Abstract
In this article, we discuss an age-structured SIR model in which disease spread not only through direct person-to-person contacts, but also spread through indirect contacts. It is evident that age also plays a crucial role in SARS virus infection including COVID-19 infection. We formulate our model as an abstract semilinear Cauchy problem in an appropriate Banach space to show the existence of solution and also show the existence of steady states. In this study, it is assumed that the population is in a demographic stationary state and we show that there is no disease-free equilibrium point as long as there is a transmission of infection due to the indirect contacts in the environment. We also solved our model numerically to study the effect of indirect contacts on the density of infected individuals.
Keywords: SIR model, age-structured population model, Riesz–Fréchet–Kolmogorov theorem, semigroups of operators
Introduction
Infectious diseases are one of the threat to humanity. Due to increase in world population and mobility, pathogen transmission is easy and it is difficult to control the spread of disease. Viral transmission depends both on the interaction with host population and with the environment.
Mathematical models can project how infectious diseases progress. The model can suggest the possible outcome of an epidemic which will help agencies to take well thought measures. In 1927, Kermack and McKendrick [6] introduced a model (called SIR model) by considering a given population having three compartments. The compartments are divided into individuals in susceptible S, infected I, and removed R classes. It is very important to study infectious diseases and their possible nature of spread.
In most instances, it is presumed that infectious diseases are spread through direct contacts between individuals. But some infectious diseases can also spread through indirect contacts like contact with contaminated surface having virus on it. Transmission through the indirect contacts occurs when there is no direct physical contact between individuals. Contact occurs from a reservoir to contaminated surfaces or objects, or to vectors such as mosquitoes, flies, mites, fleas, ticks, rodents or dogs. Through many studies, it is observed that coronaviruses (including SARS-Cov-2) may persist on objects or surfaces for some hours to many days. The persistence depends on different factors (e.g., surface type, humidity or temperature of the environment). Fomites consist of both permeable and non-permeable objects or surfaces that can be contaminated with pathogenic micro-organisms and serve as a vehicle in transmission. SARS-CoV-2, the coronavirus (CoV) causing COVID-19 is creating the most severe health issues for individuals above the age of 60—with particularly fatal results for those individuals having age above 80. In the United States, 31–59% of individuals ages 75–84 diagnosed with the virus having severe symptoms due to which hospitalization is necessary, in comparison with 14–21% of confirmed patients ages between 20 and 44. These data are based on US Centers for Disease Control and Prevention (CDC) report. Therefore, it is natural to consider age structure while modeling the infectious disease transmission. The risk of transmission of infectious disease varies in different environments, for example at school, at home, at work place or in the community. Prem et al. [14] studied projected age-specific contact rates for countries in different stages in development and with different demographic structures from those studied in POLYMOD (a European Commission project), which provides validated approximations to social contact patterns when directly measured data are not available. The data plotted in Fig. 1a–d show the relation between age of individual and age of contact, i.e., number of contacts made by individuals at all locations, at home, school and work, respectively. Yellowish color on the diagonal of Fig. 1a, b shows that individuals of same age have more chances of direct contacts, so the transmission coefficient will be large for same age individuals.
Fig. 1.
Heat maps in Fig. 1a–d shows number of contacts made by individuals at all locations, homes, schools and work respectively
From the above heat maps, it is clear that it is natural to add age structure in ordinary differential equation (ODE)-based SIR models. Therefore, after adding age structure, the ODE-based SIR models become partial differential equation (PDE) models that are more complex to analyze. There is extensive literature available on age-structured SIR models (for more details see [2, 4, 5, 7–10, 12, 13]). In [11], an epidemiological model which studies the impact of decline in population on the dynamics of infectious diseases especially childhood diseases is considered and also an example of measles in Italy is considered. Hsieh et al. [3] studied the SARS outbreak in Taiwan, using the data of daily reported cases from May 5 to June 4, 2003 to study the spread of virus. Inaba [4] discussed threshold and stability results for an age-structured SIR model, Franceschetti et al. [2] generalized the work of [4] and also considered immigration of infected individuals in all epidemiological compartments. We considered an age-structured SIR model in which individuals can also get infected due to contaminated surfaces. We also assume that the net reproduction rate of the host population is unity which also makes our model different from the model considered in [2].
Our work is divided into five sections. In Sect. 2, we formulate our age-structured SIR model. In Sect. 3, we discuss the existence of solution to our model. In Sect. 4, we discuss steady-state solutions and show that there is no disease-free steady-state solution as long as there is transmission due to indirect contacts in the environment. Last section is devoted to numerical simulation.
