A Transferable Learned Temporal Prior for Transmission Reconstruction and Decision-Relevant Uncertainty in Real Outbreak Labels

Regional surveillance data reflect local transmission, reporting, seeding, and external infection pressure, which are difficult to identify separately. We introduce GeoID-PINN, a physics-informed neural network (PINN) for susceptible-infectious-recovered-deceased (SIRD) dynamics. The model represents spatial dependence with a row-stochastic source-composition matrix whose rows assign nonnegative source weights that sum to one. We regularize this matrix toward a spatial prior constructed from distance, adjacency, commuting, or lead-lag information. In a four-region simulation with known truth, a compatible distance prior gives source-composition error 0.099. The error rises to 0.159 without regularization and 0.577 under a strongly misspecified prior, while trajectory fit and transmission-scale estimates remain similar. Accurate trajectories therefore do not guarantee recovery of the regional dependence structure. We also evaluate GeoID-PINN retrospectively using COVID-19 data from 64 Louisiana counties. Relative to an autoregressive negative-binomial baseline, Forecast-Trained Geo-PINN reduces mean squared error (MSE) from 32,957 to 11,468 and mean absolute error (MAE) from 70.60 to 57.73. The baseline has lower negative log likelihood (NLL), 5.158 versus 5.346, indicating better distributional fit but worse point accuracy. In a controlled 15-county comparison, county adjacency reduces MSE by 6.85 percent and MAE by 3.1 percent. Similar performance across plausible priors supports structured regularization but not unique edge recovery. These results require prior-sensitivity and observation-model checks before interpretation.

Accurate epidemic forecasting is crucial for public health response, resource allocation, and outbreak intervention, but remains difficult with sparse, noisy, and highly non-stationary data. Because epidemics unfold across interacting regions, spatiotemporal methods are natural candidates for improving forecasts. Despite growing interest in spatial information, no standardized benchmark exists, and current evaluations often use simple chronological train-test splits that do not reflect real-time forecasting practice. We address this gap with SpatialEpiBench, a challenging benchmark for spatiotemporal epidemic forecasting in realistic public-health settings. SpatialEpiBench includes 11 epidemic datasets with standardized rolling evaluations and outbreak-specific metrics. We evaluate adjacency-informed forecasting models with widely used epidemic priors that adapt general models to epidemiology, but find that most methods underperform a simple last-value baseline from 1 day to 1 month ahead, even during outbreaks and with these priors. We identify three major failure modes: (1) poor outbreak anticipation, (2) difficulty handling sparsity and noise, and (3) limited utility of common geographic adjacency for epidemiological spatial information. We release benchmark data, code, and instructions at https://github.com/Rachel-Lyu/SpatialEpiBench to support development of operationally useful epidemic forecasting models.

Reliable epidemiological reasoning requires synthesizing study evidence to infer disease burden, transmission dynamics, and intervention effects at the population level. Existing medical question answering benchmarks primarily emphasize clinical knowledge or patient-level reasoning, yet few systematically evaluate evidence-grounded epidemiological inference. We present EpiQAL, to our knowledge the first diagnostic benchmark for epidemiological question answering over research literature, comprising three subsets built from open-access articles across diverse diseases. The three subsets progressively test factual recall, multi-step inference, and conclusion reconstruction under incomplete information, and are constructed through a quality-controlled pipeline combining taxonomy guidance, multi-model verification, and difficulty screening. Experiments on fifteen models spanning open-source and proprietary systems reveal that current LLMs show limited performance on epidemiological reasoning, with multi-step inference posing the greatest challenge. Model rankings shift across subsets, and scale alone does not predict success. Chain-of-Thought prompting benefits multi-step inference but yields mixed results elsewhere. EpiQAL provides fine-grained diagnostic signals for evidence-grounding, inferential reasoning, and conclusion reconstruction.