ed

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Mathematical recommendations
to fight against COVID-19∗
Chenlin GU Wei JIANG

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DMA CMAP
ENS, PSL University Ecole Polytechnique
chenlin.gu@ens.fr wei.jiang@polytechnique.edu
Tianyuan ZHAO Ban ZHENG

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X2017 Department of Economics
Ecole polytechnique Ecole Polytechnique
tianyuan.zhao@polytechnique.edu
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March 2020
ban.zheng@polytechnique.edu
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Abstract
The statistics show that the mortality of COVID-19 is 20 times higher than seasonal
flu and close to that of Spanish flu, hence it is becoming an absolute priority for every
country to take efficient measure to limit the transmission of COVID-19. In this short
paper, we propose a mathematical framework to model the contagion of COVID-19
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by choosing three key parameters: infection rate, confirmation rate and quarantine
efficiency ratio. We use the experience from China to calibrate the parameters, and
then study the consequence of different measures. Our research suggest that work-
ing in distance and “distanciation sociale” (social distancing in French) is an efficient
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way to limit the contagion as soon as possible and highlight the risk of having a low
confirmation rate which happens frequently when hospital is saturated.

Keywords: COVID-19, epidemic modelling process

JEL classification: I18, C68.
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1 Introduction
The COVID-19 started in China in December 2019 and has spread quickly worldwide. The
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World Health Organisation (WHO) has declared a Public Health Emergency of International
Concern on January 30 2020 and raised global COVID-19 risk to the highest level February
28 2020. Sheikh et al. (2020) provide a general introduction and we can find its newest
evolution report on the website of WHO.
Since the outbreak of human cases of COVID-19, there are many active researches and
publications in clinical research as well as in epidemiological field. We can find a series
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of reports, from alarming estimates of actual infection number based on air travels to the
estimation of basic transmission rate, see Imai et al. (2020). The research on the estimation
∗ The views expressed here are those of the authors alone and not of their employers.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3551006
 ed
of fatality ratio could be found online1 . Wu et al. (2020) gives several scenarios to fore-
cast infection numbers and exported cases in several major Chinese cities, the estimation

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was however made before the severe social distancing policies took effect in China. The
Novel Coronavirus Pneumonia Emergency Response Epidemiology Team (2020) reports a
relatively complete data description of reported confirmed cases in China as of February
2020. Hellewell et al. (2020) attempts to model the effectiveness of isolation and contacts
tracing.
In spite of the experience from China both SARS in 2013 and COVID-19 in 2020, the
international community has divergence on the measures to take in order to avoid a possible

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pandemic outbreak. We observe that there is a significant divergence in the European
Union: Italy and France prefer different measures to limit the transmission of COVID-19.
The debate on relevant measures to take are used to be purely political but not science-based.
Our objective in this paper is very simple and clear: propose a mathematical frame-
work and use the experience from China to calibrate the parameters, and then study the

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consequence of different measures. Although none of us has experience in medical research,
we share the same academic training background in Ecole Polytechnique (France) and have
the same conviction that policy makers should reply more on mathematical model based

2 Model description and formulation

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recommendations than political concern based recommendations.
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2.1 Model description
We propose a direct mathematical description of the diffusion of COVID-19 to illustrate its
incredible speed of spread, under the condition no specific treatment and vaccine exist for
the moment.
The diffusion of COVID-19 under certain measure can be described as a variant birth-
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death process, as we study the early stage of the epidemic: we consider three types of
population

• Ic : R+ → Z the accumulative confirmed patients.

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• Ia : R+ → Z the active undetected patients.

• Iq : R+ → Z the unconfirmed patients under quarantine.

The total accumulative infections is I(t) = Ic (t) + Ia (t) + Iq (t). The diffusion can
be described as following:
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1. Infection: We start from patient zero, every patient before the confirmation/quarantine
has rate β to infect a healthy one independently, i.e. he/she generates new infection
as a Poisson process of parameter β. More formally, if no action is taken against the
spread and the virus evolves without constraint, we have
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E[I(t)] = I(0) exp(βt).

