General Patterns and Differences of Epidemic Spread COVID-19

Research Article

General Patterns and Differences of Epidemic Spread COVID-19

  • Denis Below 1
  • Felix G. Mairanowski 2*

*Corresponding Author: Felix G. Mairanowski_ Professor_ Smair Tech.GmbH, Berlin.

Citation: Denis Below, and Felix G. Mairanowski, (2024), General patterns and Differences of epidemic spread COVID 19, Archives of Medical Case Reports and Case Study, 8(2); DOI:10.31579/2692-9392/211

Copyright: © 2024, Felix G. Mairanowski. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 12 September 2024 | Accepted: 30 September 2024 | Published: 11 November 2024

Keywords: COVID-19; analytic model; lockdown; vaccination; mutation; age difference; psychological and behavioural characteristics; similarity theory

Abstract

A simple analytical model that takes into account the influence of blocking, mass vaccination and virus mutations on the intensity of COVID 19 epidemic spread is described. The results of the proposed model are in good agreement with relevant statistical data. The model uses two empirical parameters, one of which is weakly dependent on the virus strain and the other is functionally related to the blocking efficiency. Blocking efficiency depends on the behavioral characteristics of individuals, including age, and the socio-ethnic composition of the population. The psychological disposition of the population has a great influence on the development of the epidemic. In regions that are similar in their psychological and behavioral parameters, the epidemic develops in the same way. This article presents some preliminary data on the assessment of the behavioral characteristics of the population during the spread of the epidemic. The choice of settlements with homogeneous behavioral characteristics will make it possible to increase the reliability of forecast calculations of epidemic development and even to extend the results of model experimental studies conducted in small areas to the analysis of epidemics in large regions in different countries.

1.Introduction

The widespread of the COVID epidemic globally required the analyses of disease process using mathematical modelling. Most models of various levels of detail require the application of numerical methods using special computer programs. The main applied task of models - development of forecasts of epidemic development using models of high level of detail - is complicated by the need to introduce a large number of empirical coefficients., It is important to understand that in practice, increasing the detail of models does not always lead to an increase in its reliability and accuracy of calculations, since the development of the epidemic depends largely on the behavior of the local population. Behavioral characteristics of the population determine the readiness for mass vaccination and various restrictions on the introduction of a lockdown to slow down the growth of the epidemic. Based on these considerations, we set the task of developing the simplest possible model using the minimum number of empirical coefficients. However, the model should take into account the main essential factors determining the development of the epidemic. And as in the solution of any applied problem, the criterion of the model’s usefulness is the comparison of the results of calculations with real statistical data. Therefore, at all stages of model development and improvement, we sought to regularly compare calculated and statistical data. Particular attention was paid to the links between the empirical coefficients of the model and both the peculiarities of the COVIDA virus strain and the conditions for the realization of the lockdown 

2.  Methodology.

The accumulation of statistical data on the spread of COVID-19 in different countries allows us to significantly expand our understanding of various aspects of the emergence and course of the epidemic. More than a hundred different computational models have been proposed to describe the development of the epidemic. Some of them are based on the solution of a system of differential equations of various levels of detail, others are purely stochastic numerical models or analyses statistical data on the number and duration of contacts leading to virus transmission. All these models require the introduction of a number of coefficients for their agreement with observational data, and the number of coefficients, as a rule, increases with the complexity of the proposed models. We propose a relatively simple model that allows us to obtain analytical solutions. Let us write the initial differential equations of the epidemic model, taking into account the impact of lockdown and mass vaccination on the epidemic spread, as [5,6,7]: lockdown and mass vaccination on the epidemic spread, as [5,6,7]:

                                        = - λ -   )                           (1)

                                      =                                         (2),

where:

I - the number of infected persons at a given time,

3. Results

3.1 The factors influencing the spread of the epidemic 

The main goal of our work is to identify cause-and-effect relationships between the intensity of epidemic spread and the main factors affecting this process. The lack of such relationships prevents the development of reliable and unambiguous forecasting models and forces the calculations to assume different scenarios of epidemic development., the information available so far allows us to make the first steps towards a scientifically justified choice of a scenario for the forecasting model. Some of these factors are related to the nature of the epidemic and the nature of the epidemic. 

