The R = 1 threshold can misclassify epidemic stability

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Abstract

The effective reproduction number, R , is a predominant statistic for tracking infectious disease spread and informing health policies. An estimated R=1 is universally interpreted as a stability threshold distinguishing epidemic growth ( R > 1 ) from control ( R<1 ). We demonstrate that this interpretation frequently fails because R typically averages over groups with heterogeneous characteristics. We find that R=1 conceals valuable early-warning signals of resurgence and misclassifies complex dynamics as noise, generating false positive stability thresholds that diminish predictive and policymaking value. We further illustrate that a popular alternative transmissibility definition (using next-generation matrices) overcorrects this issue, producing false negative stability signals by amplifying stochastic variation. We address these limitations by adapting a recently developed statistic, E , derived from R using experimental design theory. We show that E tightly constrains the set of scenarios consistent with stability, while remaining robust to noise and establish E=1 as a more practical and meaningful real-time threshold.

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