Ascertaining the initiation of epidemic resurgences: an application to the COVID-19 second surges in Europe and the Northeast United States

Assessing a potential resurgence of an epidemic outbreak with certainty is as important as it is challenging. The low number of infectious individuals after a long regression, and the randomness associated with it, makes it difficult to ascertain whether the infectious population is growing or just fluctuating. We have developed an approach to compute confidence intervals for the switching time from decay to growth and to compute the corresponding multiple-location aggregated quantities over a region to increase the precision of the determination. We estimated the aggregate prevalence over time for Europe and the northeast United States to characterize the COVID-19 second surge in these regions during year 2020. We find a starting date as early as 3 July (95% confidence interval (CI): 1–6 July) for Europe and 19 August (95% CI: 16–23 August) for the northeast United States; subsequent infectious populations that, as of 31 December, have always increased or remained stagnant; and the resurgences being the collective effect of each overall region with no location, either country or state, dominating the regional dynamics by itself.