Theory of early warning signals of disease emergenceand leading indicators of elimination

Anticipating infectious disease emergence and documenting progress in disease elimination are important applications for the theory of critical transitions. A key problem is the development of theory relating the dynamical processes of transmission to observable phenomena. In this paper, we consider compartmental susceptible-infectious-susceptible (SIS) and susceptible-infectious-recovered (SIR) models that are slowly forced through a critical transition. We derive expressions for the behavior of several candidate indicators, including the autocorrelation coefficient, variance, coefficient of variation, and power spectra of SIS and SIR epidemics during the approach to emergence or elimination. We validated these expressions using individual-based simulations. We further showed that moving-window estimates of these quantities may be used for anticipating critical transitions in infectious disease systems. Although leading indicators of elimination were highly predictive, we found the approach to emergence to be much more difficult to detect. It is hoped that these results, which show the anticipation of critical transitions in infectious disease systems to be theoretically possible, may be used to guide the construction of online algorithms for processing surveillance data.