Past exam of the mathematics course of the University of Cambridge / 2017 / iii / Paper 207 / 3 / a

The first departure from the no-symptoms state has an exponential distribution with rate $\lambda$. Spending the entire interval there means no departure at all, soThis is the holding time survival probability. The transition probability $p_{11}(t)$ only says that the patient is symptom-free at the endpoint, allowing an onset and recovery in between, and is therefore not the answer. The formula also covers $\lambda =0$, when state 1 is absorbing.

Let $A_2(t)={\int }_0^{t}1\{X(s)=2\}ds$ be the occupation time of a continuous-time Markov chain in the symptoms state. Tonelli theorem permits exchanging the nonnegative integral and expectation. Starting from state 1, put $q=\lambda +\mu >0$. ThensoFor small $t$ the answer is $\lambda t^2/2+O(t^3)$, as expected when onset must first occur. It is between zero and $t$. If $\lambda =\mu =0$, no transition can occur and the answer is zero; the displayed quotient is interpreted separately in that degenerate case.

Dividing the expected occupation time of a continuous-time Markov chain by $t$ and letting $t\to \infty$ givesFor $\lambda ,\mu >0$ this is also the almost-sure long-run time fraction, not just the limit of an expectation. The two-state continuous-time Markov chain is irreducible and positive recurrent. Alternatively, a regeneration cycle consists of a mean $1/\lambda$ symptom-free holding time followed by a mean $1/\mu$ symptomatic holding time; the renewal-reward theorem gives $(1/\mu )/(1/\lambda +1/\mu )=\lambda /(\lambda +\mu )$. This agrees with the stationary distribution solving ${\pi }_1\lambda ={\pi }_2\mu$ and ${\pi }_1+{\pi }_2=1$.

Starting in state 1, if $\lambda =0$ the fraction is zero; if $\lambda >0$ and $\mu =0$ the patient eventually enters state 2 forever, and the fraction is one. If both rates vanish, the fraction remains zero from this initial state and the quotient $0/0$ is undefined.