Model Formulation
Let U(a, t) be the density of individuals of age a at time t. and be age-dependent mortality and fertility rates, respectively. Let be the maximum age which an individual can attain, i.e., the maximum life span of an individual. Then, the evolution of U(a, t) can be modeled by the following McKendrick–Von Foerster PDE with initial and boundary conditions:
| 2.1 |
where U(0, t) denotes the number of newborns per unit time at time t. We assume that the mortality rate with the condition and the fertility rate indicates the proportion of individuals who are still living at age a and represents the net reproduction rate. Let us assume that the net reproduction rate is 1. Therefore, steady-state solution is given by , where is given by
Let S(a, t), I(a, t) and R(a, t) be the densities of susceptible, infected and recovered individuals of age a at time t. Let be defined by
where denotes the weight factor for age class. Here, is the total number of infected individuals at time t with weight factor . In addition, let r(a, b) is the age-dependent transmission coefficient which describes the contact process between susceptible and infected individuals, i.e., r(a, b)S(a, t)I(b, t)dadb is the number of individuals who are susceptible and whose age lies between a and and contract the disease after contact with an infected individual aged between b and . We assume the form of force of infection is given in the following functional form:
Then, the disease spread according to the following system of partial differential equations:
| 2.2 |
Here, b(a) is the recovery rate of individuals and is the proportion of individuals which are infected due to indirect contacts. This factor depends on the number of infected individuals, because this proportion is directly proportional to the total number of infected individuals. Here, we are assuming that spread of disease already started and fomites are present in the environment even if the transmission coefficient r(a, b) is zero. Assume that and and also assume that all are non-negative. [1] studied how respiratory and viral disease spread in the presence of fomites. It is observed that enveloped respiratory viruses remain viable for less time and the non-enveloped enteric viruses remain viable for longer time. They calculated the inactivation coefficients of various respiratory viruses. Figure 2 shows the respiratory virus inactivation rates . In Fig. 2, we have used the short forms flu and cov for influenza and coronavirus, respectively.
Fig. 2.

Respiratory virus inactivation rates
We impose the following simplifying conditions on our model:
-
(i)
Although there may be an incubation period for some diseases, here we assume that there is no incubation period and the individuals become infected instantaneously after contact with infected individuals or fomites.
-
(ii)
We assume that the age zero individuals are not infected.
-
(iii)
The transmission coefficient r(a, b) only summarizes the contact process between susceptible and infected individuals.
-
(iv)
Population is in stationary demographic state.
-
(v)
The susceptible individuals who got infected due to contact with infected individuals have not infected due to the indirect contacts.
-
(vi)
We did not take into account social interventions such as hospitalization, and quarantine. Therefore, c is not dependent on infected individuals.
Let and be defined in the following way:
and the force of infection is given by
Then, our new system becomes
| 2.3 |
where
Therefore, new transformations reduced our system into a simpler form, i.e., boundary conditions now become constant and there is no term involving the natural mortality rate.
Existence of Solution
If we observe system (2.3) carefully, then it is clear that once susceptible and infected individuals are known, recovered individuals can be obtained easily so, it is enough to show the existence of solution to the following SI system instead of full SIR system:
| 3.1 |
We will analyze the system (3.1) only, because force of infection does not explicitly depends on recovered individuals. Let then the system (3.1) reduces to
| 3.2 |
Let equipped with the norm and be a linear operator defined as
where is the set of absolutely continuous functions. Suppose that and for . In addition, for all , there exists a constant such that
| 3.3 |
Let us define
where the bounded linear operator are defined by
Remark 3.1
If we take , then condition (3.3) is automatically satisfied.
Now, system (3.2) can be written as an abstract semilinear Cauchy problem in Banach space X
| 3.4 |
In the same manner as proved in [4], we can prove that generates a semigroup and F is continuously Fréchet differentiable on X.
Therefore, for each , there exists a maximal interval of existence and a unique solution which is continuous from to X such that
| 3.5 |
Moreover, if then for and is continuously differentiable and satisfies (3.2) on
Now, our aim is to prove the global existence and uniqueness of solution of (3.4). We will prove the existence of unique global classical solution which in turn gives the existence of unique global mild solution.
