Ethical dilemma arises from optimising interventions for epidemics in heterogeneous populations

Abstract

AbstractInterventions to mitigate the spread of infectious diseases, while succeeding in their goal, have economic and social costs associated with them. These limit the duration and intensity of the interventions. We study a class of interventions which reduce the reproduction number and find the optimal strength of the intervention which minimises the final epidemic size for an immunity inducing infection. The intervention works by eliminating the overshoot part of an epidemic, and avoids a second-wave of infections. We extend the framework by considering a heterogeneous population and find that the optimal intervention can pose an ethical dilemma for decision and policy makers. This ethical dilemma is shown to be analogous to the trolley problem. We apply this optimisation strategy to real world contact data and case fatality rates from three pandemics to underline the importance of this ethical dilemma in real world scenarios.