Epidemic spreading under mutually independent intra- and inter-host pathogen evolution

Abstract

The dynamics of epidemic spreading is often reduced to the single control parameter $R_0$, whose value, above or below unity, determines the state of the contagion. If, however, the pathogen evolves as it spreads, $R_0$ may change over time, potentially leading to a mutation-driven spread, in which an initially sub-pandemic pathogen undergoes a breakthrough mutation. To predict the boundaries of this pandemic phase, we introduce here a modeling framework to couple the network spreading patterns with the intra-host evolutionary dynamics. For many pathogens these two processes, intra- and inter-host, are driven by different selection forces. And yet here we show that even in the extreme case when these two forces are mutually independent, mutations can still fundamentally alter the pandemic phase-diagram, whose transitions are now shaped, not just by $R_0$, but also by the balance between the epidemic and the evolutionary timescales. If mutations are too slow, the pathogen prevalence decays prior to the appearance of a critical mutation. On the other hand, if mutations are too rapid, the pathogen evolution becomes volatile and, once again, it fails to spread. Between these two extremes, however, we identify a broad range of conditions in which an initially sub-pandemic pathogen can break through to gain widespread prevalence.