All calculations in this paper are based on the above methodology. 

Initial phase of the epidemic 

Let us consider, for example, the passage of the first wave in Berlin (Germany) and New York [3]. The choice of these two cities for comparison is related to the fact that, as it is commonly believed, Berlin turned out to be one of the most successful large cities, which managed to prevent active growth of the first epidemic wave, while in New York the first epidemic wave reached very high values.

Figure 1: The passage of the first wave of the epidemic in New York City [3].

Fig.1shows a comparison of statistical data with the results of calculations for the first wave of the epidemic in New York City. The calculations were performed for the value of reduction coefficient λ = 0.0345 1/day, the second coefficient Kr = 0.43 1/day for New York. Despite a good formal coincidence of the calculated and observed data (correlation coefficient above 0.95), we should note a number of their fundamental differences. The calculated curve much more gently in the initial stage of the epidemic, however, in the second stage of this wave, the introduction of sufficiently strict quarantine methods managed to sharply reduce the rate of further spread of the epidemic. Of particular interest is the study of the initial stage of the epidemic. First, it should be noted that quarantine in the city was 

introduced with a significant delay, only 63 days after the start of the epidemic. At that time, the number of detected infections, even in conditions of low testing coverage, had already reached about 1% of the city’s population. The weekly increase in infected city residents by this time had reached more than 37,000 people, which is more than 5,000 people per day or 0.065% of the population. Positive results from the introduction of quarantine could actually be observed only after two weeks, when the rate of spread of the epidemic began to decline. The main conclusion that follows from the above analysis is the need to strictly control the possible occurrence of an epidemic and take the most urgent measures to eliminate it at the initial stage. As an example of such successful tactics to combat an epidemic in the early stages, consider the passage of the first wave in Berlin, Germany. The first restrictive measures to help reduce the growth of the epidemic in Berlin were taken by the city administration about a month after it began.

Figure 2: The passage of the first wave of the epidemic in Berlin. [3].

The relative number of people infected at the same time in Berlin, as can be seen in Fig. 2, did not exceed 0.05%. The maximum daily increase in infections during the first wave was about 200 people per day or 0.0055%, that is, the relative number of infections in Berlin in the early stages of the epidemic was about 10 times less, than in New York. 

Virus mutations 

An analysis of the spread of the epidemic in a number of countries shows that in the autumnwinter period of 2020 there was a sharp increase in the rate of infection. These changes are associated with the beginning of the second wave of the epidemic due to mutation of the virus and the emergence of a new strain

Figure 3: Development of the fall-winter wave of the epidemic in New York City. [3]

Figure 3 shows the development of the epidemic during the second wave of the epidemic in New York City [3]. The results of calculations and statistical data begin to deviate after about 90 days after the beginning of the second wave of the epidemic. The growth of the epidemic after the emergence of a 

new strain of the virus for New York City was calculated using relation (7). The coefficient λ according to the present model does not depend on the virus strain and is therefore taken as constant. A comparison of the calculation results for the third wave with statistical data is shown in Figure 4.

Figure 4: Epidemic spread in New York taking into account the third wave. [3]

Results of epidemic spread calculations and observational data for the entire time period from the beginning of the second wave are shown in Figure 5.

Figure 5: Development of the second and subsequent waves of the epidemic in NYC [7].

Figure 6 shows a comparison of the estimated and observed seven-day epidemic incidence for the second and subsequent epidemic waves (per 

100,000 people). The 7-day incidence is taken as the difference in the intensity of infection over a 7-day period of time per 100,000 inhabitants.

(inc.stat.- observed data, inc.calc. - calculated data)

Figure 6: Incidence of epidemic growth over a seven-day period in NYC [7]

In general, the calculated values of the seven-day incidence do not differ significantly from those obtained from measurements; In general, the 

calculated values of the seven-day incidence do not differ significantly from those obtained from measurements;

Figure 7: The spread of the epidemic in the United Kingdom [4]

