Awareness-driven behavior changes can shift the shape of epidemics away from peaks and toward plateaus, shoulders, and oscillations

• DOI: 10.1073/pnas.2009911117
• Publication Date: 2020-12-01T22:00:29Z
• Authors: Joshua S. Weitz; Sang Woo Park; Ceyhun Eksin; Jonathan Dushoff
• Keywords: 0301 basic medicine; Behavior; 0303 health sciences; Multidisciplinary; Models, Statistical; COVID-19; Biological Sciences; Awareness; Article; United States; 3. Good health; 03 medical and health sciences; Humans; Public Health; Pandemics

SignificanceIn contrast to predictions of conventional epidemic models, COVID-19 outbreak time series have highly asymmetric shapes, with cases and fatalities declining much more slowly than they rose. Here, we investigate how awareness-driven behavior modulates epidemic shape. We find that short-term awareness of fatalities leads to emergent plateaus, persistent shoulder-like dynamics, and lag-driven oscillations in an SEIR-like model. However, a joint analysis of fatalities and mobility data suggests that populations relaxed mobility restrictions prior to fatality peaks, in contrast to model predictions. We show that incorporating fatigue and long-term behavior change can explain this phenomenon, shed light on when post-peak dynamics are likely to lead to a resurgence of cases or to sustained declines, and inform public health campaigns to control COVID-19.