We would like to thank the Institute of Advanced Study at the University
of Amsterdam for the opportunity to present the preliminary results of a
study we are conducting and will publish in 2022 with Edward Elgar.
We, Brian
Castellani and Lasse Gerrits, are working on the ‘Atlas of Social Complexity’.
In this project, we take stock of where the analysis of social complexity
stands and survey the future of the field, including mapping the most exciting
territories. The field has advanced considerably over the last twenty-five
years, reaching into just about every area of social inquiry – from sociology
and economics to the public policy and urban planning – to become one of the
largest research areas in the complexity sciences. It has also become, more
recently, entangled with the dramatic rise in big data and digital social
science; and it sits at the nexus of some of the biggest global problems we
face, from climate change to the instabilities of the global economy.
Despite these
advances, the field is by no means mature, facing twelve challenges, all of
which need addressing. Examples of those challenges include a methodological
privileging of the micro over the macro; a rather noncritical embrace of the
latest developments in computational modelling and big data and machine
learning; the canonization of the field’s core concepts such as
self-organisation and emergence; and the absence of a developed theory of power
relations and inequality. What is needed, then, is a proper mapping of where
the field has been, what is presently taking place, and what yet needs to be
done, and with it a more rigorous and critical cartography of where we are in
2020.
The purpose
of this event is two-fold. First, it is to introduce the preliminary work we have
done on the Atlas, including the field’s twelve key challenges and what we tentatively
see as the cross-cutting areas of work being done to address or get free from
them. Second, it is to set the framework for potentially interviewing
colleagues around the work they are doing to likewise push past the current
challenges of the field.
This post is the 6th of several devoted to
addressing the complex challenges of modelling the coronavirus as a public
health issue. It is also about clarifying for a wider audience how and why such
modelling is important, as well as the value and power of complex systems
thinking and computational modelling for public healthpolicy.
COMPLEX-IT: Software for Modelling Complex Multiple COVID-19 Trends
We are sharing the webinar here for those interested in seeing how this software can be used to help with understanding the spread fo COVID-19 in a way that is in line with the previous five blog posts I've done on how best to approach modelling these types of public health problems.
For those interested in exploring COMPLEX-IT, our website has an beta online and downloadable version, as well as tutorials and readings. Note: this is educational software for learning purposes only. To explore COMPLEX-IT CLICK HERE!
This post is the 5th of several devoted to
addressing the complex challenges of modelling the coronavirus as a public
health issue. It is also about clarifying for a wider audience how and why such
modelling is important, as well as the value and power of complex systems
thinking and computational modelling for public healthpolicy.
THE IMPORTANCE OF INTERDEPENDENT LOCAL/NATIONAL MODELLING
Basically, the point is that national modelling of COVID-19 (whatever the country) needs to rely in very significant ways on modelling at the local level. And by local we mean all the way down in granularity from the regional and county level to the city and community. In short, we need a complexities of place approach.
This need for local and regional models (inerdependent with each other and the national) is in addition to the need for a dashboard of multiple models -- which was a major point of my previous four posts in this series.
The value a local approach (when combined with the national) is significant.
Here are some highlights:
First, as shown in Figure 1, it allows us to monitor how a public health problem like COVID-19 evolves at different levels of scale. National trends may not reflect local trends; and basing local decisions only on national trends (and without including the local) can be misleading and detrimental, particularly in terms of how resources are allocated or local public health and how public policy decisions are made.
FIGURE 1: Chart for all major regions in England
Second,
it allows us to model and monitor how such public health issues evolve
along multiple and different pathways. For example, as shown in Figure 2, while a virus like COVID-19 might spread quickly
and widely in one region or city resulting in a major spike or wave, in
other areas is may evolve slowly or never peak at all.
FIGURE 2: Comparison of different authority districts in the North East of England
Third, as shown in Figure 3 below, it allows modelling to be case-based and cross-comparative, so that stakeholders can explore similarities
and differences in major and minor trends within a country, and at different levels of scale. Such comparisons can also be extended across countries -- but only if context is taken into acount, which goes to the next point.
