Utilizing wastewater surveillance to model behavioural responses and prevent healthcare overload during "Disease X" outbreaks.

During the COVID-19 pandemic, healthcare systems worldwide faced severe strain. This study, utilizing wastewater virus surveillance, identified that periodic spontaneous avoidance behaviours significantly impacted infectious disease transmission during rapid and intense outbreaks. To incorporate these behaviours into disease transmission analysis, we introduced the Su-SEIQR model and validated it using COVID-19 wastewater data from Beijing and Hong Kong. The results demonstrated that the Su-SEIQR model accurately reflected trends in susceptible populations and confirmed cases during the COVID-19 pandemic, highlighting the role of spontaneous collective avoidance behaviours in generating periodic fluctuations. These fluctuations helped reduce infection peaks, thereby alleviating pressure on healthcare systems. However, the effect of these spontaneous behaviours on mitigating healthcare overload was limited. Consequently, we incorporated healthcare capacity constraints into the model, adjusting parameters to further guide population behaviours during the pandemic, aiming to keep the outbreak within manageable limits and reduce strain on healthcare resources. This study provides robust support for the development of environmental and public health policies during pandemics by constructing an innovative transmission model, which effectively prevents healthcare overload. Additionally, this approach can be applied to managing future outbreaks of unknown viruses or "Disease X".