Citerank: (9) 679750Ali AsgaryAssociate Professor and Associate Director, Advanced Disaster, Emergency and Rapid Response Simulation (ADERSIM) in the School of Administrative Studies, and Adjunct Professor in the School of Information Technology, at York University.10019D3ABAB, 679806Jane HeffernanJane Heffernan is a professor of infectious disease modelling in the Mathematics & Statistics Department at York University. She is a co-director of the Canadian Centre for Disease Modelling, and she leads national and international networks in mathematical immunology and the modelling of waning and boosting immunity.10019D3ABAB, 679812Jianhong WuProfessor Jianhong Wu is a University Distinguished Research Professor and Senior Canada Research Chair in industrial and applied mathematics at York University. He is also the NSERC Industrial Research Chair in vaccine mathematics, modelling, and manufacturing. 10019D3ABAB, 701037MfPH – Publications144B5ACA0, 704045Covid-19859FDEF6, 714608Charting a FutureCharting a Future for Emerging Infectious Disease Modelling in Canada – April 2023 [1] 2794CAE1, 715328Nonpharmaceutical Interventions (NPIs)859FDEF6, 715329Nick OgdenNicholas Ogden is a senior research scientist and Director of the Public Health Risk Sciences Division within the National Microbiology Laboratory at the Public Health Agency of Canada.10019D3ABAB, 715617Schools859FDEF6

[Journal of Mathematics in Industry, 1 December 2020]

Social contact mixing plays a critical role in influencing the transmission routes of infectious diseases. Moreover, quantifying social contact mixing patterns and their variations in a rapidly evolving pandemic intervened by changing public health measures is key for retroactive evaluation and proactive assessment of the effectiveness of different age- and setting-specific interventions. Contact mixing patterns have been used to inform COVID-19 pandemic public health decision-making; but a rigorously justified methodology to identify setting-specific contact mixing patterns and their variations in a rapidly developing pandemic, which can be informed by readily available data, is in great demand and has not yet been established. Here we fill in this critical gap by developing and utilizing a novel methodology, integrating social contact patterns derived from empirical data with a disease transmission model, that enables the usage of age-stratified incidence data to infer age-specific susceptibility, daily contact mixing patterns in workplace, household, school and community settings; and transmission acquired in these settings under different physical distancing measures. We demonstrated the utility of this methodology by performing an analysis of the COVID-19 epidemic in Ontario, Canada. We quantified the age- and setting (household, workplace, community, and school)-specific mixing patterns and their evolution during the escalation of public health interventions in Ontario, Canada. We estimated a reduction in the average individual contact rate from 12.27 to 6.58 contacts per day, with an increase in household contacts, following the implementation of control measures. We also estimated increasing trends by age in both the susceptibility to infection by SARS-CoV-2 and the proportion of symptomatic individuals diagnosed. Inferring the age- and setting-specific social contact mixing and key age-stratified epidemiological parameters, in the presence of evolving control measures, is critical to inform decision- and policy-making for the current COVID-19 pandemic.

Citerank: (11) 679746Steini BrownProfessor and Dean of the Dalla Lana School of Public Health at the University of Toronto.10019D3ABAB, 679755Ashleigh TuiteAshleigh Tuite is an Assistant Professor in the Epidemiology Division at the Dalla Lana School of Public Health at the University of Toronto.10019D3ABAB, 679757Beate SanderCanada Research Chair in Economics of Infectious Diseases and Director, Health Modeling & Health Economics and Population Health Economics Research at THETA (Toronto Health Economics and Technology Assessment Collaborative).10019D3ABAB, 679777David FismanI am a Professor in the Division of Epidemiology at Division of Epidemiology, Dalla Lana School of Public Health at the University of Toronto. I am a Full Member of the School of Graduate Studies. I also have cross-appointments at the Institute of Health Policy, Management and Evaluation and the Department of Medicine, Faculty of Medicine. I serve as a Consultant in Infectious Diseases at the University Health Network.10019D3ABAB, 679802Isaac BogochClinician Investigator, Toronto General Hospital Research Institute (TGHRI)10019D3ABAB, 685230Doug ManuelDr. Manuel is a Medical Doctor with a Masters in Epidemiology and Royal College specialization in Public Health and Preventive Medicine. He is a Senior Scientist in the Clinical Epidemiology Program at Ottawa Hospital Research Institute, and a Professor in the Departments of Family Medicine and Epidemiology and Community Medicine.10019D3ABAB, 685420Hospitals16289D5D4, 701020CANMOD – PublicationsPublications by CANMOD Members144B5ACA0, 701037MfPH – Publications144B5ACA0, 704045Covid-19859FDEF6, 715390Mortality859FDEF6

[Science Briefs of the Ontario COVID-19 Science Advisory Table, 29 March 2021]

Background: As of March 28, 2021 new variants of concern (VOCs) account for 67% of all Ontario SARS-CoV-2 infections. The B.1.1.7 variant originally detected in Kent, United Kingdom accounts for more than 90% of all VOCs in Ontario, with emerging evidence that it is both more transmissible and virulent.