Figure 7 represents statistical data and calculations for the epidemic development from the beginning of so called "second wave" in the United Kingdom [4]. Calculation 1 was performed according to the dependencies [3] and [4] for the reduction coefficient λ = 0.035 1/day Approximately 100 days after the beginning of the second wave, a new rise in the epidemic growth is observed due to the emergence of a new virus strain. Therefore, further calculation of the epidemic spread was performed according to dependence (3a) (calculation2) The coefficient characterizing the transmission rate of the virus was calculated according to ratio [4] and was 

equal to K = 0.5 1/day. Considering, however, that a study of this new virus species revealed its transmissibility to be markedly higher than that of the former species, this coefficient was increased to K = 0.52 1/day. The United Kingdom was chosen as an example because of the large number of studies on the characteristics of the epidemics associated with this new strain, sometimes called the "English virus" in various countries. A similar pattern was also observed in Scotland (Fig.8). The emergence of new virus strains and their impact on the spread of the epidemic is particularly clear when considering the impendence rather than the total increase in the number of infections.

Figure 8: Development of the second and subsequent waves of the epidemic in Scotland

Figure 9: Seven-day epidemic incidence in Scotland.

Figures 8 and 9 show observations and calculations for the second and subsequent waves of the epidemic in Scotland [9]. Equation [7] was used for the second period, when the rate of infection growth was determined by two strains of the virus, equation [6] was used for the third period, and equation [8] was used for the fourth period. The results of calculations using the proposed method are in quite satisfactory agreement with the observed data. During the period under review, three characteristic peaks in the number of infected people can be identified.

Figure 10: Incidence of epidemic growth over a seven-day period for Berlin [6].

(inc.stat.- observational data, inc.calc. - calculated data) 

Fig. 10 shows a comparison of the calculated and observed values of the seven-day incident for the second and subsequent waves of the epidemic (per 100000 inhabitants) in Berlin [6]. In general, the calculated and statistical data are in good agreement with each other. The consistency of these results can be improved by shifting the calculated data to the right by about 10 days, i.e., by taking into account the "lag" effect of the response of the epidemic growth to the lockdown measures. Since abrupt changes in the epidemic growth rate are mainly associated with virus mutation and the emergence of a new strain significantly different from the previous one, the growth rate of the mutant virus variant was back- calculated

Figure.11 Growth intensity of the new virus strain in Berlin [6]

The relative number of patients infected with the new virus strain (Figure 11) was calculated as the ratio of the daily (weekly averaged) number of patients infected with the second virus strain s2 to the total daily increase in coronavirus infections (s1+s2). Observational data were obtained directly from virus sequencing. Given the time shift, the convergence of calculation and measurement results could be improved 

Lockdown and mass vaccination

The model can be used to analyse the effectiveness of isolation and vaccination. To successfully use the proposed model for forecasting purposes, it is necessary to relate the reduction factor λ to specific lockdown 

actions. The effectiveness of blocking will be characterized by the parameter L [6]:

L = 

4. Age differences

 

The spread of the epidemic for different age groups was analyzed using the city of Berlin and Scotland as an example. From the general population of Berlin, 10 groups are distinguished, epidemic [8]

Figure 16: Epidemic prevalence in the age groups 0-9 and 10-19 years old [8]

(i.calc 0-9, i.calc 10-19 - calculation for age groups 0-9 and 10-19, respectively, i.stat.Berlin, i.stat.0-9, i.stat.10-19 - observational data for Berlin and for age groups 0-9 and 10-19, respectively),

The results of calculations according to the proposed methodology for the age groups 0-9 years and 10-19 years are presented in Figure. 16. The same graph shows the observed data both for the corresponding age groups and for Berlin as a whole [8]. 

Figure.17 and Fig.18 shows the comparison of calculated and observed incident values for age groups 0-9 and 10-19 years respectively. In these and subsequent graphs the following notations have been introduced:

Figure 17: Seven-day incident for the 0-9 age group [8]

Figure 18: Seven-day incident for the 10-19 age group [8]

(inc.stat.-incident values for the indicated age groups and for Berlin from observed data, inc.calc. - inc.calc.-incident values for the specified age groups.) In general, the calculated and statistical data on incident values are qualitatively and quantitatively in quite satisfactory agreement with each other. At the same time, the intensity of the epidemic growth for the 0-9 age 

group is significantly lower than for both the 10-19 age group and Berlin as a whole. This can be explained both by the lower contact rate for children in the younger age group and possibly by their weaker susceptibility to viral disease. In the process of this work, calculations were performed for all ten age groups. In general, for each of the selected groups, the results of calculations are in satisfactory agreement with the observed data.

