Abstract
COVID-19, caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a global pandemic and created unprecedented public health challenges throughout the world. Despite significant progresses in understanding the disease pathogenesis and progression, the epidemiological triad of pathogen, host, and environment remains unclear. In this paper, we develop a multiscale model to study the coupled within-host and between-host dynamics of COVID-19. The model includes multiple transmission routes (both human-to-human and environment-to-human) and connects multiple scales (both the population and individual levels). A detailed analysis on the local and global dynamics of the fast system, slow system and full system shows that rich dynamics, including both forward and backward bifurcations, emerge with the coupling of viral infection and epidemiological models. Model fitting to both virological and epidemiological data facilitates the evaluation of the influence of a few infection characteristics and antiviral treatment on the spread of the disease. Our work underlines the potential role that the environment can play in the transmission of COVID-19. Antiviral treatment of infected individuals can delay but cannot prevent the emergence of disease outbreaks. These results highlight the implementation of comprehensive intervention measures such as social distancing and wearing masks that aim to stop airborne transmission, combined with surface disinfection and hand hygiene that can prevent environmental transmission. The model also provides a multiscale modeling framework to study other infectious diseases when the environment can serve as a reservoir of pathogens.
Keywords: Between-host dynamics; COVID-19; Multiscale model; Within-host dynamics.
【저자키워드】 COVID-19, multiscale model, Between-host dynamics, Within-host dynamics., 【초록키워드】 Treatment, public health, SARS-CoV-2, viral infection, coronavirus, Infectious diseases, Pathogenesis, social distancing, Infection, Masks, Intervention, Local, Transmission, Antiviral treatment, Infectious disease, progression, severe acute respiratory syndrome Coronavirus, global pandemic, Spread, Outbreaks, Characteristics, pathogen, implementation, Model, transmission route, Pathogens, epidemiological, epidemiological data, disease, hand hygiene, Analysis, hygiene, can not, other infectious diseases, disease pathogenesis, acute respiratory syndrome, Virological, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, infected individual, infected individuals, measure, reservoir, coupling, Host, Prevent, highlight, develop, caused, include, the disease, facilitate, provide, wearing mask, 【제목키워드】 Dynamics, Model,