Changes in behaviour when adherers to an intervention experience a different epidemic than non-adherers

TL;DR

This study models how individual adherence to NPIs affects epidemic dynamics, revealing that behavior significantly influences infection outcomes and can alter epidemic severity.

Contribution

It introduces a coupled behavioral-epidemiological model with behavioral switching, providing new insights into how adherence impacts disease spread.

Findings

Stronger NPIs and higher initial adherence reduce infections.

Adherers consistently face lower infection risks than non-adherers.

Behavioral switching based on perceived benefits influences epidemic outcomes.

Abstract

Non-pharmaceutical interventions (NPIs), including mask-wearing, physical distancing, and hygiene measures, provide the primary means of reducing transmission in the early stages of an epidemic. Individuals adopt one of two strategies-adherence (A) or non-adherence (N) to NPIs. These strategies influence the transmission rate and thus the number of infections, but they also come with inherent costs and benefits. We propose a model coupling behavior and disease dynamics in adherers and non-adherers based on the SIR framework. This gives rise to six behavioral-epidemiological compartments. Using numerical simulations and analytical considerations, we first examine the case where strategies are fixed. Stronger NPIs and more initial adherers lead to fewer infections, and adherers consistently experience lower infection risk than non-adherers. We then introduce behavioral switching based on the benefits and costs of the two strategies. When NPIs are effective, higher transmission rates promote adherence, resulting in fewer infections. Strikingly, in high-severity outbreaks, even modestly effective NPIs can significantly reduce infections. These findings highlight the critical role of the coupling between behavior and disease dynamics, and underscore how individual choices can compromise or compensate public health interventions.