2. Incubation period: Before showing symptom, a patient has an incubation period,

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which is a random variable T > 0. From the statistic in the early cases given by Li et
al. (2020), T is very close to a Gamma distribution of density p(t), see Figure 1.
1 https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/

news--wuhan-coronavirus/

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bn n−1 −bt

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p(t) = t e . (1)
Γ(n)

and Shao et al. (2020) use these data to identify the approximated parameters n = 5
and b = 32 , which implies E[T ] = n/b = 7.5.
3. Confirmation: After the incubation period, the symptoms appear and the infection
of the patient will be confirmed by the diagnostic test with a probability θ ∈ [0, 1]

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(confirmation rate). In the ideal case, this parameter could be 1. But as the symptom
of COVID-19 is close to that of flu, and the number of test cases is limited, this
parameter is smaller than 1.
4. Separation and quarantine: A confirmed case is separated, and those who have

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contacted the case will be put in quarantine with probability α ∈ [0, 1] (quarantine
efficiency rate), because the infection may occur in some public space (train, airport,
flight, supermarket, restaurants etc) and it requires efforts to track all.

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Figure 1: A picture from Shao et al. (2020) to illustrate the distribution of incubation period
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between the infection and symptom.

Figure 2 illustrates the above diffusion process. In Table 1, we summarize the variables
and parameters which we define in this section to describe the diffusion.

Variable Value (Range) Definition

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T [0, 30] Incubation period from infection to symptom.

θ [0,1] The rate of confirmation once detected.
β 0.34 The rate of contamination.
α [0,1] The probability to be under quarantine.
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Table 1: Definition and range of values of variables or parameters used to describe the
diffusion.

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Figure 2: A genealogy representation of the infection on the left when no action is imple-

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mented to stop the diffusion. Otherwise, if we have a policy of quarantine, after T days
once one infection is confirmed, those with close contacts will be traced and put under quar-
antine. Moreover, it is several parameters (incubation period length T , infection rate β,
confirmation rate θ and quarantine efficiency rate α) determine the evolution in long term.
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2.2 Reproductive number
As we have seen from the description, it is the class Ia which has a high possibility to infect
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the healthy people, while this class is sometimes hard to be identified during the incubation
period. Since the infection sometimes occurs in public spaces, patients do not know how and
where they are infected; Indeed, they even do not know whether they are infected before the
onset of symptoms; Nevertheless, they are Coronavirus carrier and can infect other people,
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see Li et al. (2020). Therefore, the task to stop the epidemic is to transform all Ia to Ic or
Iq such that no new infection occurs in the sense person-to-person infection. In this way,
a new spread by person-to-person contact is not allowed at the earliest opportunity. More
precisely, Figure 3 illustrates the transition between three states of the infection.
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Figure 3: The transition between three states of the infection.

In the literature of medicine and epidemic, another quantity known as reproductive

number R0 is also used to measure the risk of epidemic. It is the expectation of number of

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 ed
infections directly or indirectly triggered by one patient. Generally speaking, the number of
the n-th generations of infections is (R0 )n .

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We have three distinguished phases:

• Supercritical case: R0 > 1, then the epidemic has an exponential increment.

• Critical case: R0 = 1, then the epidemic exists for long time.

• Subcritical case: R0 < 1, then after a period, the epidemic will be well controlled.

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Suppose that the confirmation can be made immediately and perfectly i.e. the confirma-
tion rate θ = 1 and there is no quarantine policy for the those contacted by the confirmed
cases i.e. the quarantine efficiency rate α = 0, then we have:

R0 = βE[T ]. (2)

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Imai et al. (2020) shows that the basic reproduction number R0 was estimated to 2.6
with uncertainty range 1.5 to 3.5. Since we know E[T ] = 7.5 from the Equation 1, we obtain

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the infection rate β ' 0.34 using the Equation 2. If the quarantine policy is applied and the
rate of confirmation is not perfect meaning that 0 6 θ < 1, asymptotically we have:

e0 ' β(1 − α)E[T /θ] = β(1 − α) E[T ].

R
θ
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Once again, we deduce that the long incubation period and the high rate of contamination
is the key point in the spread of the virus. Mathematically, to control the diffusion is to
make R e0 smaller than 1, the possible efforts are:

• Reduce the infection rate β by avoiding activities in public spaces and person-to-person
contact, and by encouraging people to have more protection of themselves.
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• Make confirmation rate θ as close to 1 as possible, for example, improving the precision
of diagnostic tests and the number of tests. See Yang et al. (2020) for detailed
discussion about chest CT and RT-PCR testing in coronavirus disease.
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• Increase quarantine rate α by making all the efforts to track the confirmed cases and
finding out the contacted people.

