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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Proc+Natl+Acad+Sci+U+S+A 2020 ; 117 (39): 24180-24187 Nephropedia Template TP
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Spatial heterogeneity can lead to substantial local variations in COVID-19 timing and severity #MMPMID32913057
Thomas LJ; Huang P; Yin F; Luo XI; Almquist ZW; Hipp JR; Butts CT
Proc Natl Acad Sci U S A 2020[Sep]; 117 (39): 24180-24187 PMID32913057show ga
Standard epidemiological models for COVID-19 employ variants of compartment (SIR or susceptible-infectious-recovered) models at local scales, implicitly assuming spatially uniform local mixing. Here, we examine the effect of employing more geographically detailed diffusion models based on known spatial features of interpersonal networks, most particularly the presence of a long-tailed but monotone decline in the probability of interaction with distance, on disease diffusion. Based on simulations of unrestricted COVID-19 diffusion in 19 US cities, we conclude that heterogeneity in population distribution can have large impacts on local pandemic timing and severity, even when aggregate behavior at larger scales mirrors a classic SIR-like pattern. Impacts observed include severe local outbreaks with long lag time relative to the aggregate infection curve, and the presence of numerous areas whose disease trajectories correlate poorly with those of neighboring areas. A simple catchment model for hospital demand illustrates potential implications for health care utilization, with substantial disparities in the timing and extremity of impacts even without distancing interventions. Likewise, analysis of social exposure to others who are morbid or deceased shows considerable variation in how the epidemic can appear to individuals on the ground, potentially affecting risk assessment and compliance with mitigation measures. These results demonstrate the potential for spatial network structure to generate highly nonuniform diffusion behavior even at the scale of cities, and suggest the importance of incorporating such structure when designing models to inform health care planning, predict community outcomes, or identify potential disparities.