Modeling-informed policy, policy evaluated by modeling: Evolution of mathematical epidemiology in the context of society and economy

TL;DR

This paper reviews the evolution of mathematical epidemiology, emphasizing how models inform public health policies during COVID-19 and highlighting the importance of realistic features in modeling for effective decision-making.

Contribution

It clarifies the core structure of epidemiological models and demonstrates how they can incorporate realism to better guide policy decisions during epidemics.

Findings

Models are primarily rooted in compartmental frameworks.

Incorporating community and decision-making features enhances realism.

Models enable testing policy impacts in silico, reducing trial-and-error risks.

Abstract

The COronaVIrus Disease 2019 (COVID-19) pandemic that has had the world in its grip from the beginning of 2020, has resulted in an unprecedented level of public interest and media attention on the field of mathematical epidemiology. Ever since the disease came to worldwide attention, numerous models with varying levels of sophistication have been proposed; many of these have tried to predict the course of the disease over different time-scales. Other models have examined the efficacy of various policy measures that have been adopted (including the unparalleled use of "lockdowns") to contain and combat the disease. This multiplicity of models may have led to bewilderment in many quarters about the true capabilities and utility of mathematical modeling. Here we provide a brief guide to epidemiological modeling, focusing on how it has emerged as a tool for informed public-health policy-making and has in turn, influenced the design of interventions aimed at preventing disease outbreaks from turning into raging epidemics. We show that the diversity of models is somewhat illusory, as the bulk of them are rooted in the compartmental modeling framework that we describe here. While their basic structure may appear to be a highly idealized description of the processes at work, we show that features that provide more realism, such as the community organization of populations or strategic decision-making by individuals, can be incorporated into such models. We conclude with the argument that the true value of models lies in their ability to test in silico the consequences of different policy choices in the course of an epidemic, a much superior alternative to trial-and-error approaches that are highly costly in terms of both lives and socio-economic disruption.