The report by the ‘Imperial College COVID-19 Response Team’ has been released on March 16th ( https://tinyurl.com/tcdy42y ). 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) 'mitigation', which focuses on slowing but not necessarily stopping epidemic spread (i.e. 'Herd Immunity"), and (b) 'suppression', 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 'suppression' 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 'suppression' 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're heading for a 'suppression' 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'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)