The generation time distribution: Its role for estimating R, biases that may occur, and their consequences

The generation time distribution (GTD), the time between getting infected and infecting others, plays a key role when estimating the basic (or current) reproduction number R for infectious diseases, through the Euler–Lotka equation. Please note that the GTD is not a scalar like R, but a distribution. In the talk I will describe potential biases when estimating the GTD, and their effect on estimates of R. First I will do this for the initial stage of an epidemic before preventive measures are put in place, and then when estimating the current reproduction number during an ongoing epidemic where preventive measures and disease immunity may be present. The two situations will be illustrated with Ebola and COVID-19 respectively.