We add more remarks on these parameters: if we suppose θ = 1 and keep β = 0.34

deduced above unchanged, then to make R̃0 < 1, we have:
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R
e0
α'1− ' 0.62.
βE[T ]

Numerically, it requires that the quarantine efficiency rate α > 0.6 to prevent the spread
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of the COVID-19, which is a threshold comparatively high, but still possible.

If we reduce the infection rate β by 1/4 and keep the other parameters unchanged, then
R0 is also reduced by 1/4. Hence, reduce the infection rate β is a practical and efficient way
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to limit the contagion. One of the most efficient ways to realize this objective is to reduce
human contact and activities. Theoretically, one day or two days working from distance
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during a week may reduce the infection rate β by 1/4 and it is the most efficient way to
protect ourselves and also others.
Finally, we have to highlight that R e0 is also very sensitive with respect to the confirmation
rate θ. It is especially in the case that too many patients in hospital and the medical resources

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 ed
are saturated. We see, once the confirmation rate θ goes down to 0.5, even we improve the
quarantine efficiency rate α to 0.8,

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e0 ' β(1 − α) E[T ] = 0.34 × 0.2 × 7.5 = 1.02 > 1.
R (3)
θ 0.5
We remark Hellewell et al. (2020) as a research sharing similar ideas and finds about the
effect of isolation in controlling COVID-19.

2.3 Mortality

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WHO said recently that the mortality rate of COVID-19 can differ, ranging from 0.7% to
up to 4%, depending on the quality of the health-care system where it is treated. The most
recent report from WHO at March 5, 2020 estimates it to be 3.4% globally, see Berkeley
Lovelace and Higgins-Dunn (2020). A little earlier, Wu and McGoogan (2020) summarizes
72314 cases from the Chinese Center for Disease Control and Prevention: the case-fatality

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rate is 2.3% (1023 of 44672 confirmed cases), and 14.8% in patients aged over 80 years (208
of 1408), 8.0% in patients aged 70 − 79 years (312 of 3918) and 49.0% in critical cases (1023
of 2087).

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Thus, the death rate is 20 times higher than that of seasonal flu (0.1%) and close to that
of 1918 influenza pandemic (estimated 2.3% ∼ 3% by WHO (2019)). Especially, when the
hospital is saturated, the mortality will climb. Thus it also implies the importance to avoid
the explosion in large scale.
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3 Simulation
In the following, we do some simulations to back up our model and provide some suggestions
for public health policy. In Figure 5, we present the statistics from the data updated on
March 5th 2020 in France and in China. In Figure 6 and Figure 7, we study the future
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evolution in France under different measures by 100 Monte-Carlo simulations. By comparing

the available statistics, we suppose the evolution starts from 8 unconfirmed infections from
14/02/2020, which results in 163 infections on 01/03/2020 by average of 100 trajectories. We
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simplify a little the model by supposing that after quarantine, the infection will be confirmed
immediately, so Iq is also classified as Ic and we only study (Ia , Ic ). The Representative
parameters are chosen as following:
• Group A - Weak measure (β, θ, α) = (0.34, 0.3, 0.2).
• Group B - Normal measure (β, θ, α) = (0.34, 0.5, 0.4).
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• Group C - Strong measure (β, θ, α) = (0.34, 0.7, 0.6).

• Group D - Very strong measure (β, θ, α) = (0.34, 0.9, 0.8).
• Group E - Normal measure with reduction of activities (β, θ, α) = (0.25, 0.5, 0.4).
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We see from the simulation, in the case Group A when the measure is too weak, in a
month the confirmed infections will explode to 12400 with nearly 14000 undetected cases -
then the whole medical system in France will go down and become a catastrophe. In the
Group D with very strong measure, we see that the trend will be under control, however, we
compare Group E and Group B which have the same (θ, α) as normal measure, but Group
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E has an infection rate β 1/4 lower than Group B, the diffusion of epidemic of the Group
E is controlled as well as Group D. As a consequence, this result may suggest that working
in distance and “distanciation sociale” (social distancing in French) as a possible answer to
COVID-19 or the moment.

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South Korea 4,335

Italy 1,696

Iran 1,501

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Diamond Princess 705

Japan 274

Germany

France

Spain
130
120
108
150

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Singapore

Hong Kong 100

United States 88

Kuwait 56

Bahrain 47

Thailand 43
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Taiwan 40

United Kingdom 40

Australia 30
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Malaysia 29

Canada 24

Switzerland 24
0 1,000 2,000 3,000 4,000
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Number of confirmed cases at 2020-03-02 09:15

Figure 4: Number of confirmed infections until March 2 2020. The data comes from https:
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//bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/ (BNO news).

