Stochastic model results (Figures 2 & 3) suggest that enhancement of epidemic duration is common throughout this region of parameter space, whereas enhancement of epidemic size is only observed where equilibrium populations of infectious individuals are sufficient to allow long-term persistence without stochastic extinction.
High attack rate combined with a short epidemic duration and long expected duration of mechanical ventilation represents the worst scenario in terms of bed occupancy rate and thus the maximal burden.
In comparison, by reinstituting cycles at the 10-case trigger even with the lax 3-case threshold, peak illness rates were dramatically flattened (to <100 cases for mild and generally <200 cases for severe epidemics), and the epidemic duration was lengthened because of the on-off cycling of mitigation strategies.
We obtained expressions for the expected outbreak size and the distribution of epidemic duration.
The data obtained from these simulations were used to calculate the final size, peak size, time to peak, and epidemic duration as a function of the difference between t a and t0.
When surveys covered most of the epidemic duration (74% in Ngozi, 85% in Karuzi, 83% in Damot Gale), malaria was the probable cause of death for a comparable proportion of the population (1.5% [8,900/574,400] in Ngozi, 0.9% [2,800/308,400] in Karuzi, and 1.9% [5,400/286,600] in Damot Gale).
The longer epidemic duration occurs because the average number of mitigation cycles increases from 1 to 3. The percentage of the population requiring antivirals increases from 2% to 5% and adult days at home increase from 6 to 9 days.
The correct outbreak source is the one that satisfies the minimum of the aforementioned sum for the whole epidemic duration.
For small values of p, the epidemics are short and limited (small epidemic duration, T, and small final epidemic size, R ∞ ).
As illustrated by simulations described in the previous section, the choice of the distribution of the infection duration has various impacts on global epidemic outputs such as epidemic duration, epidemic size or epidemic peak in a metapopulation.
