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COVID-19 abatement strategies have risks and uncertainties which could lead to repeating waves of infection. We show—as proof of concept grounded on rigorous mathematical evidence—that periodic, high-frequency alternation of into, and out-of, lockdown effectively mitigates second-wave effects, while allowing continued, albeit reduced, economic activity. Periodicity confers (i) predictability, which is essential for economic sustainability, and (ii) robustness, since lockdown periods are not activated by uncertain measurements over short time scales. In turn—while not eliminating the virus—this fast switching policy is sustainable over time, and it mitigates the infection until a vaccine or treatment becomes available, while alleviating the social costs associated with long lockdowns. Typically, the policy might be in the form of 1-day of work followed by 6-days of lockdown every week (or perhaps 2 days working, 5 days off) and it can be modified at a slow-rate based on measurements filtered over longer time scales. Our results highlight the potential efficacy of high frequency switching interventions in post lockdown mitigation. All code is available on Github at https://github.com/V4p1d/FPSP_Covid19. A software tool has also been developed so that interested parties can explore the proof-of-concept system., Author summary Why? The design of post-lockdown mitigation policies while vaccines are still not available is pressing now as new secondary waves of the virus have emerged in many countries (for example, in Spain, France, UK, Italy, Israel, and others), and as several of these countries grapple with the reintroduction of full lockdown measures. What do we do and find? We propose efficacious and realisable methods based on control theory to tame the complex behaviour of COVID-19 in well mixed populations. We achieve this through a policy of fast intermittent lockdown intervals with regular period. We illustrate how our approach offers a fundamentally new perspective on ways to design COVID-19 exit strategies from policies of total lockdown. Our theoretical results are also very general and apply to a wide range of epidemiological models. What do these findings mean? Unlike many other proposed abatement strategies, which have risks and uncertainties possibly leading to multiple waves of infection, we demonstrate that our proposed policies have the potential to suppress the virus outbreak, while at the same time allowing continued economic activity. These policies, while of practical significance, are built on rigorous theoretical results, which are to the best of our knowledge, new in mathematical epidemiology. An extensive validation is carried out using a detailed epidemic model validated on real COVID-19 data from Italy and published very recently in Nature Medicine.

Testing, tracking and tracing abilities have been identified as pivotal in helping countries to safely reopen activities after the first wave of the COVID-19 virus. Contact tracing apps give the unprecedented possibility to reconstruct graphs of daily contacts, so the question is: who should be tested? As human contact networks are known to exhibit community structure, in this paper we show that the Kemeny constant of a graph can be used to identify and analyze bridges between communities in a graph. Our ‘Kemeny indicator’ is the value of the Kemeny constant in the new graph that is obtained when a node is removed from the original graph. We show that testing individuals who are associated with large values of the Kemeny indicator can help in efficiently intercepting new virus outbreaks, when they are still in their early stage. Extensive simulations provide promising results in early identification and in blocking the possible ‘super-spreaders’ links that transmit disease between different communities.

The recent COVID-19 outbreak has motivated an extensive development of non-pharmaceutical intervention policies for epidemics containment. While a total lockdown is a viable solution, interesting policies are those allowing some degree of normal functioning of the society, as this allows a continued, albeit reduced, economic activity and lessens the many societal problems associated with a prolonged lockdown. Recent studies have provided evidence that fast periodic alternation of lockdown and normal-functioning days may effectively lead to a good trade-off between outbreak abatement and economic activity. Nevertheless, the correct number of normal days to allocate within each period in such a way to guarantee the desired trade-off is a highly uncertain quantity that cannot be fixed a priori and that must rather be adapted online from measured data. This adaptation task, in turn, is still a largely open problem, and it is the subject of this work. In particular, we study a class of solutions based on hysteresis logic. First, in a rather general setting, we provide general convergence and performance guarantees on the evolution of the decision variable. Then, in a more specific context relevant for epidemic control, we derive a set of results characterizing robustness with respect to uncertainty and giving insight about how a priori knowledge about the controlled process may be used for fine-tuning the control parameters. Finally, we validate the results through numerical simulations tailored on the COVID-19 outbreak.