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Title: COVID-19 transmission models in the real world: models, data, and policy.

Abstract:ÌýSimple mathematical models of COVID-19 transmission gained prominence in the early days of the pandemic. These models provided researchers and policymakers with qualitative insight into the dynamics of transmission and quantitative predictions of disease incidence. More sophisticated models incorporated new information about the natural history of COVID-19 disease and the interaction of infected individuals with the healthcare system, to predict diagnosed cases, hospitalization, ventilator usage, and death. Models also provided intuition for discussions about outbreaks, vaccination, and the effects of non-pharmaceutical interventions like social distancing guidelines and stay-at-home orders. But as the pandemic progressed, complex real-world interventions took effect, people everywhere changed their behavior, and the usefulness of simple mathematical models of COVID-19 transmission diminished. This challenge forced researchers to think more broadly about empirical data sources that could help predictive models regain their utility for guiding public policy. In this presentation, I will describe my view of the successes and failures of population-level transmission models in the context of the COVID-19 pandemic. I will outline the evolution of a project to predict COVID-19 incidence in the state of Connecticut, from development of a transmission model to engagement with public health policymakers and initiation of a new data collection effort. I argue that a new data source – passive measurement of close interpersonal contact via mobile device location data – is a promising way to overcome many of the shortcomings of traditional transmission models. I conclude with a summary of the impact this work has had on the COVID-19 response in Connecticut and beyond.

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