FIGURE 3: Map showing COVID-19 cumulative cases by major authority districts in England
Fourth, it honours and is grounded in the massiveimpact that context has on how a public health issue like COVID-19 impacts a particular place.
Context can be thought of as not just social, economic, political and cultural but also ecological and environmental; and impacthere can be thought of in several ways (this is not an exhaustive list):
how the environment-ecology of an area facilitates or hinders the spread of a disease (rural, urban, suburban, etc).
how various social determinants influence a disease's impact, including inequality, population density, access to public health resources, racism and discrimination and also social deprivation -- as modelled, for example, by various multiple deprivation indices (Figure 4 below).
the capacity for a particular place to respond to a public health crisis, as in the case of access to the resources needed for dealing with COVID-19, from critical supplies needed for hospitals and care homes to plans for social distancing and businesses reopening to managing the mental health aspects of sheltering people in place.
FIGURE4: Example of the English Index of Multiple Deprivation
Fifth, to reiterate the point, it acknowledges that we need a dashboard of multiple models. Not only do we need regional models, but even then we need more than one. Agent-based models, deterministic models, machine learning models, statistical m
odels, and historical models that help to widen our understanding of the lived experiences and historical nature of the public health issue being examined.
Sixth, it is entirely grounded in the reality that local areas are interdependent, interconnected and interactive. Local modelling is not a pretext for another form of isolated thinking, where the only concern is the immediate community. Instead, the focus is to think global but model local. All local models need to recognise a region's interdependence with other nearby and distant regions as well as the national and international. The global spread of COVID-19 has basically shouted this point!
Seventh, it allows for a more complex systems approach to public policy. Such an approach includes developing policies that are sensitive to context and to multiple path dependencies and outcomes, which are taking place at different levels of scale. It also includes policies that recognise that any public health intervention, no matter how simple, takes place in a wider ranges of interdependent complex systems, resulting in knock-on effects and so forth.For more on the policy aspect, see the work my colleagues at CECAN (Centre for the Study of Complexity Across the Nexus) to develop the2020 Magenta Booksupplementary guide, Handling Complexity in Policy Evaluation.
Eighth, such regionally grounded, locally focused, and nationally and internationally connected policy-based modelling needs to be co-produced with key public and private stakeholders!
Co-production leads to better
modelling for several reasons. First, the models can be designed in direct
response to the needs of a community or region. Second, they allow for more
immediate feedback and learning. And, third, what is modelled – as in the case
of the agent-based model we have created – can be adapted as new or different
insights are needed. For example, in March and April the main question of concern
in the UK was if, when and where the peak would be achieved. Now, as many countries are easing social distancing, the concern is how various exit strategies
(or going back into shelter-in-place) will impact the spread of the virus? For us, the obvious answer is that it will
depend entirely upon context -- and also the interdependence of one context with another! Communities therefore need regional models,
alongside the capacity to adapt national policies into local strategies, so they
can make more contextually sensitive decisions that reduce rather than produce
increased health harms and inequalities.
Conclusions
These, then, are my general recommendations -- and ones my colleagues in the COVID-19 Community Health and Social Care Modelling Team would agree with. Again, we do not pretend to have the only or best
answer to the current situation; and, despite the need for regional modelling, we still support the importance of national level modelling and a national strategy.
But, to reiterate our point, if we are to take the next step in this worldwide
modelling challenge, we need a more diverse set of models that are more
sensitive to and emerge out of not just the national, but also the local and
the complexities of its socio-ecological context. Looking to the near future,
such a modelling-public-policy dashboard is most likely to become even more
important, as COVID-19 is probably the first in a series of global social and
health problems we are about to face.
This post is the 4th of several devoted to
addressing the complex challenges of modelling the coronavirus as a public
health issue. It is also about clarifying for a wider audience how and why such
modelling is important, as well as the value and power of complex systems
thinking and computational modelling for public healthpolicy.
