Epidemic Dynamics Research Articles

Modelling the COVID-19 pandemic: Focusing on the case of Greece

The SARS-CoV-2 infection (COVID-19) pandemic created an unprecedented chain of events at a global scale, with European counties initially following individual pathways on the confrontation of the global healthcare crisis, before organizing coordinated public vaccination campaigns, when proper vaccines became available. In the meantime, the viral infection outbreaks were determined by the inability of the immune system to retain a long-lasting protection as well as the appearance of SARS-CoV-2 variants with differential transmissibility and virulence. How do these different parameters regulate the domestic impact of the viral epidemic outbreak? We developed two versions of a mathematical model, an original and a revised one, able to capture multiple factors affecting the epidemic dynamics. We tested the original one on five European countries with different characteristics, and the revised one in one of them, Greece. For the development of the model, we used a modified version of the classical SEIR model, introducing various parameters related to the estimated epidemiology of the pathogen, governmental and societal responses, and the concept of quarantine. We estimated the temporal trajectories of the identified and overall active cases for Cyprus, Germany, Greece, Italy and Sweden, for the first 250 days. Finally, using the revised model, we estimated the temporal trajectories of the identified and overall active cases for Greece, for the duration of the 1230 days (until June 2023). As shown by the model, small initial numbers of exposed individuals are enough to threaten a large percentage of the population. This created an important political dilemma in most countries. Force the virus to extinction with extremely long and restrictive measures or merely delay its spread and aim for herd immunity. Most countries chose the former, which enabled the healthcare systems to absorb the societal pressure, caused by the increased numbers of patients, requiring hospitalization and intensive care.

Dynamical analysis of a class of SEIR models through delayed strategies

In recent decades, the mathematical modeling of infectious diseases, real-world problems, non-linear dynamical complex systems, etc., has increased significantly. According to World Health Organization, tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity, poor diet, lack of physical activity, and excessive drinking of alcohol. Approximately 5%–10% of cancers are due to inherited genetic defects. The objective is to investigate the impact of time delays in implementing control measures on the epidemic dynamics. The classification of cell population has four compartments: susceptible cells (x), cancer-infected cells (y), virus-free cells (v), and immune cells (z). Our focus is to find the equilibria of the problem and their stability. The stability of the solutions is of two types: locally asymptotic and globally asymptotic. The Routh–Hurwitz criterion, Volterra-type Lyapunov function, and LaSalle’s invariance principle are used to verify the stability of solutions. The graphical behavior depicts the stable solutions to a real-world problem and supports the stability analysis of the problem. The findings contribute to the understanding of epidemic dynamics and provide valuable information for designing and implementing effective intervention strategies in public health systems.

Statistical Analysis of Common Respiratory Viruses Reveals the Binary of Virus-Virus Interaction.

Respiratory viruses may interfere with each other and affect the epidemic trend of the virus. However, the understanding of the interactions between respiratory viruses at the population level is still very limited. We here conducted a prospective laboratory-based etiological study by enrolling 14,426 patients suffered from acute respiratory infection (ARI) in Beijing, China during 2005 to 2015. All 18 respiratory viruses were simultaneously tested for each nasal and throat swabs collected from enrolled patients using molecular tests. The virus correlations were quantitatively evaluated, and the respiratory viruses could be divided into two panels according to the positive and negative correlations. One included influenza viruses (IFVs) A, B, and respiratory syncytial virus (RSV), while the other included human parainfluenza viruses (HPIVs) 1/3, 2/4, adenovirus (Adv), human metapneumovirus (hMPV), and enterovirus (including rhinovirus, named picoRNA), α and β human coronaviruses (HCoVs). The viruses were positive-correlated in each panel, while negative-correlated between panels. After adjusting the confounding factors by vector autoregressive model, positive interaction between IFV-A and RSV and negative interaction between IFV-A and picoRNA are still be observed. The asynchronous interference of IFV-A significantly delayed the peak of β human coronaviruses epidemic. The binary property of the respiratory virus interactions provides new insights into the viral epidemic dynamics in human population, facilitating the development of infectious disease control and prevention strategies. IMPORTANCE Systematic quantitative assessment of the interactions between different respiratory viruses is pivotal for the prevention of infectious diseases and the development of vaccine strategies. Our data showed stable interactions among respiratory viruses at human population level, which are season irrelevant. Respiratory viruses could be divided into two panels according to their positive and negative correlations. One included influenza virus and respiratory syncytial virus, while the other included other common respiratory viruses. It showed negative correlations between the two panels. The asynchronous interference between influenza virus and β human coronaviruses significantly delayed the peak of β human coronaviruses epidemic. The binary property of the viruses indicated transient immunity induced by one kind of virus would play role on subsequent infection, which provides important data for the development of epidemic surveillance strategies.

