A Model for Reinfections and the Transition of Epidemics

Abstract

Reinfections of infected individuals during a viral epidemic contribute to the continuation of the infection for longer periods of time. In an epidemic, contagion starts with an infection wave, initially growing exponentially fast until it reaches a maximum number of infections, following which it wanes towards an equilibrium state of zero infections, assuming that no new variants have emerged. If reinfections are allowed, multiple such infection waves might occur, and the asymptotic equilibrium state is one in which infection rates are not negligible. This paper analyzes such situations by expanding the traditional SIR model to include two new dimensionless parameters, ε and θ, characterizing, respectively, the kinetics of reinfection and a delay time, after which reinfection commences. We find that depending on these parameter values, three different asymptotic regimes develop. For relatively small θ, two of the regimes are asymptotically stable steady states, approached either monotonically, at larger ε (corresponding to a stable node), or as waves of exponentially decaying amplitude and constant frequency, at smaller ε (corresponding to a spiral). For θ values larger than a critical, the asymptotic state is a periodic pattern of constant frequency. However, when ε is sufficiently small, the asymptotic state is a wave. We delineate these regimes and analyze the dependence of the corresponding population fractions (susceptible, infected and recovered) on the two parameters ε and θ and on the reproduction number R0. The results provide insights into the evolution of contagion when reinfection and the waning of immunity are taken into consideration. A related byproduct is the finding that the conventional SIR model is singular at large times, hence the specific quantitative estimate for herd immunity it predicts will likely not materialize.