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Modeling Incorporating the Severity-Reducing Long-term Immunity: Higher Viral Transmission Paradoxically Reduces Severe COVID-19 During Endemic Transition

  • Hyukpyo Hong (Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology (KAIST)) ;
  • Ji Yun Noh (Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST)) ;
  • Hyojung Lee (Department of Statistics, Kyungpook National University) ;
  • Sunhwa Choi (Division of Fundamental Research on Public Agenda, National Institute for Mathematical Sciences) ;
  • Boseung Choi (Biomedical Mathematics Group, Institute for Basic Science (IBS)) ;
  • Jae Kyoung Kim (Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology (KAIST)) ;
  • Eui-Cheol Shin (Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST))
  • Received : 2022.03.11
  • Accepted : 2022.05.04
  • Published : 2022.06.30
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Abstract

Natural infection with severe acute respiratory syndrome-coronavirus-2 or vaccination induces virus-specific immunity protecting hosts from infection and severe disease. While the infection-preventing immunity gradually declines, the severity-reducing immunity is relatively well preserved. Here, based on the different longevity of these distinct immunities, we develop a mathematical model to estimate courses of endemic transition of coronavirus disease 2019 (COVID-19). Our analysis demonstrates that high viral transmission unexpectedly reduces the rates of progression to severe COVID-19 during the course of endemic transition despite increased numbers of infection cases. Our study also shows that high viral transmission amongst populations with high vaccination coverages paradoxically accelerates the endemic transition of COVID-19 with reduced numbers of severe cases. These results provide critical insights for driving public health policies in the era of 'living with COVID-19.'

Keywords

Acknowledgement

The authors thank Life Science Editors for editing support. This work was supported by the Institute for Basic Science (IBS-R801-D2 to E.-C.S. and IBS-R029-C3 to J.K.K.), Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea HI20C0452 (J.Y.N.), National Research Foundation of Korea (NRF-2021R1A2C1095639 to S.C., NRF-2020R1F1A1A01066082 to B.C., and 2019H1A2A1075303 to H.H.)

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