Questions: What are the risks of COVID-19 hospitalization, ICU admission and death caused by VOCs as compared with the early variants of SARS-CoV-2?

What is the early impact of new VOCs on Ontario’s healthcare system?

Findings: A retrospective cohort study of 26,314 people in Ontario testing positive for SARS-CoV-2 between February 7 and March 11, 2021, showed that 9,395 people (35.7%) infected with VOCs had a 62% relative increase in COVID-19 hospitalizations (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.41 to 1.87), a 114% relative increase in ICU admissions (OR 2.14, 95% CI 1.52 to 3.02), and a 40% relative increase in COVID-19 deaths (OR 1.40, 95% CI 1.01 to 1.94), after adjusting for age, sex and comorbidities.

A meta-analysis including the Ontario cohort study and additional cohort studies in the United Kingdom and Denmark showed that people infected with VOCs had a 63% higher risk of hospitalization (RR 1.63, 95% CI 1.44 to 1.83), a doubling of the risk of ICU admission (RR 2.03, 95% CI 1.69 to 2.45), and a 56% higher risk of all-cause death (RR 1.56, 95% CI 1.30 to 1.87). Estimates observed in different studies and regions were completely consistent, and the B.1.1.7 variant was dominant in all three jurisdictions over the study periods.

The number of people hospitalized with COVID-19 on March 28, 2021, is 21% higher than at the start of the province-wide lockdown during the second wave on December 26, 2020, while ICU occupancy is 28% higher.

Between December 14 to 20, 2020, there were 149 new admissions to ICU; people aged 59 years and younger accounted for 30% of admissions. Between March 15, 2021 and March 21, 2021, there were 157 new admissions to ICU; people aged 59 years and younger accounted for 46% of admissions.

Interpretation: The new VOCs will result in a considerably higher burden to Ontario’s health care system during the third wave compared to the impact of early SARS-CoV-2 variants during Ontario’s second wave.

Since the start of the third wave on March 1, 2021, the number of new cases of SARS-CoV-2 infection, and the COVID-19 hospital and ICU occupancies have surpassed prior thresholds at the start of the province-wide lockdown on December 26, 2020.

Citerank: (22) 679703EIDM?The Emerging Infectious Diseases Modelling Initiative (EIDM) – by the Public Health Agency of Canada and NSERC – aims to establish multi-disciplinary network(s) of specialists across the country in modelling infectious diseases to be applied to public needs associated with emerging infectious diseases and pandemics such as COVID-19. [1]7F1CEB7, 679761Caroline ColijnDr. Caroline Colijn works at the interface of mathematics, evolution, infection and public health, and leads the MAGPIE research group. She joined SFU's Mathematics Department in 2018 as a Canada 150 Research Chair in Mathematics for Infection, Evolution and Public Health. She has broad interests in applications of mathematics to questions in evolution and public health, and was a founding member of Imperial College London's Centre for the Mathematics of Precision Healthcare.10019D3ABAB, 679769Christopher CottonChristopher Cotton is a Professor of Economics at Queen’s University where he holds the Jarislowsky-Deutsch Chair in Economic & Financial Policy.10019D3ABAB, 679776David EarnProfessor of Mathematics and Faculty of Science Research Chair in Mathematical Epidemiology at McMaster University.10019D3ABAB, 679797Huaiping ZhuProfessor of mathematics at the Department of Mathematics and Statistics at York University, a York Research Chair (YRC Tier I) in Applied Mathematics, the Director of the Laboratory of Mathematical Parallel Systems at the York University (LAMPS), the Director of the Canadian Centre for Diseases Modelling (CCDM) and the Director of the One Health Modelling Network for Emerging Infections (OMNI-RÉUNIS). 10019D3ABAB, 679806Jane HeffernanJane Heffernan is a professor of infectious disease modelling in the Mathematics & Statistics Department at York University. She is a co-director of the Canadian Centre for Disease Modelling, and she leads national and international networks in mathematical immunology and the modelling of waning and boosting immunity.10019D3ABAB, 679812Jianhong WuProfessor Jianhong Wu is a University Distinguished Research Professor and Senior Canada Research Chair in industrial and applied mathematics at York University. He is also the NSERC Industrial Research Chair in vaccine mathematics, modelling, and manufacturing. 10019D3ABAB, 679826Laura CowenAssociate Professor in the Department of Mathematics and Statistics at the University of Victoria.10019D3ABAB, 679842Mark LewisProfessor Mark Lewis, Kennedy Chair in Mathematical Biology at the University of Victoria and Emeritus Professor at the University of Alberta.10019D3ABAB, 679858Patrick BrownAssociate Professor in the Centre for Global Health Research at St. Michael’s Hospital, and in the Department of Statistical Sciences at the University of Toronto.10019D3ABAB, 679859Patrick LeightonPatrick Leighton is a Professor of Epidemiology and Public Health at the Faculty of Veterinary Medicine, University of Montreal, and an active member of the Epidemiology of Zoonoses and Public Health Research Group (GREZOSP) and the Centre for Public Health Research (CReSP). 10019D3ABAB, 679869Rob DeardonAssociate Professor in the Department of Production Animal Health in the Faculty of Veterinary Medicine and the Department of Mathematics and Statistics in the Faculty of Science at the University of Calgary.10019D3ABAB, 679875Sarah OttoProfessor in Zoology. Theoretical biologist, Canada Research Chair in Theoretical and Experimental Evolution, and Killam Professor at the University of British Columbia.10019D3ABAB, 679890Troy DayTroy Day is a Professor and the Associate Head of the Department of Mathematics and Statistics at Queen’s University. He is an applied mathematician whose research focuses on dynamical systems, optimization, and game theory, applied to models of infectious disease dynamics and evolutionary biology.10019D3ABAB, 686724Ellen RaffertyDr. Ellen Rafferty has a Master of Public Health and a PhD in epidemiology and health economics from the University of Saskatchewan. Dr. Rafferty’s research focuses on the epidemiologic and economic impact of public health policies, such as estimating the cost-effectiveness of immunization programs. She is interested in the incorporation of economics into immunization decision-making, and to that aim has worked with a variety of provincial and national organizations.10019D3ABAB, 701020CANMOD – PublicationsPublications by CANMOD Members144B5ACA0, 701037MfPH – Publications144B5ACA0, 701071OSN – Publications144B5ACA0, 701222OMNI – Publications144B5ACA0, 704045Covid-19859FDEF6, 714608Charting a FutureCharting a Future for Emerging Infectious Disease Modelling in Canada – April 2023 [1] 2794CAE1, 715387SMMEID – Publications144B5ACA0

