain them for more than a short period of time. Intervention policy design often relies on numerical simulations of epidemic models, but comparing policies and assessing their robustness demands clear principles that apply across strategies. Here we derive the theoretically optimal strategy for using a time-limited intervention to reduce the peak prevalence of a novel disease in the classic Susceptible-Infectious-Recovered epidemic model. We show that broad classes of easier-to-implement strategies can perform nearly as well as the theoretically optimal strategy. But neither the optimal strategy nor any of these near-optimal strategies is robust to implementation error: small errors in timing the intervention produce large increases in peak prevalence. Our results reveal fundamental principles of non-pharmaceutical disease control and expose their potential fragility. For robust control, an intervention must be strong, early, and ideally sustained .
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The COVID-19 pandemic has highlighted the need for control measures that reduce the epidemic peak ("flattening the curve").
In the absence of drugs and vaccines, policymakers use non-pharmaceutical interventions such as social distancing to decrease rates of disease-causing contact, with the aim of reducing or delaying the epidemic peak. These measures carry social and economic costs, so societies may be unable to maintain them for more than a short period of time. Intervention policy design often relies on numerical simulations of epidemic models, but comparing policies and assessing their robustness demands clear principles that apply across strategies.
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optimal
theoretically optimal strategy for using a
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for reducing peak epidemic prevalence in the standard
to reduce the peak prevalence of a novel disease in the classic
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(SIR)
epidemic
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alternative, more practical interventions
broad classes of easier-to-implement strategies
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provably
theoretically
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However, none of these strategies are
But neither the optimal strategy nor any of these near-optimal strategies is
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errors: mistiming the start of the intervention by even a single week can be enormously costly, for realistic epidemic parameters. Sustained control measures, though less efficient than optimal and near-optimal time-limited interventions, can be used in combination with time-limited strategies to mitigate the catastrophic risks of mistiming
error: small errors in timing the intervention produce large increases in peak prevalence. Our results reveal fundamental principles of non-pharmaceutical disease control and expose their potential fragility. For robust control, an intervention must be strong, early, and ideally sustained