This Is How We Can Beat the Coronavirus
https://www.theatlantic.com/ideas/archive/2020/03/how-we-beat-coronavirus/608389/
Related FT article -
Imperial College Study:
Summary Report 9
The
global impact of COVID-19 has been profound, and the public health threat it
represents is the most serious seen in a respiratory virus since the 1918 H1N1
influenza pandemic. Here we present the results of epidemiological modelling
which has informed policymaking in the UK and other countries in recent weeks.
In the absence of a COVID-19 vaccine, we assess the potential role of a number
of public health measures – so-called non-pharmaceutical interventions (NPIs) –
aimed at reducing contact rates in the population and thereby reducing
transmission of the virus. In the results presented here, we apply a previously
published microsimulation model to two countries: the UK (Great Britain
specifically) and the US. We conclude that the effectiveness of any one
intervention in isolation is likely to be limited, requiring multiple
interventions to be combined to have a substantial impact on transmission.
Two
fundamental strategies are possible: (a) mitigation, which focuses on slowing
but not necessarily stopping epidemic spread – reducing peak healthcare demand
while protecting those most at risk of severe disease from infection, and (b)
suppression, which aims to reverse epidemic growth, reducing case numbers to
low levels and maintaining that situation indefinitely. Each policy has major
challenges. We find that that optimal mitigation policies (combining home
isolation of suspect cases, home quarantine of those living in the same
household as suspect cases, and social distancing of the elderly and others at
most risk of severe disease) might reduce peak healthcare demand by 2/3 and
deaths by half. However, the resulting mitigated epidemic would still likely
result in hundreds of thousands of deaths and health systems (most notably
intensive care units) being overwhelmed many times over. For countries able to
achieve it, this leaves suppression as the preferred policy option.
We
show that in the UK and US context, suppression will minimally require a
combination of social distancing of the entire population, home isolation of
cases and household quarantine of their family members. This may need to be
supplemented by school and university closures, though it should be recognised
that such closures may have negative impacts on health systems due to increased
absenteeism. The major challenge of suppression is that this type of intensive
intervention package – or something equivalently effective at reducing
transmission – will need to be maintained until a vaccine becomes available
(potentially 18 months or more) – given that we predict that transmission will
quickly rebound if interventions are relaxed. We show that intermittent social distancing
– triggered by trends in disease surveillance – may allow interventions to be
relaxed temporarily in relative short time windows, but measures will need to
be reintroduced if or when case numbers rebound. Last, while experience in
China and now South Korea show that suppression is possible in the short term,
it remains to be seen whether it is possible long-term, and whether the social
and economic costs of the interventions adopted thus far can be reduced.