QUICK SUMMARY
The focus of the first post was to explain how models influence public
health policy and why some models are better at modelling COVID-19 than others,
given the challenge of complexity.Thepostendedaskingthequestion:So,whatdoesaneffectivemodellooklike? (CLICK
HERE for the first post) In response I said I would review two of the
models getting the most attention. Before turning to these models, however, the
second post reviewed, from a complex systems perspective, what a public health
model of infectious disease looks like in the first place. (CLICK HERE for the second post) The 3rd post
reviewed the first of our two models: the simulation model by Ferguson and colleagues at Imperial College London (CLICK HERE for the third post).
The current post
will review the utility of complex network modelling for infectious diseases and, more specifically, the model by Vespignani
and colleagues at Northeastern University in theStates.
The failure to embrace public health
In most
western countries -- particularly those located in the global north -- the
narrative of modern medicine is rather consistent: our medical problems are our
own, each of us, including their cause and cure. If someone is depressed, we
see it's a psychological problem; if someone is overweight, it is a personal
eating issue; and if someone regularly catches the flu it as a problem with
their immunesystem.
Public health experts, epidemiologists, health sociologists, medical anthropologists
and social workers have rather consistently challenged this idea, arguing
instead that, contrary to the picture painted by western medicine, our health is not anywhere near as personal and private
as we tend to think it.
And the argument has been reasonably convincing. Nuances aside, the
intertwined histories of population and public health throughout the world are
ultimately a story of significant accomplishment. As proof, a short list is
sufficient: clean drinking water, sanitation, food safety, air quality,
vaccines and preventable diseases, tobacco control, family planning and so
forth. And these accomplishments have extended themselves well into the
globalized era in which we presently live through the monumental efforts of
such globally- focused organisations as the World
Health Organization.
Still, despite
these accomplishments and tremendous successes, population and public health in
the 21st century faces a crisis of understanding. And the major
culprits, it appears (in addition to more localized factors) are the same
economic, political, cultural, and technological forces of globalization that
have, in many ways, purportedly made the world a better place. In short, we've
enjoyed the benefits of public health without embracing its most important
point:
The message is this: thecausesandcuresofourhealtharelargelyapublicmatter,andincomplex
and nuanced ways that we regularly (and perhaps purposely) fail to understand. Equally
important -- from the negative impact poverty has on wellbeing to ensuring
citizens equitable access to healthcare -- these causes and cures are primarily
social determinants and social solutions.
The hidden influence
of social networks
Perhaps one of the most important studies to demonstrate to
western medicine the importance of
public health was the game-changing 2007 study by Christakis and Fowler -- The Spread of Obesity in a Large Social Network Over 32 Yearspublished in the New England
Journal of Medicine. The network scientist, Albert-László Barabási, who
wrote a
commentary whenthestudywaspublished,in which he clarifieswhythisstudywassoimportant. He states:
A recent study reported that among people who carried a single
copy of the high- risk allele for the FTO gene, which is associated with fat
mass and obesity, the risk of obesity
increased by 30%. The risk of obesity increased by 67% among people who carried
two alleles, and on average they gained 3.0 kg (6.6 lb) or more.1 Given that
approximately one sixth of the population of European descent is homozygous for
this allele, this link between the FTO gene and obesity appears to be one of
the strongest genotype–phenotype associations detected by modern
genome-screening techniques” (p.404).
But here is
Barabási’s key point:
That obesity has a genetic component is not surprising:
researchers have long known that it often runs in families. In this issue of the
Journal, Christakis and Fowler suggest that friends have an even more important
effect on a person’s risk of obesity than genes do.
In short, when it comes to health issues such as obesity, our
social networks are a more important cause and cure. Our health is impacted
significantly by the networks with which we interact, which include not only
families, friends and partners, but also co-workers, acquaintances and the
networks of people we randomly interact with in public. Even more difficult to
grasp -- and this is one of the most important insights that Christakis and
Fowler showed -- is that our health is also significantly impacted by the
networks with which our networks interact and so on and so forth. And, it is
this important insight regarding the role that social networks play in our
health that makes the study of social networks is so powerful. Barabási
explains it likethis:
The authors reconstructed a social network
showing the ties between friends, neighbors, spouses, and family members among
participants of the Framingham Heart Study, making use of the fact that the
participants had been asked to name their friends to facilitate follow-up in
the study. The authors observed that when two
persons perceived each other as friends, if one friend became obese during a
given time interval, the other friend’s chances of following suit increased
by 171%. Among pairs of adult
siblings, if one sibling became obese, the chance that the other would become
obese increased by 40%. The results of this study also indicate that obesity is clustered in communities. For example, the risk that the friend of a friend of an obese person
would be obese was about 20% higher in the observed network than in a random
network; this effect vanished only by the fourth degree ofseparation.