Theorem 3.2
The abstract Cauchy problem (3.4) has a unique global solution on X with initial data , where V is defined by
Proof
Let
We will prove that after a finite time t, the mild solution enters into V and the set is positively invariant. First, let us observe that
Observe that if then . Now, let us write the remaining problem as abstract Cauchy problem
| 3.6 |
| 3.7 |
where with
Then, we have
where is the strongly continuous semigroup generated by the operator . Here, if and can be evaluated using monotone iteration scheme
Therefore, for non-negative t, when . Now, let us define
then it satisfies
where
Then, we have
where W(t) is the positive strongly continuous translation semigroup with the generator . Since W(t) is nilpotent semigroup, therefore, we have
and for which shows that for for all non-negative t. Therefore, the norm of local solution is finite as far as it is defined, which gives the existence of unique global mild solution.
Steady-State Solutions
In this section, we are choosing . The possible reason is that since we do not know how many infected are coming into contact with susceptible, we can assume this as a constant rate.
In addition, the calculation of is difficult, because not all new infections are reported, and it is often difficult to know how many susceptibles were exposed. However, can be calculated for an infectious disease in an endemic state if homogeneous mixing of the population and a rectangular population distribution (such as that generally found in developed countries) is assumed. In this case, is given by , where A is the average age of infection. In other words, A is the average time spent in the susceptible group before becoming infected. The rate of becoming infected is, therefore, (since rate is 1/time). The advantage of this method of calculating is that data on the average age of infection are very easily obtainable, even if not all cases of the disease are reported. In addition, in the absence of social interventions such as quarantine, we can assume Therefore, our model in steady state can be written as
| 4.1 |
with .
Steady-state solution can be obtained as
The force of infection depends on the number of infected individuals which, in turn depends on the proportion of individuals getting infected due to indirect contacts (steady-state solution shows this). Therefore, force of infection will automatically take care of fomites present in the environment.
The force of infection is given by
| 4.2 |
| 4.3 |
| 4.4 |
Using (4.2), we can get the following estimate:
where and are the and norms, respectively, and U is the total population.
It is clear that there is no disease-free equilibrium as long as there is transmission due to indirect contacts. That means if there are fomites present in the environment contaminated with pathogenic micro-organisms, disease still can spread without direct contact between susceptible and infected individuals.
On Banach space , with positive cone let us define
| 4.5 |
Suppose that we have the following assumptions:
satisfies uniformly for with extended by defining for a.e.
There exist such that for a.e. .
There exist satisfying such that a.e. .
Observe that
| 4.6 |
Since force of infection is non-negative, we have
and because of assumption (A2), we have . Now, we will prove an important theorem which will help us to show the existence of fixed point to (4.5).
Theorem 4.1
Let and suppose that the assumptions (A1)–(A3) hold, then
is bounded, closed, convex and also .
is completely continuous.
Hence, Schauder’s principle gives existence of fixed point of (4.5).
Proof
Boundedness of set is clear and also for any we have
Closedness also follows from the definition of . Now, we will show that .
where is an upper bound on . Now , using the fact that , we can easily prove that
for some generic constant M. Now,
| 4.7 |
Let us first estimate the first integral as follows:
where M is a generic constant. Similarly,
which proves the continuity of .
Now, we will prove that is a compact operator, so let us define by
| 4.8 |
| 4.9 |
| 4.10 |
The operators are linear, continuous and positive. By applying Riesz–Fréchet–Kolmogorov theorem on compactness in , we can conclude that are compact operators. Now, let us define the nonlinear operators by
| 4.11 |
| 4.12 |
Here, are continuous and hence are compact operators in .
Therefore, is compact operator. Hence, Schauder’s principle gives existence of fixed point of (4.5).
Let denote the Fréchet derivative of at 0, i.e.,
Clearly, T is a positive linear, continuous and also compact operator. Let us define
| 4.13 |
| 4.14 |
where is the sequence of the proportion of individuals infected due to indirect contacts. The spectral radius of the operator T plays an important role in deciding the nature of equilibrium solutions, i.e., whether disease-free equilibrium solution exists or not. In our case if there is a proportion of individuals who are infected due to fomites, disease-free equilibrium point will not exists. Our aim is to prove the following theorem:
Theorem 4.2
Let be as defined in (4.13) and be analogous to in which c is replaced by .
If the spectral radius , then the sequence of fixed points of converges to zero.
If the spectral radius of is larger than 1, then such that
Our aim is also to prove that
which gives dependence of force of infection on . Before proving the above theorem, we will prove some lemmas and also state some theorems.
Definition 4.3
Let be a cone in the Banach space E, then the cone is called total if the following set:
is dense in the Banach space E.