Figure 19: Epidemic distribution in the age groups 20-29 and 30-39 years old [8]

As an example, here is a graph of the spread of the virus epidemic for the age groups 20-29 and 30-39 years. (Fig.19). It should be emphasized that these two age groups are responsible for more than 35% of all infections in the city of Berlin.

Figure 20: Epidemic spread in the 80-89 and 90+ age groups [8]

Other important age groups for the analysis are the elderly groups from 80 to 89 years of age and the 90+ age group. These groups are relatively small and they do not determine the intensity of the epidemic growth in Berlin (the number of infections in these groups does not exceed 7% of the total number of infections in the city). However, the number of infections in these groups largely determines the mortality rate from COVID disease. Figure 20 shows a comparison of the calculated results with the observed data for these age groups. The intensity of the epidemic for the 80-89 age group does not differ significantly from the average for Berlin. In contrast, the level of infection in the 90+ age group at the beginning of the epidemic is more than twice as high as the average (the reduction coefficient λ was assumed to be 0.0315 1/day). This is partly due to the fact that the majority of city residents of this age live in nursing homes, where diseases can become mass. In addition, the transmission rate for residents of this age is also higher than the average for the general population. However, it is these two age groups that have the priority right to be vaccinated, as a result of which the percentage of vaccinated residents of these age groups reaches more than 80%. As a result, starting about 200 days after the beginning of the epidemic wave, there is a sharp decline in the number of infected people, as can be seen in Figure 20 and especially in Figure 21.

Figure 21: Seven-day incident for the 80-89 age group [8]

Figure 22: Seven-day incident for the 90+ age group [8]

By analyzing the graph in Figure 22, we can see that before vaccination, the infection rate in the 90+ group was about 5 times higher than the Berlin average. Only as a result of mass vaccination was it possible to extinguish the virus epidemic in this age group within a month.

Figure 23: Values of coefficients λ for different age groups [8]

The values of the coefficients used in the model for calculations for different age groups are presented in Figure. 23. Qualitatively similar results were obtained in a study of the development of epidemic for different age groups in Scotland [9] Unfortunately, the statistical data are not harmonized across countries even in Europe. Therefore, the division into age groups in Scotland and Germany is somewhat different. As well as in Berlin, the intensity of the epidemic in children under 14 is significantly lower than in the general population, while for the 15-24 age group the relative number of infections is 1.5 times higher than for the general population in Scotland.

Figure 24: Epidemic development for the age groups 25-44 and 45-64 [9].

As shown in Figure 24, the intensity of the epidemic in the age groups 25-44 and 45-64 years old is almost identical and weakly different from the general population. The results for each of these age groups correspond well with the observations.

Figure 25: Development of the epidemic for the age groups 65-84 and 85+ [9].

In the age groups of the elderly aged 65 to 84 and 85+, nearly complete vaccination of this group markedly reduced the intensity of the epidemic caused by the delta variant of the virus (Figure.25). This is especially well seen when comparing the epidemic development in these age groups and in the general population in the fourth quarter of time (at t≥300 days) The general conclusion for both Berlin and Scotland is that the epidemic development in the age range 20-60 is not significantly different from the average, whereas the epidemic is less intense for the groups from about 60-85 years of age and 

for children under 15 years of age. For the 85+ group, the epidemic is more intense than the population average. The lower epidemic development rate for this group is largely due to active, almost total vaccination. 

5. Social and ethnic background

The spread of the epidemic may be influenced by the socio-demographic characteristics of the population In Berlin, for example, before the start of mass vaccination, there was a large unevenness in the number of diseases throughout the city [1,10].

Figure 26: The depends of infection rate on foreigners from countries OIC [10]

Figure 26 shows the results of statistics on the relative increase in infections during the second wave of the epidemic in Berlin. As can be seen from this figure, there is great unevenness in the number of infected people across the city. Thus, while in some neighborhoods, such as Treptow-Kˆ penik, the maximum increase in the number of infected persons does not exceed 50 persons per day, in the Neukˆ ln it reaches 300 persons per day and 

considering that one of the most likely places of infection are apartments where people communicate most intensively, it can be assumed, that the growth of the epidemic should depend on the area per person, i.e., on the density of apartments. Taking into account that one of the most likely places of transmission is apartments, where people communicate most intensively. we can assume that the growth of the epidemic should depend on the area per person, i.e., on the density of apartments.