Phase-Informed Bayesian Ensemble Models Improve Performance of COVID-19 Forecasts

Despite hundreds of methods published in the literature, forecasting epidemic dynamics remains challenging yet important. The challenges stem from multiple sources, including: the need for timely data, co-evolution of epidemic dynamics with behavioral and immunological adaptations, and the evolution of new pathogen strains. The ongoing COVID-19 pandemic highlighted these challenges; in an important article, Reich et al. did a comprehensive analysis highlighting many of these challenges. In this paper, we take another step in critically evaluating existing epidemic forecasting methods. Our methods are based on a simple yet crucial observation - epidemic dynamics go through a number of phases (waves). Armed with this understanding, we propose a modification to our deployed Bayesian ensembling case time series forecasting framework. We show that ensembling methods employing the phase information and using different weighting schemes for each phase can produce improved forecasts. We evaluate our proposed method with both the currently deployed model and the COVID-19 forecasthub models. The overall performance of the proposed model is consistent across the pandemic but more importantly, it is ranked third and first during two critical rapid growth phases in cases, regimes where the performance of most models from the CDC forecasting hub dropped significantly.

EINNs: Epidemiologically-Informed Neural Networks

We introduce EINNs, a framework crafted for epidemic forecasting that builds upon the theoretical grounds provided by mechanistic models as well as the data-driven expressibility afforded by AI models, and their capabilities to ingest heterogeneous information. Although neural forecasting models have been successful in multiple tasks, predictions well-correlated with epidemic trends and long-term predictions remain open challenges. Epidemiological ODE models contain mechanisms that can guide us in these two tasks; however, they have limited capability of ingesting data sources and modeling composite signals. Thus, we propose to leverage work in physics-informed neural networks to learn latent epidemic dynamics and transfer relevant knowledge to another neural network which ingests multiple data sources and has more appropriate inductive bias. In contrast with previous work, we do not assume the observability of complete dynamics and do not need to numerically solve the ODE equations during training. Our thorough experiments on all US states and HHS regions for COVID-19 and influenza forecasting showcase the clear benefits of our approach in both short-term and long-term forecasting as well as in learning the mechanistic dynamics over other non-trivial alternatives.

The tumour is in the detail: Local phylogenetic, population and epidemiological dynamics of a transmissible cancer in Tasmanian devils.

Infectious diseases are a major threat for biodiversity conservation and can exert strong influence on wildlife population dynamics. Understanding the mechanisms driving infection rates and epidemic outcomes requires empirical data on the evolutionary trajectory of pathogens and host selective processes. Phylodynamics is a robust framework to understand the interaction of pathogen evolutionary processes with epidemiological dynamics, providing a powerful tool to evaluate disease control strategies. Tasmanian devils have been threatened by a fatal transmissible cancer, devil facial tumour disease (DFTD), for more than two decades. Here we employ a phylodynamic approach using tumour mitochondrial genomes to assess the role of tumour genetic diversity in epidemiological and population dynamics in a devil population subject to 12 years of intensive monitoring, since the beginning of the epidemic outbreak. DFTD molecular clock estimates of disease introduction mirrored observed estimates in the field, and DFTD genetic diversity was positively correlated with estimates of devil population size. However, prevalence and force of infection were the lowest when devil population size and tumour genetic diversity was the highest. This could be due to either differential virulence or transmissibility in tumour lineages or the development of host defence strategies against infection. Our results support the view that evolutionary processes and epidemiological trade-offs can drive host-pathogen coexistence, even when disease-induced mortality is extremely high. We highlight the importance of integrating pathogen and population evolutionary interactions to better understand long-term epidemic dynamics and evaluating disease control strategies.

