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PART DEUX #THREADTALK #Tweetorial
"Everything you ever wanted to know about Lockdowns"
by
@DrDomPimenta
for
@MSiUK_
Part 2: Lockdown Vs The Economy
Full article: https://modernsocietyinitiative.org/latest-research/f/part-2-lockdown-vs-the-economy
Thread begins
/1
"Everything you ever wanted to know about Lockdowns"
by
@DrDomPimenta
for
@MSiUK_
Part 2: Lockdown Vs The Economy
Full article: https://modernsocietyinitiative.org/latest-research/f/part-2-lockdown-vs-the-economy
Thread begins
/1
1/ If you missed part 1, about what a virus is and how social interventions reduce the spread, go away and catch up here:
https://twitter.com/DrDomPimenta/status/1311763161389903880?s=20
We will wait for you.
https://twitter.com/DrDomPimenta/status/1311763161389903880?s=20
We will wait for you.
2/ Okay. So to return to our most extreme example of lock-down possible, everyone 100% isolated for 3 weeks:
- we would eliminate the virus effectively
- but freeze all in-person economic activity
Here, the R is 0, as in one COVID case infects NO ONE else
https://en.wikipedia.org/wiki/Basic_reproduction_number
- we would eliminate the virus effectively
- but freeze all in-person economic activity
Here, the R is 0, as in one COVID case infects NO ONE else
https://en.wikipedia.org/wiki/Basic_reproduction_number
3/ This would mean new case numbers dropping 100% over 6 days (the generation time).
With nearly zero virus around, the economy could get going again nearly instantly.
With nearly zero virus around, the economy could get going again nearly instantly.
4/ If we took a much softer approach (e.g. advice WFH perhaps the R drops only to 0.9.
Meaning new cases dropping by 10% every 6 days, so this strategy requires over 15 weeks instead of 1.
During those weeks we can't reopen, as that negates the point of the intervention.
Meaning new cases dropping by 10% every 6 days, so this strategy requires over 15 weeks instead of 1.
During those weeks we can't reopen, as that negates the point of the intervention.
5/ This graph shows hard vs soft action and delayed vs immediate.
If we act NOW and HARD (R0.5), (yellow) we reach safe zone (orange) in 3 weeks. If we act NOW but SOFT (blue R0.9) it takes 15wks.
If cases double, HARD takes 1 week LONGER (green) and SOFT (red) takes>22weeks.
If we act NOW and HARD (R0.5), (yellow) we reach safe zone (orange) in 3 weeks. If we act NOW but SOFT (blue R0.9) it takes 15wks.
If cases double, HARD takes 1 week LONGER (green) and SOFT (red) takes>22weeks.
6/ So again just like a fire, spray the garden hose on it and it takes a long while to burn out. All the while you have to stand there, when you could be doing something else.
Equally, three fire engines and a crew of 20 and you're done in an hour. Plus your house is still there
Equally, three fire engines and a crew of 20 and you're done in an hour. Plus your house is still there
7/ Also, the HIGHER the amount of virus in the community, the MORE CAREFUL you have to be, meaning MORE PRECAUTIONS.
E.g. say you have 100 interactions/day, & 1 of those interactions is infected, if you FORGOT to take precautions HALF the time, you are unlikely to get infected.
E.g. say you have 100 interactions/day, & 1 of those interactions is infected, if you FORGOT to take precautions HALF the time, you are unlikely to get infected.
8/ But if say 50 of those interactions are infected, you would have to be MUCH MORE CONSISTENT to avoid getting infected.
PRECAUTIONS = SOCIAL DISTANCING, SPECIAL MEASURES IN SHOPS etc.
So the LESS VIRUS THERE is, the SAFER and MORE NORMAL it can be.
PRECAUTIONS = SOCIAL DISTANCING, SPECIAL MEASURES IN SHOPS etc.
So the LESS VIRUS THERE is, the SAFER and MORE NORMAL it can be.
9/ Lastly, #COVID is often asymptomatic. So that 1 in 100 person,
could
be
YOU.
And therefore you infect EVERYONE you meet where you don't take precautions.
https://wwwnc.cdc.gov/eid/article/26/6/20-0495_article
could
be
YOU.
And therefore you infect EVERYONE you meet where you don't take precautions.
https://wwwnc.cdc.gov/eid/article/26/6/20-0495_article
10/ So BOTH individual compliance AND societal measures influence the levels of virus in the community, and allow interactions to continue (and therefore the economy) in a normal fashion.
Which is why there is no economy vs virus control, you can't have one without the other.
Which is why there is no economy vs virus control, you can't have one without the other.
11/ Let's have a look.
In the UK we locked down with a high number of cases, and took a very long time to recover, still 30% working from home in September.
(also note park use increased to 100%).
In the UK we locked down with a high number of cases, and took a very long time to recover, still 30% working from home in September.
(also note park use increased to 100%).
12/ Now let's look at South Korea, where they had very early social distancing and testing throughout.
A reduction in around 30% of retail and workplaces early on, but back to near-normal by Apr/May.
A reduction in around 30% of retail and workplaces early on, but back to near-normal by Apr/May.
13/ We can see the same pattern in New Zealand, early and very hard lockdown here when cases were very low, but rapid recovery as well, retail and workplaces nearly back to normal by June.
14/ We see this pattern across the world: the countries that had the least deaths/per million also did the best economically:
Control the virus, reopen the economy. Sweden is an outlier, the same GDP hit as Denmark, but 5x the deaths.