Figure 27: The depends of infection rate on the size of the living area per person [1].

Figure. 27 shows the graph of dependence of the epidemic growth intensity on this factor. Contrary to expectations, the relationship between these parameters turned out to be extremely weak, the correlation coefficient is about r = - 0.22. The correlation between the intensity of epidemic growth and the population density in Berlin districts and the relative number of 

emigrants was analyzed. The correlation coefficients between the intensity of the epidemic growth and these parameters are approximately 65%. But unexpectedly, the relative number of emigrants from member countries of the Organization of the Islamic Conference (OIC) (Turkey, Arab States, some African countries) in each district was found to have the maximum impact.

Figure 28: The depends of infection rate on foreigners from countries OIC [1].

Figure 28 shows the dependence of the number of infected people for each of the 12 districts in Berlin on foreigners from countries OIC. The high correlation coefficient (r = 0.93) shows that the connection between these parameters is not only statistically reliable, but also practically functional. It is important to emphasize that the growth curves of not only the first but also the second wave of the epidemic for the district of Charlottenburg practically coincide with the curves for Berlin and for Germany as a whole. The relative numbers of OIC residents for Charlottenburg, Berlin and Germany are 12 per cent, 11 per cent and about 10 per cent respectively whereas in the Neukˆ ln area the number is twice as high. Apparently, foreigners from member countries of Islamic countries have closer family and friendship ties, which can contribute to more intensive transmission of the virus. After mass vaccination in Berlin, differences in the intensity of epidemic growth were leveled out, although epidemic growth remained higher in areas of Berlin with a higher proportion of emigrants. This is due to the fact that the vaccination rate for the native population is higher than among emigrants. 

6. Psychological and behavioral characteristics of the population

The relationship between the willingness to comply with the lockdown rules and psychological and behavioral characteristics of individuals has been studied in connection with the spread of COVID by a large number of psychologists and sociologists In [12] it is shown that individuals with more active reactions to stress or disgust more closely follow lockdown rule. An important objective indicator of the level of disgust, as well as other basic emotions - fear, anxiety or stress - can be an analysis of changes in heart rate. This physiological indicator can provide information about how quickly and well the body adapts to external influences. Heart rate variability (HRV) is the change i intervals (differences in duration) between heartbeats over time. 

The peaks of heart rate detected by the cardiogram are called R-spikes, and the intervals between R-spikes are called RR intervals. LF (“low frequency”: 0.04-0.15 Hz) is characterized by longer changes in successive RR intervals. LF is influenced by both the sympathetic and parasympathetic systems, but the sympathetic system has a greater effect. HF (“high frequency”: 0.15–0.4 Hz) represents short- term changes in successive RR intervals and is a reliable indicator of parasympathetic activation. The LF/HF ratio is often used to measure the balance in the ANS between the sympathetic (SNS) system, which is called the "fight or flight" system, suggesting that its activity favors highly aroused, active states, while the parasympathetic system (PNS) is called the system "rest and digestion." Experimental and theoretical studies were carried out by D. Below at the University of Potsdam to study the relationship between the disgust reaction and HRV characteristics [11]. The purpose of this study was to investigate whether the intensity of the disgust response could be related to heart rate variability and used for diagnostic purposes in the future. 30 students from the University of Potsdam took part in the study. The images and objects were to be rated by subjects according to their subjective level of disgust response. The results of heart rate measurements during arousal were compared with 5-minute preliminary similar measurements in a calm state (baseline). The stability coefficient B is used as a characteristic value that reflects the intensity of changes in the physiological reactions of the heart [1]. Coefficient B is calculated as the ratio of HF values during excitation and in the resting phase: 

B(HF) = HF(E)/HF (Base Line) 

HF(E) is HF during the excitation phase, HF (Base Line) is HF during the resting phase.

Figure 29: Dependence of B coefficient on LF/HF ratio [1].

