Origins of the problematic E in SEIR epidemic models

Infect Dis Model. 2024 Mar 24;9(3):673-679. doi: 10.1016/j.idm.2024.03.003. eCollection 2024 Sep.

Abstract

During the COVID-19 pandemic, over one thousand papers were published on "Susceptible-Exposed-Infectious-Removed" (SEIR) epidemic computational models. The English word "exposed" in its vernacular and public health usage means a state of having been in contact with an infectious individual, but not necessarily infected. In contrast, the term "exposed" in SEIR modeling usage typically stands for a state of already being infected but not yet being infectious to others, a state more properly termed "latently infected." In public health language, "exposed" means possibly infected, yet in SEIR modeling language, "exposed" means already infected. This paper retraces the conceptual and mathematical origins of this terminological disconnect and concludes that epidemic modelers should consider using the "SLIR" notational short-hand (L for Latent) instead of SEIR.

Keywords: Exposed; History; Latent infection; Notation; SEIR model.