In other words, as Christakis and Fowler suggest, the impact that others have on
our health is not just an issue of 'birds of a feather flocking together'.
Instead, it appears that health is a social contagion. It spreads across oursocialnetworks.Thehealthofoursocialnetworksimpactsandisdeeplyintertwinedwith our individual health. And we, in
turn, influence the health of the networks of which we are a part.
For more on this study and its
social network, watch this video. And for more on the role networks play in
health, watch this Ted Talk by Christakis.
How social networks
impact COVID-19
While such an insight by Christakis and Fowler
was a game-changer, the next challenge -- which network scientists working in
fields such as public health and infectious disease modelling have spent the
last decade or more trying to understand -- is how exactly how these social
networks impact health, as well as what a health versus unhealthy social
network looks like. Case in point is COVID-19 and the complex network model by Vespignani and colleagues at Northeastern
University in the States. Before we proceed to that study, a few key network
terms need to be defined.
As with our
review of microsimulation and modelling in general in my previous posts, we
cannot get into the details of social networks sufficiently in a post. We can,
however, review some key concepts and, for those interested, a few online
sources for learning more, sufficient to understand what network scientists are
trying to understand about the role social networks play in the spread of the
coronavirus.
KEY TERMS
Here
is a quick list of key terms – which can be found in (Newman, 2003) – that network
scholars
use:
Vertex
or a node: A fundamental unit of a network
represented usually by a dot.
Edge
or a link: A line connecting vertices.
Directed
or undirected edges: An edge is directed is if it
runs only in one direction (such as in a one-way road between two points),
and undirected if it runs in both directions (Newman 2003, p. 173). A
network in which all edges are directed is referred to as a directed
network or graph.
Neighborhood
of a node i in a graph is simply defined as the set of all nodes that the
node i is connected to. The usual convention is to assume that i is not
connected to itself i.e., avoid loops.
Degree:
The number of connections (edges) a vertex has. For a directed network,
one wants to know the direction of those connections. Those connections
going out are called ’out-degree,’ and those coming in are called
’in-degree.’
Component:
The component to which a vertex belongs is the set of all vertices that
can be reached from that vertex using existing edges in the network. ’For
a directed graph, there is an in-component and an out-component, which are
the sets of vertices from which the vertex can be reached and which can be
reached from it,’ respectively (Newman 2003, p. 173).
Geodesic
path: The geodesic path refers to shortest
route in the network from one vertex to another.
Diameter:
’is the length of the longest geodesic path in a network’ (Newman 2003, p.
173).
USEFUL REFERENCES
Of the
numerous writings on networks currently available – for example, (Albert and
Barabasi, 2002, Barabasi, 2003) – two authors stand head and shoulders above
the rest (at least for us), mainly for the quality of their critical insights
into network analysis, which is important, as well as the clarity and
accessibility of their writing. Those two authors are Mark Newman and John
Scott. Newman is highly useful because he is trained as a physicist
and is one of the top scholars in the field of complex networks; in turn, Scott
is a sociologist and one of the leading scholars in social networks. One of the best online books is Introduction to Social Network Methods by Robert
A. Hanneman and Mark Riddle.
The
effect of travel restrictions on the spread of the 2019 novel coronavirus
(COVID-19) outbreak
Now
that we have a basic sense of some of the key concepts of network science, we
can turn to the Network study on travel
restrictions by Alessandro Vespignani and international colleagues through
the Network Science Institute at Northeastern University.(As with my review of the
Imperial model inBlog
Post 3, I will quote from their work and then, in green font,
make some comments for clarification)
THEY STATE: Motivated by the rapid
spread of COVID-19 in Mainland China, we use a global metapopulation disease
transmission model to project the impact of travel limitations on the national
and international spread of the epidemic. The model is calibrated based on
internationally reported cases and shows that at the start of the travel ban
from Wuhan on 23 January 2020, most Chinese cities had already received many
infected travelers.”
