Empowering Epidemic Response: The Role of Reinforcement Learning in Infectious Disease Control

Non-pharmaceutical interventions (NPIs), such as diagnostic testing and quarantine, are crucial for controlling infectious disease outbreaks but are often constrained by limited resources, particularly in early outbreak stages. In real-world public health settings, resources must be allocated across multiple outbreak clusters that emerge asynchronously, vary in size and risk, and compete for a shared resource budget. Here, a cluster corresponds to a group of close contacts generated by a single infected index case. Thus, decisions must be made under uncertainty and heterogeneous demands, while respecting operational constraints. We formulate this problem as a constrained restless multi-armed bandit and propose a hierarchical reinforcement learning framework. A global controller learns a continuous action cost multiplier that adjusts global resource demand, while a generalized local policy estimates the marginal value of allocating resources to individuals within each cluster. We evaluate the proposed framework in a realistic agent-based simulator of SARS-CoV-2 with dynamically arriving clusters. Across a wide range of system scales and testing budgets, our method consistently outperforms RMAB-inspired and heuristic baselines, improving outbreak control effectiveness by 20%-30%. Experiments on up to 40 concurrently active clusters further demonstrate that the hierarchical framework is highly scalable and enables faster decision-making than the RMAB-inspired method.

Purpose The WHO's COVID-19 non-pharmaceutical interventions (e.g., lockdowns, vaccinations) effectively curb transmission but impose heavy economic strains. Existing research often neglects individual behaviors and falsely assumes perfect infection tracking and flawless policy execution, failing to account for real-world uncertainties and errors. Methods We propose an integrative approach incorporating uncertainties in both epidemic measurement (infections/hospitalizations) and policy implementation. We built a simulation model of 1,000 individuals making real-time choices regarding mask-wearing, vaccination, and shopping. Concurrently, policymakers deploy interventions (lockdowns, mandates) based on health and economic observations. This framework is driven by hierarchical reinforcement learning agents, utilizing deep Q-networks alongside uncertainty-aware policy gradient variants (DDPG and TD3). Results The simulations effectively managed the epidemic's progression. Masking and vaccinations proved highly effective, significantly reducing both the outbreak's peak height and duration. By integrating individual behaviors, policy uncertainties, and multifaceted interventions, our dynamic control approach successfully mitigated the epidemic's impact. Conclusions Our model overcomes previous research limitations by embedding uncertainty and human behavior into public health policy frameworks. The simulation demonstrates that accounting for individual choices and imperfect data is crucial for designing effective interventions during complex pandemics, with masks and vaccines serving as pivotal tools.

Epidemic forecasting faces a fundamental challenge: human behavior dynamically responds to disease spread, creating feedback loops that induce distribution shifts at policy intervention points. This renders data-driven models unreliable under distribution shift. We propose SL-BiLEM (Structured Learnable Behavior-in-the-Loop Epidemic Model), leveraging physical constraints as regularization for robust extrapolation. The framework decomposes effective transmission as $β_{\text{eff}}(t,g) = β_0(g) \times m_{\text{policy}}(t) \times m_{\text{media}}(t) \times m_{\text{comp}}(t,g)$, where monotonicity, smoothness, and bounded-jump constraints on the learned compliance function maintain predictive validity under novel policy regimes. Beyond forecasting, SL-BiLEM enables counterfactual analysis for intervention decision support. We validate forecasting on three real-world datasets (cruise ship, school influenza, and school-district COVID-19 surveillance) and evaluate counterfactual recovery on synthetic benchmarks with known ground truth. SL-BiLEM demonstrates: (1) 76% improvement over neural-mechanistic baselines, with only 53% OOD degradation versus 1142% for neural baselines under policy-induced shift; (2) 100% bootstrap CI coverage across 27 synthetic counterfactual experiments; and (3) Treatment Effect Accuracy exceeding 0.85. These results establish SL-BiLEM as an interpretable tool for public health decision-makers seeking accurate prediction and principled intervention planning.