title: The optimal treatment of an infectious disease with two strains.
abstract: This paper explores the optimal treatment of an infectious disease in a Susceptible-Infected-Susceptible model, where there are two strains of the disease and one strain is more infectious than the other. The strains are perfectly distinguishable, instantly diagnosed and equally costly in terms of social welfare. Treatment is equally costly and effective for both strains. Eradication is not possible, and there is no superinfection. In this model, we characterise two types of fixed points: coexistence equilibria, where both strains prevail, and boundary equilibria, where one strain is asymptotically eradicated and the other prevails at a positive level. We derive regimes of feasibility that determine which equilibria are feasible for which parameter combinations. Numerically, we show that optimal policy exhibits switch points over time, and that the paths to coexistence equilibria exhibit spirals, suggesting that coexistence equilibria are never the end points of optimal paths.
authors.affiliation: Faculty of Economics, University of Cambridge, Cambridge, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Rowthorn
authors.affiliation: Department of Economics, University of Warwick, Coventry, CV4 7AL, UK. s.walther@warwick.ac.uk.
authors.forename: Selma
authors.initials: S
authors.lastname: Walther
mesh_terms: D060085:Coinfection / Q000382:microbiology / Q000628:therapy; D003141:Communicable Diseases / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D008954:Models, Biological; D014774:Virulence
keywords: Economic epidemiology; Multiple strain infection; Optimal control; Treatment