A possible method of selecting spatial epidemic models based on Turing’s diffusive threshold

Spatial epidemic has increasingly become the focus of attention of the global population, and epidemics modeling is an important tool for its prevention and control. However, how to choose the better model has always the challenge faced by modelers. This paper provides a possible method of model selection based on two Turing’s diffusive thresholds of a spatial epidemic model: the inherent diffusive threshold and the practical diffusive threshold. It is a new classification in terms of original Turing region obtained by linear analysis. The inherent diffusive threshold of the model is mathematical without realistic significance; on the contrary, the practical diffusive threshold is the physical diffusive threshold. The region between two thresholds has both realistic and mathematical significance. For a classical spatial epidemic model, we derive these two types of thresholds, and find that the larger the area size between two thresholds, the more models contain dynamical behaviors possibly describing spatial epidemic transmission dynamics which are also the models needed by modelers. Our approach may provide a new insight into the selection of spatial epidemic models.

Data assimilation method for improving the global spatiotemporal predictions of epidemic dynamics yielded by an ensemble Kalman filter and Metropolis–Hastings sampling

AbstractAssimilating the latest epidemic data can improve the predictions of epidemic dynamics compared with those using only dynamic models. However, capturing the nonlinear spatiotemporal heterogeneity remains challenging. We propose a data assimilation method to simultaneously update the parameters and states with respect to their spatiotemporal variation intervals by (1) developing a susceptible-infected-removed-vaccinated model by considering vaccination strategy and quarantine periods and (2) assimilating real-time epidemic data using an ensemble Kalman filter for daily updates of the state variables and Metropolis–Hastings sampling for weekly parameter estimation. Synthetic experiments and a WebGIS-based global prediction system demonstrate the sufficient nowcasting accuracy of this method. An analysis of the system outcomes shows that modeling vaccination details, embedding reasonable model and observation errors, using up-to-date parameters, and avoiding the prediction of sporadic cases can increase the correlation coefficient and coefficient of determination by more than 31.35% and 161.19%, respectively, and decrease the root mean square error by more than 54.17%. Our prediction system has been working well for more than 700 days. Its worldwide nowcasting accuracies have been continuously improved, where the overall correlation coefficients, coefficient of determination, and threat percent score exceed 0.7, 0.5 and 65%, respectively. The proposed method lays promising groundwork for the real-time spatiotemporal prediction of infectious diseases.

Mumps epidemic dynamics in the United States before vaccination (1923–1932)

Mumps is a vaccine-preventable, reemerging, and highly transmissible infectious disease. Widespread vaccination dramatically reduced cases; however, case counts have been increasing over the past 20 years. To provide a quantitative overview of historical mumps dynamics that can act as baseline information to help identify causes of mumps reemergence, we analyzed timeseries of cases reported from 1923 to 1932 in the United States. During that time, 239,230 mumps cases were reported in 70 cities. Larger cities reported annual epidemics and smaller cities reported intermittent, sporadic outbreaks. The critical community size above which transmission continuously occurred was likely between 365,583 and 781,188 individuals but could range as high as 3,376,438 individuals. Mumps cases increased as city size increased, suggesting density-dependent transmission. Using a density-dependent SEIR model, we calculated a mean effective reproductive number (Re) of 1.2. Re varied by city and over time, with periodic high values that could characterize short periods of very high transmission known as superspreading events. Case counts most often peaked in March, with higher-than-average transmission from December through April and showed a correlation with weekly births. While certain city pairs in Midwestern states had synchronous outbreaks, most outbreaks were less synchronous and not driven by distance between cities. This work demonstrates the importance of long-term infectious disease surveillance data and will inform future studies on mumps reemergence and control.

Evolutionary Game of Vaccination Considering Both Epidemic and Economic Factors by Infectious Network of Complex Nodes

Vaccines are recognized as an effective way to control the spread of epidemics. It should be noted that the vaccination of a population is influenced not only by the infectiousness of a disease but also the vaccination strategy, such as the cost of vaccination. An accurate prediction model is helpful in forecasting the most likely trend to support smart decisions. In order to solve this problem, a model of epidemic spread dynamics is proposed, which is called the Susceptible–Infected–Vaccinated with vaccine A–Vaccinated with vaccine B–Recovered (SIVAVBR) model. This model assesses the competition between two vaccines in terms of economic cost and protection effectiveness in an open-market economy. The optimization process of individual vaccination decision-making was studied in an evolutionary game. In addition, a novel network containing environmental nodes and individual nodes was used to simulate the increase in infection probability caused by aggregation. Using the mean-field approach, the existence and stability of the disease-free equilibrium point and the endemic equilibrium point were demonstrated. Numerous simulations were further carried out to examine the relationship between the basic reproduction number and epidemic dynamics. The results reveal that immunization hesitation reduces the immunity level of the entire population. It is important to improve vaccine efficiency and affordability for manufacturers to become more competitive. Establishing the core individuals in the network is also a means of quickly occupying the market.