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Figure 5: Evolution of number of confirmed infections in France (left) and in China

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(right). In China, it takes one month with efforts to stop the momentum of spread.
Note that in China, a big jump comes from a change of confirmation criteria in the
middle of February when many pending cases are confirmed. The data comes from
the report of https://www.who.int/emergencies/diseases/novel-coronavirus-2019/
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situation-reports (WHO).

4 Conclusion
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This paper is a declaration of love for the humanity and for the countries that we have
lived such as China and France. We would like to help our people by mathematical tools:
describe clearly the problem and attempt to make some science-based recommendations.
We propose a mathematical framework to model the contagion of COVID-19 by choosing
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three key parameters: infection rate, confirmation rate and quarantine efficiency ratio. We
use the experience from China to calibrate the parameters and then study the consequence
of different measures. We suggest that working in distance and social distancing is a effi-
cient way to limit the contagion as soon as possible and highlight the risk of having a low
confirmation rate which happens frequently when hospital is saturated.
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This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3551006
 ed
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Figure 6: 100 traces of Monte-Carlo simulation under 4 different measures, from 14/02/2020
to the end of March 2020. The parameters are indicated on the title and the blue curves,
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red curves represent the evolution of confirmed cases and undetected cases. In the title
“AVG” is the average number of confirmed case at Day 50 (about the end of March 2020)
and “POT” is that of undetected cases.
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Figure 7: A simulation of the evolution under the measure of reduction of activities. Com-
pared to the Group B in Figure 6 where θ = 0.5, α = 0.4 is a normal measure, but the
reduction of activities by 1/4 stops the diffusion.
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5 Appendix

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In this part, we give some details about the Equation 5. In the following we denote by
N (dx) a Poisson point measure of parameter β i.e. we have N (A) ∼ Poisson(β|A|) for any
A ⊂ R Borel measurable. Moreover, for any f ∈ Cb (R), we have
Z Z
E[ f (x) N (dx)] = β f (x) dx.
A A

For the Equation 5, since the infection comes independently of the law of the incubation

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period, we have
"Z # Z ∞ Z t
T  
E 1 N (dx) = E E 1 N (dx) p(t)dt
0 0 0
∞

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Z 
=E βt p(t)dt
0
= βE[T ].

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Equation is an asymptotic formula in the following sense: instead of the Gamma dis-
tribution, we suppose T follows an exponential distribution exp(1/T0 ) with the same mean
T0 = E[T ] to obtain memoryless property. We also suppose at first θ = 1. We denote Z the
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infection we want to study and R the number of infection caused by Z. Then we have:
∞
X ∞
X
R
e0 = E[R] = P[R > k] = P [R > k|R > k − 1] P [R > k − 1] . (4)
k=1 k=1

The exact value of R

e0 requires a detailed study of the genealogy behavior in the dynamic.
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But by using the “mean-field” approximation, it implies a new infection before

• the signal Z is confirmed, which follows exp(1/T0 );
• the signal that other patients contacting Z are confirmed and Z is put under quar-
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antine. Asymptotically, it follows exp( αR

T0 ), as there are by average R0 infections
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contacting Z, each has waiting time exp(1/T0 ) and rate α to be confirmed.

So we have
β
P [R > k|R > k − 1] ' .
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1 αR0
β+ T0 + T0

Then we put these results in Equation 4 and obtain that:

∞
!k
X β
R
e0 =
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1 αR0
k=1
β + T0 + T0
β 1
= 1 αR0
× β
β+ T0+ T0 1− αR
β+ T1 + T 0
0 0

βT0
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= .
1 + αβE[T ]
When we introduce θ in the model, it changes the waiting time to be confirmed that
T ∼ exp(θ/T0 ). Thus we get the desired result.

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6 Acknowledgement

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We would thank Xin Lv (Orsay), Tunan Zhu (ENS), Honghao Li (Institute Curie), Waner
Chen, Mingxing Du, Yiyang Yu (Diderot), Keming Zhang (Diderot), Prof. Wenbin Chen
(Fudan) for helpful discussions. We should thanks everyone who are fighting against COVID-
19, specially we present our deep respect to Prof. Nanshan Zhong, Doctor Wenliang LI and
all medical doctors devoted themselves to protect the population.

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