SOME SPECIFICS ABOUT THEIR MODEL
THEY STATE: To
model the international spread of the COVID-19 out-break we use the Global
Epidemic and Mobility Model (GLEAM), an individual-based, stochastic, and
spatial epidemic model.
Castellani
comment: As you may recall from Post 3, I
explained what stochastic models are. Here they are using a similar approach,
as its value is it allows for real-world randomness and messiness to enter the modelling
process.Also, similar to the Imperial
model, it is individual-based and spatial.
THEY STATE: GLEAM
uses a metapopulation network approach integrated with real-world data where
the world is divided into sub-populations centered around major transportation
hubs (usually airports). The subpopulations are connected by the flux of
individuals traveling daily among them. The model includes over 3,200
sub-populations in roughly 200 different countries and territories. The airline
transportation data consider daily origin-destination traffic flows from the
Official Aviation Guide (OAG) and IATA databases (updated in 2019), while
ground mobility flows are de-rived by the analysis and modeling of data
collected from the statistics offices for 30 countries on 5 continents.
Mobility variations in Mainland China were derived from Baidu Location-Based
Services (LBS).
Castellani comment: Here
is where the network model is different from the Imperial model. In the network
model, network data is used, specifically transportation data. These data are
key because then the progression of COVID-19 could be modelled along these networks. If you click on the image to the right -->, it will allow you to run an infectious disease model on a social network. To run the model hit SETUP and then GO.
THEY STATE: Within
each sub-population, the human-to-human transmission of COVID-19 is modeled using
a compartmental representation of the disease where individuals can occupy one
of the following states: Susceptible (S), Latent (L), Infectious
(I) and Removed (R). Susceptible individuals can acquire the
virus through contacts with individuals in the infectious compartment, and
become latent, meaning they are infected but cannot transmit the infection yet.
Castellani
comment: Similar to the Imperial model, which I dicussed in Post 3, this network model follows the basic SEIR
model (susceptible, exposed, infected and recovered).
So, what did they learn?
THEY STATE:The analysis
of the COVID-19 outbreak and the modeling assessment of the effects of travel
limitations could be instrumental to national and international agencies for
public health response planning.We show that
by 23 January 2020, the epidemic had already spread to other cities within
Main-land China. The travel quarantine around Wuhan has only modestly delayed
the epidemic spread to other areas of Main-land China. This is in agreement
with separate studies on the diffusion of the SARS-CoV-2 virus in Mainland
China.
THEY STATE: The model
indicates that while the Wuhan travel ban was initially effective at reducing
international case importations, the number of cases observed outside Mainland
China will resume its growth after 2-3 weeks from cases that originated
elsewhere.
THEY STATE: Furthermore,
the modeling study shows that additional travel limitations up to 90% of the
traffic have a modest effect unless paired with public health interventions and
behavioral changes that achieve a considerable reduction in the disease
transmissibility.
Castellani comment: While some of their predictions require update (as new data has become available, which is why testing and information is so important!) their general insight has proven useful, as it has been corroborated by other models and the data -- namely, social distancing, testing, and governmentally led public health interventions to mitigate and suppress the spread of COVID-19.
THEY STATE: The model
also indicates that even in the presence of the strong travel restrictions in
place to and from Mainland China since 23 January 2020, a large number of
individuals exposed to the SARS-CoV-2 have been traveling internationally
without being detected.Moving
forward we expect that travel restrictions to COVID-19 affected areas will have
modest effects, and that transmission-reduction interventions will provide the
greatest benefit to mitigate the epidemic.
Summary
As this study has hopefully demonstrated, network model are a useful addition to the other approaches being employed to understand the coronavirus. Network models are primarily valuable because they allow us to see the specific routes by which disease travels through a population or, more specifically, a community. In the case of the current study, they could follow the disease along major transportation routes.