Mild mitigation measures will not be enough to stop a massive spike in coronavirus cases overwhelming the health system, argues a paper released by researchers at Imperial College London.
Policies such as widespread social distancing, quarantining of people with exposure and the closure of schools and universities will need to be in place for many months to have any chance of seriously suppressing COVID-19 cases, the paper argues.
“The world is facing the most serious public health crisis in generations. Here we provide concrete estimates of the scale of the threat countries now face,” says Professor Neil Ferguson, head of the Abdul Latif Jameel Institute for Disease and Emergency Analytics at Imperial College.
They focus on two broad scenarios: essentially, slowing the spread to make it more manageable, and reducing spread enough that infections fall.
“We use the latest estimates of severity to show that policy strategies which aim to mitigate the epidemic might halve deaths and reduce peak healthcare demand by two-thirds, but that this will not be enough to prevent health systems being overwhelmed.
“More intensive, and socially disruptive interventions will therefore be required to suppress transmission to low levels. It is likely such measures — most notably, large scale social distancing — will need to be in place for many months, perhaps until a vaccine becomes available.
The paper has been credited with changing the United Kingdom’s strategy on the outbreak. Initially the UK was pursuing a more hands-off approach, with the nation’s chief scientific advisor suggesting 60% of the population needed to contract the disease to reach herd immunity to help control it in the long term.
But the Imperial College paper argues that strategies focusing on “slowing but not necessarily stopping” epidemic spread “would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over”.
In an unmitigated epidemic scenario, the researchers predict 510,000 deaths in the UK, and over two million in the United States, the two countries included in their modelling — though they believe results would be similar for other rich countries. At the peak, demand for intensive and critical care beds would exceed capacity by 30 times.
Undertaking moderately intrusive measures — such as case isolation, household quarantine and social distancing of just the elderly — would lead to perhaps 250,000 deaths in the UK and more than one million deaths in the United States. Even under optimistic assumptions, surge limits for both general ward and ICU beds would be exceeded by at least 8-fold.
For a full report, please go the Mandarin.
Adelaide last week held presentations by the Joint Committee for End of Life Choices. It was not reported in our only paper , Murdoch’s Advertiser, although The Advertiser did print a letter alerting me to the event.
With pressure on health services, families in the 20- 30-40 age bracket MUST be prioritised . I’m 83 , fit and busy. I know what I want and I’ve signed an Advanced Health Directive which I fear is useless .
Does Crikey have the courage to open up a debate on Voluntary Assisted Dying which is timely yet subject to scare campaigns?
I have long advocated changes to the euthanasia law to allow Advanced Health Directives to be obeyed.
My argument : With Covid-19 ’s pressure on nursing staff and bed spaces (possibly worse in the future) , why should (for example ) aged patients condemned to bed with dementia after a massive stroke be denied their expressed human right to die with dignity, which they signed in their Advanced Health Directives when they had the power to assert their choice?
It is about our end- of – life CHOICE, made when we are in sound mind.
I would wish for more clarification from society .
Ars longa vita brevis— I hope.
I’m with you all the way, Sweeney, even though I’m only 74 (nearly).
Apart from many other things, the idea of an Australian future led by the likes of the present government front bench is not an enticing thought, anyway.
What chance that a new word/old concept will enter public discourse – TRIAGE?
Tick.
Based on what is happening in the world of science rather than the bullshit bubble of economics, is we can slow the spread we may have some drugs to fight with. There are three that show promise.
What, sticking your head in the sand, talking about how much you’re doing, waiting to see what the rest of the world is doing, weighing up the cost and hoping it all goes away doesn’t work?
Crikey, this report is five days old, a long time at the moment – why have you waited so long to cover it?
Keane’s assinine “analysis” and focus on the economy is not what we need. We need independent, critical thinking and the voices of those who know what they’re talking about, not puff pieces about panic buying and how stupid people on social media are.
Publishing this story, however late, is a good start, but this paper has been criticised for some basic flaws, such as “ignori[ng] contact tracing (at the core of policies in South Korea, China or Singapore among others) or travel restrictions (critical in China), ignor[ing] the impact of big crowds…” (see “The Hammer and the Dance” by Tomas Pueyo, as well as “Review of Ferguson et al “Impact of non-pharmaceutical interventions…” Chen Shen†, Nassim Nicholas Taleb∗, Yaneer Bar-Yam†
†New England Complex Systems Institute, ∗School of Engineering, New York University
First Version March 17, 2020.”
At this time, Crikey, we need MUCH better than you have been delivering!
I couldn’t agree more Bob. Lift your game Crikey.
And they expect to be paid for this banal paraphrasing?
Ridding Australia of the Covid 19 virus in one hit
Let us try and address the Covid 19 virus problem in cybernetic terms.
Shutting down positive feedback
The Covid 19 virus spread is a positive feedback mechanism. In this instance the feedback gain can be very high, 1 to 44 in one Uruguayan case and this magnitude of gain can be very hard to dampen. This is particularly so where there is a feedback delay caused by the time lag between capacity to infect others and symptoms. To shut down this kind of aggressive positive feedback it is best to cut the feedback loop. This is preferable to trying to dampen the system as this takes too much time which extends economic and social disruption and costs more lives.
Ability to test
To cut the positive feedback loop we have to test everyone at the same time and isolate those who are positive until they are no longer infectious.
This means we must have testing kits. In the case of Australia with a population of about 24.5 million the requisite variety is 25 million kits. We want to test twice so the requisite variety becomes 50 million. This sounds a lot until you think of how many doses of various vaccines we produce for Australians each year. Preferably we want testing kits that use swabs and produce a quick result. False positives, within reason, are not a problem.
Testing
So, whilst we are developing and producing the testing kits we need a system to assemble 24.5 million people for testing in one day. We need to develop this system in parallel with test kit development so it is on-line when the test kits are available.
Rather than set up a new system from scratch, it is quicker, cheaper and safer to adapt an existing system, if there is one. We do have a system with the requisite variety to assemble Australian citizens at convenient sites in one day. It is the electoral system and this is the natural choice. But it will take time to add additional variety and adapt it and this process should begin without delay. The electoral system can be adapted by adding non-citizens to the database and arranging for medical staff or temporary medical staff to administer tests, process results and feed the results back to the database.
So, on a specified date, probably a Saturday, all persons residing in Australia, citizens and non-citizens, will attend polling booth sites but instead of voting they will be tested for the virus.
Segregation/Enforcement
If they are found positive they must self-exclude until given the all-clear by a subsequent test. Each person is given a lanyard with photo-id and notification of their status – green for negative and red for positive. They must wear the lanyard when away from home, i.e. in public. Nobody will be allowed in public places without a green lanyard. Those wearing a red lanyard must keep away from others and use it only to attend necessary secured appointments such as driving to a testing site. The requisite variety for enforcement will come from the variety constituted by the public itself including supermarket personnel, storekeepers and the public generally; this will match the variety of any transgressors.
One week later the process will be repeated to pick up any strays and test the efficacy of the first testing/segregation.
Assuming a successful outcome, the lanyards can be discarded after five weeks from the first test date.
Naturally, testing and quarantine measures must be maintained at airports and ports. In all other respects, business can get back to normal in Australia.
This one-day testing and segregation process can be carried out in parallel with other measures designed to dampen the positive feedback and mitigate damage, measures such as the development of vaccines, increase of hospital facilities, medications etc.