In turn, the stability coefficient was found to be dependent on the LF/HF ratio at rest. Figure 29 shows the results of the relationship between the psychological stability coefficient B (HF) and the LF/HF ratio during the baseline measurement. The correlation coefficient between these parameters is r = 0.623, p < .01. The corresponding approximate formula for this relationship can be written as [1]. 

B(HF) = 1 + 0.15 LF/HF (12).

By introducing the stability factor B (HF), it is possible to predict the degree of physiological response to feelings of disgust or stress. This requires measuring the LF/HF ratio at rest, as was done in this study during the baseline measurement. Substituting this value into the formula (12), we find the expected value of the B (HF) ratio. The less this coefficient differs from 1, meaning the more stable the nervous system is, the more appropriate the response to the lockdown and vaccination compliance rules would predictably be. To increase the reliability of these findings, it is necessary to analyze in more detail the dependence of the stability coefficient B (HF) on the LF/HF ratio. In the future, it would be useful to relate the stability factor to the coefficient λ used in the model.

7. Dimensionless complexes-an indicators of the commonality of epidemic spread

The process of epidemic development, according to the developed model, is defined by three dimensionless parameters: k /λ, αv/λ and λt [10]. All variables that make up these complexes have dimensionality 1/s and characterize the intensities of individual processes: k - infection, λ - reduction of infections as a result of lockdown and αv - vaccination. Each of these processes depends on many factors, some of them can be regulated, and others cannot. The parameter k, which depends on virus strain, population size and climatic conditions, is not controllable. The other two parameters depend on the effectiveness of lockdown and vaccination respectively, i.e., they can and should be administratively regulated. From the analysis of the graphs in Fig. It follows that the spread of the epidemic in widely differing size areas is almost identical. To verify this conclusion, observations of the second wave of the epidemic in New York, Germany and Berlin were compared. These results are presented in Fig. 30. In order to exclude the influence of the previous wave, the difference between the current value of the number of infected people and their values at the time of the second wave is used. Using this technique, 

As can be seen from this figure, all three curves practically coincide up to a certain point in time. Only about 90 days after the beginning of this epidemic wave, the growth of the infection in New York became significantly higher than in Berlin and Germany. This means that only the passage of the third wave of the epidemic for New York is significantly different from Berlin.

Figure 30: Changes in the number of infections compared to their numbers at the beginning of the second wave [10]
However, an important general pattern was simultaneously established: some curves of relative growth of the epidemic practically coincide. The identity of the epidemic development curves for different territories, for example Germany, Berlin and New York at certain points in time, allows us to draw a very important practical conclusion about the possibility of using similarity theory in predicting the occurrence and development of the epidemic. In particular, this will allow the use of large- scale modelling when transferring the results of a model experiment carried out in small areas (for example, the Charlottenburg district of Berlin) to much larger areas (for example, Berlin and even Germany). These similarity methods are currently widely used in hydrodynamics, thermal engineering and in solving many other physical and technological problems. With reliable prediction of the values of model coefficients, and therefore dimensionless complexes, it will be possible to widely and successfully use these methods in epidemiology. 