We propose an independent institute of emerging infectious disease modellers and policy experts, with an academic core, capable of renewing itself as needed. This institute will combine science and knowledge translation to inform decision-makers at all levels of government and ensure the highest level of preparedness (and readiness) for the next public health emergency. The Public Health Modelling Institute will provide cost-effective, science-based modelling for public policymakers in an easily visualizable, integrated framework, which can respond in an agile manner to changing needs, questions, and data. To be effective, the Institute must link to modelling groups within government, who are best able to pose questions and convey results for use by public policymakers.

[Physics of Fluids, 31 May 2022]

Superspreading events and overdispersion are hallmarks of the COVID-19 pandemic. However, the specific roles and influence of established viral and physical factors related to the mechanisms of transmission, on overdispersion, remain unresolved. We, therefore, conducted mechanistic modeling of SARS-CoV-2 point-source transmission by infectious aerosols using real-world occupancy data from more than 100 000 social contact settings in ten US metropolises. We found that 80% of secondary infections are predicted to arise from approximately 4% of index cases, which show up as a stretched tail in the probability density function of secondary infections per infectious case. Individual-level variability in viral load emerges as the dominant driver of overdispersion, followed by occupancy. We then derived an analytical function, which replicates the simulated overdispersion, and with which we demonstrate the effectiveness of potential mitigation strategies. Our analysis, connecting the mechanistic understanding of SARS-CoV-2 transmission by aerosols with observed large-scale epidemiological characteristics of COVID-19 outbreaks, adds an important dimension to the mounting body of evidence with regard to airborne transmission of SARS-CoV-2 and thereby emerges as a powerful tool toward assessing the probability of outbreaks and the potential impact of mitigation strategies on large scale disease dynamics.

[bioRxiv, 21 December 2023]

School closures were used as strategies to mitigate transmission in the COVID-19 pandemic. Understanding the nature of SARS-CoV-2 outbreaks and the distribution of infections in classrooms could help inform targeted or ‘precision’ preventive measures and outbreak management in schools, in response to future pandemics. In this work, we derive an analytical model of Probability Density Function (PDF) of SARS-CoV-2 secondary infections and compare the model with infection data from all public schools in Ontario, Canada between September-December, 2021. The model accounts for major sources of variability in airborne transmission like viral load and dose-response (i.e., the human body’s response to pathogen exposure), air change rate, room dimension, and classroom occupancy. Comparisons between reported cases and the modeled PDF demonstrated the intrinsic overdispersed nature of the real-world and modeled distributions, but uncovered deviations stemming from an assumption of homogeneous spread within a classroom. The inclusion of near-field transmission effects resolved the discrepancy with improved quantitative agreement between the data and modeled distributions. This study provides a practical tool for predicting the size of outbreaks from one index infection, in closed spaces such as schools, and could be applied to inform more focused mitigation measures.