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The report by the ‘Imperial College COVID-19 Response Team’ has been released on March 16th ( https://tinyurl.com/tcdy42y ).">https://tinyurl.com/tcdy42y&q... Now that things have calmed down a bit, I felt I should produce a thread summarising my personal take on it. (1/15)
It was much anticipated as it is considered as the scientific rationale driving the UK government’s strategy to mitigate the covid-19 pandemic. It was also allegedly shared with the White House. (2/15)
The ‘Imperial College COVID-19 Response Team’ is possibly the best rapid pandemic response unit in the world. I was based in that unit between 2007-2012 and can testify that their scientists are technically superb. (3/15)
The modelling is sophisticated. Though, the report is somewhat narrow in its remit and some conclusions may be ‘best-case-scenarios’, despite its conclusions being somewhat uncomfortable. The modelling is based on strong assumptions, some that could be more explicit. (4/15)
Key assumptions include the fact that immunisation is long-term. This remains a big unknown it remains to be seen how long immunisation lasts for, following infection by SARS-COV-2. Some evidence suggests immunity might be relatively short-lived. (5/15)
The report does not explicitly consider the economic/health impact of different mitigation measures. For instance, the scenario of a 18-month lockdown would devastate the economy and could hence reduce life expectancy beyond the toll that SARS-COV-2 might exert on its own. (6/15)
The report concludes that the effectiveness on the Covid-19 pandemic of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission. (7/15)
Two basic strategies are considered: (a) & #39;mitigation& #39;, which focuses on slowing but not necessarily stopping epidemic spread (i.e. & #39;Herd Immunity"), and (b) & #39;suppression& #39;, which aims to reduce case numbers to low levels and maintaining that situation indefinitely. (8/15)
The report has been widely interpreted as being supportive of the & #39;suppression& #39; strategy, which may entail a country-wide lockdown for up to 18 months. This may be a slight misunderstanding of a sophisticated piece, which acknowledges there is no easy solution. (9/15)
Though, the report is in fact fairly balanced and acknowledges (but doesn’t model) the extreme economic damage that a & #39;suppression& #39; strategy would inflict on the economy (and by extrapolation to health, education and longevity). (10/15)
The report can be read in many different ways, but fundamentally, it confirms that we are facing a series of uncomfortable options within a continuum ranging from paying a heavy death toll right now vs. an uncertain and possibly even worse future. (11/15)
There may actually be no choice. Politically, but also morally and ethically, any option leading to a heavy death toll over the coming months, but offering the possible prospect of maximising long-term life-expectancy would be a difficult sell. (12/15)
As such, I have little doubt we& #39;re heading for a & #39;suppression& #39; approach to covid-19. Given the many unknowns and the difficult moral implications, it probably makes sense to try to address the most urgent issue. There are times when tactics might trump strategy. (13/15)
Pandemics like this one have been looming for millennia, and covid-19 won& #39;t be the last humanity will face. We have been caught napping and we now have to deal from a position of weakness with a difficult situation that could have been, in principle, largely avoidable. (14/15)
I predict some difficult times ahead in the immediate future. Though, I have some hopes that the COVID-19 pandemic will bring the best out of humanity, and that this crisis will act as a catalyst for us to deal more effectively, together, with future global challenges. (15/15)
