Lockdown interventions in SIR model: Is the reproduction number the right control variable?

Abstract: The recent COVID-19 pandemic highlighted the need of non-pharmaceutical interventions in the first stages of a pandemic. Among these, lockdown policies proved unavoidable yet extremely costly from an economic perspective. To better understand the tradeoffs between economic and epidemic costs of lockdown interventions, we here focus on a simple SIR epidemic model and study lockdowns as solutions to an optimal control problem. We first show numerically that the optimal lockdown policy exhibits a phase transition from suppression to mitigation as the time horizon grows, i.e., if the horizon is short the optimal strategy is to impose severe lockdown to avoid diffusion of the infection, whereas if the horizon is long the optimal control steers the system to herd immunity to reduce economic loss. We then consider two alternative policies, motivated by government responses to the COVID-19 pandemic, where lockdown levels are selected to either stabilize the reproduction number (i.e., "flatten the curve") or the fraction of infected (i.e., containing the number of hospitalizations). We compute analytically the performance of these two feedback policies and compare them to the optimal control. Interestingly, we show that in the limit of infinite horizon stabilizing the number of infected is preferable to controlling the reproduction number, and in fact yields close to optimal performance.