Agent-based epidemics simulation to compare and explain screening and vaccination prioritization strategies

This paper describes agent-based models of epidemics dynamics, willingly simplified with the goal not to predict the evolution of the epidemics, but to explain the underlying mechanisms in an interactive way. They allow to compare screening prioritization strategies, and vaccination priority strategies, on a virtual population. The models are implemented in Netlogo in two simulators, published online at https://nausikaa.net/index.php/simulating-epidemics/ to let people experiment. This paper reports on model design, implementation, and experimentations. We have compared screening strategies to assess the epidemics versus control it by quarantining infectious people; and we have compared vaccinating older people with more risk factors, versus younger people with more social contacts.

Spatial heterogeneity and infection patterns on epidemic transmission disclosed by a combined contact-dependent dynamics and compartmental model.

Epidemics, such as COVID-19, have caused significant harm to human society worldwide. A better understanding of epidemic transmission dynamics can contribute to more efficient prevention and control measures. Compartmental models, which assume homogeneous mixing of the population, have been widely used in the study of epidemic transmission dynamics, while agent-based models rely on a network definition for individuals. In this study, we developed a real-scale contact-dependent dynamic (CDD) model and combined it with the traditional susceptible-exposed-infectious-recovered (SEIR) compartment model. By considering individual random movement and disease spread, our simulations using the CDD-SEIR model reveal that the distribution of agent types in the community exhibits spatial heterogeneity. The estimated basic reproduction number R0 depends on group mobility, increasing logarithmically in strongly heterogeneous cases and saturating in weakly heterogeneous conditions. Notably, R0 is approximately independent of virus virulence when group mobility is low. We also show that transmission through small amounts of long-term contact is possible due to short-term contact patterns. The dependence of R0 on environment and individual movement patterns implies that reduced contact time and vaccination policies can significantly reduce the virus transmission capacity in situations where the virus is highly transmissible (i.e., R0 is relatively large). This work provides new insights into how individual movement patterns affect virus spreading and how to protect people more efficiently.

Epidemic dynamics and spatial segregation driven by cognitive diffusion and nonlinear incidence

AbstractWe propose susceptible‐infected‐susceptible epidemic reaction–diffusion models with cognitive movement and nonlinear incidence in a spatially heterogeneous environment. The cognitive dispersal term takes either random diffusion or symmetric diffusion. Building upon the ‐estimates of positive solutions under , we state the asymptotic dynamics for , . The numerical results reveal spatial segregation of susceptible and infected populations: (a) the heterogeneous random diffusion can segregate the population and reduce the infection fraction significantly; (b) the segregation phenomenon disappears as the ratio approaches one from below; (c) the disease‐free region strengthens the segregation induced by heterogeneous random diffusion; (d) the segregation governed by random diffusion is more sensitive to the incidence mechanism; (e) the distribution of steady states driven by symmetric diffusion is always similar to that by homogeneous diffusion.

Novel Approach for Identification of Basic and Effective Reproduction Numbers Illustrated with COVID-19.

This paper presents a novel numerical technique for the identification of effective and basic reproduction numbers, Re and R0, for long-term epidemics, using an inverse problem approach. The method is based on the direct integration of the SIR (Susceptible-Infectious-Removed) system of ordinary differential equations and the least-squares method. Simulations were conducted using official COVID-19 data for the United States and Canada, and for the states of Georgia, Texas, and Louisiana, for a period of two years and ten months. The results demonstrate the applicability of the method in simulating the dynamics of the epidemic and reveal an interesting relationship between the number of currently infectious individuals and the effective reproduction number, which is a useful tool for predicting the epidemic dynamics. For all conducted experiments, the results show that the local maximum (and minimum) values of the time-dependent effective reproduction number occur approximately three weeks before the local maximum (and minimum) values of the number of currently infectious individuals. This work provides a novel and efficient approach for the identification of time-dependent epidemics parameters.

