The pluses and minuses of R0.

The concept of the basic reproduction number (R0) occupies a central place in epidemic theory. The value of R0 determines the proportion of the population that becomes infected over the course of a (modelled) epidemic. In many models, (i) an endemic infection can persist only if R0>1, (ii) the value of R0 provides a direct measure of the control effort required to eliminate the infection, and (iii) pathogens evolve to maximize their value of R0. These three statements are not universally true. In this paper, some exceptions to them are discussed, based on the extensions of the SIR model.