Control the virus, reopen the economy. Sweden is an outlier, the same GDP hit as Denmark, but 5x the deaths.
15/ So the simplest way to restore the economy is to take every action to reduce and control virus spread as much as possible.
Let's take a break to let that sink in.
Let's take a break to let that sink in.
16/ Why do we have to do anything at all? Can't we just 'live with it' and re-open the economy unheeded.
Wiser and cooler heads than mine have addressed this in detail, but let's go through it: https://www.independentsage.org/a-deliberate-population-immunity-strategy-before-a-vaccine-why-it-wouldnt-work-and-why-it-shouldnt-be-tried/
Wiser and cooler heads than mine have addressed this in detail, but let's go through it: https://www.independentsage.org/a-deliberate-population-immunity-strategy-before-a-vaccine-why-it-wouldnt-work-and-why-it-shouldnt-be-tried/
17/ Firstly, how many of us CAN live with it?
Between 20%...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30854-0/fulltext
and 30%...
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30264-3/fulltext
Would be considered HIGH RISK for COVID-19 in the UK.
Between 20%...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30854-0/fulltext
and 30%...
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30264-3/fulltext
Would be considered HIGH RISK for COVID-19 in the UK.
18/ This immediately presents THREE problems:
1- Locking up 20 million people indefinitely isn't practical
2 - The economy goes into the toilet anyway with such a large section isolated
3 - With 30% 'shielded', it would be very hard to reach herd immunity anyway.
1- Locking up 20 million people indefinitely isn't practical
2 - The economy goes into the toilet anyway with such a large section isolated
3 - With 30% 'shielded', it would be very hard to reach herd immunity anyway.
19/ Secondly, it isn't actually possible to shield those people alone: in workplaces, schools, intergenerational homes - we are mixing all the time.
We could try to bubble entire homes, but that would have the same problems as above.
We could try to bubble entire homes, but that would have the same problems as above.
20/ Thirdly, WE ALREADY 'LET IT RIP'
We took no significant action with confirmed community transmission for 3-4 weeks in the UK.
This resulted in a national crisis, with 13,000 patients admitted to ICU with COVID, avg age of 60, 90% fully independent. https://www.icnarc.org/DataServices/Attachments/Download/baa7de02-3f00-eb11-912b-00505601089b
We took no significant action with confirmed community transmission for 3-4 weeks in the UK.
This resulted in a national crisis, with 13,000 patients admitted to ICU with COVID, avg age of 60, 90% fully independent. https://www.icnarc.org/DataServices/Attachments/Download/baa7de02-3f00-eb11-912b-00505601089b
21/ There are NO countries in the world that didn't take some sort of significant action. No one has ever tried 'let it rip'.
Here's a nice video of the whole world taking action over the Spring:
Here's a nice video of the whole world taking action over the Spring:
22/ FOURTHLY, we don't know that long-term immunity is even possible.
Antibodies wane after initial infection: https://www.ecdc.europa.eu/en/covid-19/latest-evidence/immune-responses
Worse, even mild cases in low risk individuals can create severe long-term health problems: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30701-5/fulltext
Antibodies wane after initial infection: https://www.ecdc.europa.eu/en/covid-19/latest-evidence/immune-responses
Worse, even mild cases in low risk individuals can create severe long-term health problems: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30701-5/fulltext
23/ Even a rare side effect that only affects 1% of those infected would produce 600,000 cases if 60m were infected.
If it was just 1 in 1000, that would still be 60,000 patients affected. This would have significant workforce and economic consequences as well.
If it was just 1 in 1000, that would still be 60,000 patients affected. This would have significant workforce and economic consequences as well.
24/ Lastly, we can see despite lock-down lifting in May and June many still stayed at home. "Let it rip" isn't going to work if many still don't go back to the economy out of free choice.
25/ Once more, the ONLY way back to normality is to suppress the virus and keep it suppressed, as it has been in many countries around the world.
This requires vigilance, compliance and consistent public messaging to maintain.
This requires vigilance, compliance and consistent public messaging to maintain.
26/ Finally, economic intervention and virus control are even further intertwined:
- the rules have to be economically viable or people can't follow them e.g. paid self-isolation, furlough schemes
-the less virus in the community, businesses stay open and staff at work
- the rules have to be economically viable or people can't follow them e.g. paid self-isolation, furlough schemes
-the less virus in the community, businesses stay open and staff at work
27/ So in summary,
-early and hard action is shorter, and gets the economy open again quicker
-the countries with the best virus control have the best economic record as well
-'let it rip' is as dangerous economically as it is medically
-early and hard action is shorter, and gets the economy open again quicker
-the countries with the best virus control have the best economic record as well
-'let it rip' is as dangerous economically as it is medically
Tl:DR?
"THERE IS NO ECONOMY VERSUS VIRUS CONTROL, IN A PANDEMIC YOU CAN'T HAVE ONE WITHOUT THE OTHER."
Thank you for coming to my second #ThreadTalk for @MSiUK_
Time for a drink.
"THERE IS NO ECONOMY VERSUS VIRUS CONTROL, IN A PANDEMIC YOU CAN'T HAVE ONE WITHOUT THE OTHER."
Thank you for coming to my second #ThreadTalk for @MSiUK_
Time for a drink.
Look out for the final Part 3 tomorrow: Lockdowns versus the NHS.