A dynamic approach to supply chain reconfiguration and ripple effect analysis in an epidemic

The COVID-19 pandemic has illustrated the unprecedented challenges of ensuring the continuity of operations in a supply chain as suppliers’ and their suppliers stop producing due the spread of infection, leading to a degradation of downstream customer service levels in a ripple effect. In this paper, we contextualize a dynamic approach and propose an optimal control model for supply chain reconfiguration and ripple effect analysis integrated with an epidemic dynamics model. We provide supply chain managers with the optimal choice over a planning horizon among subsets of interchangeable suppliers and corresponding orders; this will maximize demand satisfaction given their prices, lead times, exposure to infection, and upstream suppliers’ risk exposure. Numerical illustrations show that our prescriptive forward-looking model can help reconfigure a supply chain and mitigate the ripple effect due to reduced production because of suppliers’ infected workers. A risk aversion factor incorporates a measure of supplier risk exposure at the upstream echelons. We examine three scenarios: (a) infection limits the capacity of suppliers, (b) the pandemic recedes but not at the same pace for all suppliers, and (c) infection waves affect the capacity of some suppliers, while others are in a recovery phase. We illustrate through a case study how our model can be immediately deployed in manufacturing or retail supply chains since the data are readily accessible from suppliers and health authorities. This work opens new avenues for prescriptive models in operations management and the study of viable supply chains by combining optimal control and epidemiological models.

A real-world data validation of the value of early-stage SIR modelling to public health

Performance of Susceptible-Infected-Recovered (SIR) model in the early stage of a novel epidemic may be hindered by data availability. Additionally, the traditional SIR model may oversimplify the disease progress, and knowledge about the virus and transmission is limited early in the epidemic, resulting in a greater uncertainty of such modelling. We aimed to investigate the impact of model inputs on the early-stage SIR projection using COVID-19 as an illustration to evaluate the application of early infection models. We constructed a modified SIR model using discrete-time Markov chain to simulate daily epidemic dynamics and estimate the number of beds needed in Wuhan in the early stage of COVID-19 epidemic. We compared eight scenarios of SIR projection to the real-world data (RWD) and used root mean square error (RMSE) to assess model performance. According to the National Health Commission, the number of beds occupied in isolation wards and ICUs due to COVID-19 in Wuhan peaked at 37,746. In our model, as the epidemic developed, we observed an increasing daily new case rate, and decreasing daily removal rate and ICU rate. This change in rates contributed to the growth in the needs of bed in both isolation wards and ICUs. Assuming a 50% diagnosis rate and 70% public health efficacy, the model based on parameters estimated using data from the day reaching 3200 to the day reaching 6400 cases returned a lowest RMSE. This model predicted 22,613 beds needed in isolation ward and ICU as on the day of RWD peak. Very early SIR model predictions based on early cumulative case data initially underestimated the number of beds needed, but the RMSEs tended to decline as more updated data were used. Very-early-stage SIR model, although simple but convenient and relatively accurate, is a useful tool to provide decisive information for the public health system and predict the trend of an epidemic of novel infectious disease in the very early stage, thus, avoiding the issue of delay-decision and extra deaths.

Impact of social and demographic factors on the spread of the SARS-CoV-2 epidemic in the town of Nice

IntroductionSocio-demographic factors are known to influence epidemic dynamics. The town of Nice, France, displays major socio-economic inequalities, according to the National Institute of Statistics and Economic Studies (INSEE), 10% of the population is considered to live below the poverty threshold, i.e. 60% of the median standard of living.ObjectiveTo identify socio-economic factors related to the incidence of SARS-CoV-2 in Nice, France.MethodsThe study included residents of Nice with a first positive SARS-CoV-2 test (January 4-February 14, 2021). Laboratory data were provided by the National information system for Coronavirus Disease (COVID-19) screening (SIDEP) and socio-economic data were obtained from INSEE. Each case’s address was allocated to a census block to which we assigned a social deprivation index (French Deprivation index, FDep) divided into 5 categories. For each category, we computed the incidence rate per age and per week and its mean weekly variation. A standardized incidence ratio (SIR) was calculated to investigate a potential excess of cases in the most deprived population category (FDep5), compared to the other categories. Pearson’s correlation coefficient was computed and a Generalized Linear Model (GLM) applied to analyse the number of cases and socio-economic variables per census blocks.ResultsWe included 10,078 cases. The highest incidence rate was observed in the most socially deprived category (4001/100,000 inhabitants vs 2782/100,000 inhabitants for the other categories of FDep). The number of observed cases in the most social deprivated category (FDep5: N = 2019) was significantly higher than in the others (N = 1384); SIR = 1.46 [95% CI:1.40–1.52; p < 0.001]. Socio-economic variables related to poor housing, harsh working conditions and low income were correlated with the new cases of SARS-CoV-2.ConclusionSocial deprivation was correlated with a higher incidence of SARS-CoV-2 during the 2021 epidemic in Nice. Local surveillance of epidemics provides complementary data to national and regional surveillance. Mapping socio-economic vulnerability indicators at the census block level and correlating these with incidence could prove highly useful to guide political decisions in public health.

