The R = 1 threshold can misclassify epidemic stability
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.
Authors
- Uri Obolski (ORCID: https://orcid.org/0000-0001-7594-9745)
- Mauricio Santillana (ORCID: https://orcid.org/0000-0002-4206-418X)
- Kris V Parag
- Anne Cori
Institutions
- Northeastern University (US)
- Harvard University (US)
- Tel Aviv University (IL)
- King's College London (GB)
- Imperial College London (GB)
Publication Details
- Journal
- Communications Physics
- Published
- 2026-04-15
- DOI
- https://doi.org/10.1038/s42005-026-02631-6
- Primary Topic
- COVID-19 epidemiological studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Tel Aviv University
- Medical Research Council