Theorem 4.4
(Krein-Rutman 1948) Let E be a real Banach space and be total order cone in E. Let be positive linear and compact operator w.r.t. and also . Then, is an eigenvalue of and with eigenvectors in and , respectively.
In SIR model without fomites the transmission coefficient c, Inaba [4] proved the following results:
Theorem 4.5
([4] Proposition 4.6). Let T be the Fréchet derivative of at 0
If the spectral radius , then there is a disease-free fixed point to the operator .
If the spectral radius , then there exist at least one nonzero fixed point of .
Theorem 4.6
([15] Theorem V6.6). Let , and be a finite measure space. Suppose is defined by
non-negative is measurable kernel which satisfy the following assumptions:
Some power of is compact.
- and
Then, is an eigenvalue of with a unique normalized eigen function g satisfying -a.e. Moreover, if -a.e, then every other eigenvalue of has the bound
Let be a sequence in such that as a.e. , i.e., proportion of individuals who are susceptible to fomite infection are becoming less and is defined as in (4.5) with .
Proposition 4.7
There exist a converging subsequence of such that if , then is the fixed point of .
Proof
Since is compact and a converging subsequence and let
Since
Since is continuous, we have
which proves that
Lemma 4.8
Suppose be as defined in (4.13), then is an eigenvalue of both and with unique strictly positive normalized eigenvectors and f, respectively.
Proof
We know that
and is a compact operator by Theorem 4.1. Comparing with , conditions of Theorem 4.6 are satisfied, and therefore, is the only eigenvalue of with a unique normalized eigenvector , satisfying and every other eigenvalue of satisfy . In addition, and both have the same nonzero eigenvalues with same multiplicities. Since is the only eigenvalue of with a unique normalized eigenvector , is also an algebraically simple eigenvalue of with unique normalized eigen function f. Now our task is to prove that eigen function f is strictly positive. Suppose function representing the functional f be defined as
there exist a function which is continuous and and vanishes at (because of assumption (A2)) such that
Therefore, f is strictly positive as .
Lemma 4.9
Let and be as defined in (4.13) and (4.14), respectively. Then,
Proof
Clearly, uniformly. Since and are compact operators and and are simple eigenvalues of and , respectively, we have the conclusion of our lemma.
Now, we are ready to prove our Theorem 4.2.
Proof
We know that any converging subsequence of converges to , the fixed point of . By Theorem 4.5, for has only one fixed point which is 0. Therefore, every convergent subsequence of converges to zero, i.e., the sequence converges to zero. Now, we will prove the part (b) of the theorem.
Given , by lemma 4.9 we have
Let be the strictly positive eigenvector of with eigenvalue . Then, for all n, we have
where and is defined by integral on R.H.S. of (4.6) with c replaced by .
Observe that
Therefore,
which implies
then the conclusion of our theorem holds.
Numerical Simulation
We applied finite-difference scheme to solve our model numerically. It is assumed that r(a, b) is of the form and is taken 60 Years. We take initial age distributions of the following form
Age-dependent mortality rate is taken as and recovery rate is taken as . Other age-dependent functions are
From Fig. 3a, b, it is clear that c(a) affect the density of infected individuals. For next two plots Fig. 4a and Fig. 4b, we take c(a) as
and
respectively. We are assuming that the individuals with age between 20 and 60 are highly susceptible to infection due to indirect contacts. This assumption makes sense because most of the individuals in working class lies in this age group. Especially, front-line workers lie in this age class (Fig. 4).
Fig. 3.
c(a) is taken as zero in (a) and in (b)
Fig. 4.
The figure depicts the effect of c(a), the peak is attained at a higher value in the age interval (20, 60]
It is clear that the peak will be attained at higher value as long as there is infection through indirect contacts.
Discussion
The figures on data related to interaction show that the age plays a crucial role in SARS diseases and especially in COVID-19 infection as well as in recovery. Therefore, we have studied an age-structured SIR model in which susceptible individuals not only get infected due to direct contact with infected person, but can also get infected due to indirect contacts. We proved that there is no disease-free equilibrium as long as there is transmission due to indirect contacts in the environment. That means for instance if there are fomites present in the environment contaminated with pathogenic micro-organisms, disease still can spread without direct contact between susceptible and infected individuals. Therefore, removing fomites present on the surfaces is one of the effective measure to slow the infection. Hence sanitization of surfaces and proper care to front-line workers will help to fight with such diseases. Main idea in this work is to study the role of indirect contacts in the dynamics of infectious diseases.
Acknowledgements
We are thankful to both the reviewer and editor for their valuable comments and suggestions to improve the manuscript.
Footnotes
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