Modelling COVID-19 epidemic with confirmed cases-driven contact tracing quarantine

The pandemic of novel coronavirus disease 2019 (COVID-19) has been a severe threat to public health. The policy of close contract tracing quarantine is an effective strategy in controlling the COVID-19 epidemic outbreak. In this paper, we developed a mathematical model of the COVID-19 epidemic with confirmed case-driven contact tracing quarantine, and applied the model to evaluate the effectiveness of the policy of contact tracing and quarantine. The model is established based on the combination of the compartmental model and individual-based model simulations, which results in a closed-form delay differential equation model. The proposed model includes a novel form of quarantine functions to represent the number of quarantine individuals following the confirmed cases every day and provides analytic expressions to study the effects of changing the quarantine rate. The proposed model can be applied to epidemic dynamics during the period of community spread and when the policy of confirmed cases-driven contact tracing quarantine is efficient. We applied the model to study the effectiveness of contact tracing and quarantine. The proposed delay differential equation model can describe the average epidemic dynamics of the stochastic-individual-based model, however, it is not enough to describe the diverse response due to the stochastic effect. Based on model simulations, we found that the policy of contact tracing and quarantine can obviously reduce the epidemic size, however, may not be enough to achieve zero-infectious in a short time, a combination of close contact quarantine and social contact restriction is required to achieve zero-infectious. Moreover, the effect of reducing epidemic size is insensitive to the period of quarantine, there are no significant changes in the epidemic dynamics when the quarantine days vary from 7 to 21 days.

Estimating the fitness cost and benefit of antimicrobial resistance from pathogen genomic data.

Increasing levels of antibiotic resistance in many bacterial pathogen populations are a major threat to public health. Resistance to an antibiotic provides a fitness benefit when the bacteria are exposed to this antibiotic, but resistance also often comes at a cost to the resistant pathogen relative to susceptible counterparts. We lack a good understanding of these benefits and costs of resistance for many bacterial pathogens and antibiotics, but estimating them could lead to better use of antibiotics in a way that reduces or prevents the spread of resistance. Here, we propose a new model for the joint epidemiology of susceptible and resistant variants, which includes explicit parameters for the cost and benefit of resistance. We show how Bayesian inference can be performed under this model using phylogenetic data from susceptible and resistant lineages and that by combining data from both we are able to disentangle and estimate the resistance cost and benefit parameters separately. We applied our inferential methodology to several simulated datasets to demonstrate good scalability and accuracy. We analysed a dataset of Neisseria gonorrhoeae genomes collected between 2000 and 2013 in the USA. We found that two unrelated lineages resistant to fluoroquinolones shared similar epidemic dynamics and resistance parameters. Fluoroquinolones were abandoned for the treatment of gonorrhoea due to increasing levels of resistance, but our results suggest that they could be used to treat a minority of around 10% of cases without causing resistance to grow again.

A cyclic behavioral modeling aspect to understand the effects of vaccination and treatment on epidemic transmission dynamics

Evolutionary epidemiological models have played an active part in analyzing various contagious diseases and intervention policies in the biological sciences. The design in this effort is the addition of compartments for treatment and vaccination, so the system is designated as susceptible, vaccinated, infected, treated, and recovered (SVITR) epidemic dynamic. The contact of a susceptible individual with a vaccinated or an infected individual makes the individual either immunized or infected. Inventively, the assumption that infected individuals enter the treatment and recover state at different rates after a time interval is also deliberated through the presence of behavioral aspects. The rate of change from susceptible to vaccinated and infected to treatment is studied in a comprehensive evolutionary game theory with a cyclic epidemic model. We theoretically investigate the cyclic SVITR epidemic model framework for disease-free and endemic equilibrium to show stable conditions. Then, the embedded vaccination and treatment strategies are present using extensive evolutionary game theory aspects among the individuals in society through a ridiculous phase diagram. Extensive numerical simulation suggests that effective vaccination and treatment may implicitly reduce the community risk of infection when reliable and cheap. The results exhibited the dilemma and benefitted situation, in which the interplay between vaccination and treatment evolution and coexistence are investigated by the indicators of social efficiency deficit and socially benefited individuals.