The nexus between disease surveillance, adaptive human behavior and epidemic containment

Abstract

Epidemics exhibit interconnected processes that operate at multiple time and organizational scales, a hallmark of complex adaptive systems. Modern epidemiological modeling frameworks incorporate feedback between individual-level behavioral choices and centralized interventions. Nonetheless, the realistic operational course for disease detection, planning, and response is often overlooked. Disease detection is a dynamic challenge, shaped by the interplay between surveillance efforts and transmission characteristics. It serves as a tipping point that triggers emergency declarations, information dissemination, adaptive behavioral responses, and the deployment of public health interventions. Evaluating the impact of disease surveillance systems as triggers for adaptive behavior and public health interventions is key to designing effective control policies. We examine the multiple behavioral and epidemiological dynamics generated by the feedback between disease surveillance and the intertwined dynamics of information and disease propagation. Specifically, we study the intertwined dynamics between: $(i)$ disease surveillance triggering health emergency declarations, $(ii)$ risk information dissemination producing decentralized behavioral responses, and $(iii)$ centralized interventions. Our results show that robust surveillance systems that quickly detect a disease outbreak can trigger an early response from the population, leading to large epidemic sizes. The key result is that the response scenarios that minimize the final epidemic size are determined by the trade-off between the risk information dissemination and disease transmission, with the triggering effect of surveillance mediating this trade-off. Finally, our results confirm that behavioral adaptation can create a hysteresis-like effect on the final epidemic size.