Discussion

The comparison of a large number of calculated and statistical data confirms the possibility of successfully using the proposed simple model to calculate the spread of the COVID-19 epidemic. Significant differences in these data are found only when calculating the epidemic growth among the 90+ age group. (Figure 22). The discrepancy between the calculated and statistical data for this population group is probably due to small contacts of people within the group, which contradicts the condition of applying the model for separate age groups. For all other estimated conditions, it was found that the average statistical deviation of estimated data from those recorded in official documents does not exceed 5%. Taking into account the simplicity of the model, we can recommend its use by the administration of settlements for operational analysis and management of the epidemic without involving specialists in the field of computer modelling. Another important advantage of the model is that the obtained analytical solutions allow analyzing the separate influence of each of the determining factors on the development of the epidemic. Combining these parameters into dimensionless complexes allows for large-scale modelling of the epidemic growth process. Such modelling has been widely used in applied physics, for example, in aero-hydromechanics and heat engineering, and allowed to determine on small-scale models the performance characteristics of various real objects, such as airplanes, hydro dams or boilers of thermal power plants. With the help of dimensionless complexes in epidemiology it would be possible, for example, to analyze the efficiency of epidemic management on the basis of studying the course of these processes in small settlements. In general, an epidemic in different localities should be identical. However, this identity is significantly disturbed due to differences in the willingness of the population to comply with the lockdown rules, which is accounted for in the model by the coefficient λ. As this coefficient increases, the rate of epidemic limitation increases. Decreasing epidemic limitation is characteristic of both some ethnic populations in the United States [13] and some immigrant communities in Europe [1]. In all likelihood, this can be explained by the lower level of trust of these population groups both in the local administration and in the prescriptions of medical authorities. The effectiveness of limiting the development of the epidemic depends on the psychological mood of the population. Significant changes in the behavior of the population can be observed in the same territories. Of course, this is largely due to the actions of the local administration to reduce the level of the disease. For example, at the beginning of the first wave of the epidemic in New York City, the necessary administrative measures to control the epidemic were not activated, resulting in high levels of disease and deaths due to virus infection. In contrast, in Berlin, all the necessary administrative resources were deployed and the first wave of the epidemic was relatively calm. As for the second wave, the situation changed dramatically. In New York, more stringent measures were taken to control compliance with the lockdown and vaccination restrictions, while in Berlin these restrictions were more leniently enforced. As a result, the incidence of the virus in Berlin increased significantly during this period and reached the level in New York (Figure. 30). The willingness of the population to comply with the requirements of lockdown and vaccination largely depends also on the psychological mood of the population. As an important indicator of such mood, we used the coefficient of psychological stability introduced by us, which is related to the activity of an individual's reaction to stress or aversion. This assumption is not confirmed by a sufficient amount of statistically independent data and requires further substantiation. The formula for the relationship between this coefficient and the physiological characteristics of the individual should also be further tested using additional data. The main conclusion for us is that, at present, any improvement of a model for predicting the spread of an epidemic must first of all objectively take into account the psychological and behavioral characteristics of the local population Psychological factors influencing avoidance mechanisms are grouped under the general term “behavioral immune system”. As shown, for example, in [14], the behavioral immune system has a strong influence on the growth of an epidemic. 

An important limitation of this paper should be noted. It does not examine the consequences of waning immunity to COVID over time after vaccination. Given that COVID, like any viral disease, does not stop completely but can only decline, and the continuous mutation of the virus, it is crucial to predict possible new waves of the epidemic. The lack of such a forecast does not allow for reliable prediction of critical situations related to the COVID epidemic. 

Conclusion

1. The proposed simple analytical model of ASILV accurately describes the development of the COVID19 epidemic for areas of different sizes and geographical characteristics. The model's calculation methodology takes into account the impact of lockdown and vaccination of the population, as well as the possibility that new strains of the virus may emerge due to mutation. 

2. Delaying the introduction of a lockdown or mass vaccination of the population at the onset of each new wave of the epidemic leads to the risk of an uncontrollable increase in the epidemic. 

3. The model uses two empirical coefficients: one related to the transmissibility of the virus strain, and the other, the reduction factor, related to the effectiveness of the lockdown. As the reduction factor increases, the growth of the epidemic slows down. The value of this coefficient depends on the age distribution of the population, the size and ethnic composition of emigration groups. 

4. The reduction coefficient is functionally related to the parameter of lockdown efficiency. The effectiveness of lockdown is largely determined by the willingness to comply with social restrictions, i.e., it is closely related to psychological and behavioral characteristics of the population. To assess the possible reaction of the population to the requirements of lockdown, the coefficient of mental stability is introduced, which is objectively related to the parameters of heart rate in the unexcited state. 

5. On the basis of comparison of data on epidemic development and calculations, the identity of infection spread for significantly different territories is established. This phenomenon is explained with the help of the proposed model by the allocation of nondimensional complexes responsible for the intensity of epidemic development. The application of similarity theory methods may allow in the future to extend the modeling results obtained for small regions to larger territories. 

6. Some fundamentally important conclusions, such as the study of the influence of the psychological state of the population on the rate of spread of infection or suggestions on the possibility of using similarity theory methods, are based on studies in their initial stages and require further substantiation and clarification.

References

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Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

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Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

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Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

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Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

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Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

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Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

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Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

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Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

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Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

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Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

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Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

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Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

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Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

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Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

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Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

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Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

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Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

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Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

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Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

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Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

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S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

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Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

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George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

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Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

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Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

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Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann