Update: For a more positive take than the one below, also see: “Progress On COVID-19 Treatment? Looks Like It.“
Epidemiologists at Imperial College in London released a report on Monday that shocked government officials in the UK and the US. Unless drastic measures are taken immediately to combat the spread of the COVID-19 virus, the scientists say deaths from the virus could reach 2.2 million in the United States and 510,000 in the UK. More ambitious measures could cut both numbers in half, but the crisis will not be resolved completely until a vaccine is available — a process that could easily take 18 months or more.
The study has not yet been peer reviewed, but officials in both the UK and US government have taken the warning from the scientists to heart. That is the primary reason the president of the US has stopped telling people the virus is a hoax perpetrated by Democrats or George Soros and started treating the subject with the seriousness it deserves.
The findings were published in the 9th report from the WHO Collaborating Center for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London. Professor Neil Ferguson, head of the MRC GIDA team and director of the Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), says:
“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. 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.”
Ferguson told CNN that a copy of the report was given to the Trump administration over the weekend and shared with the CDC on Monday. Sir Patrick Vallance, chief scientific adviser to the UK government, has confirmed to CNN the Imperial College study was among those the UK government was looking at. “What suppression in that paper talks about is exactly what we are doing,” he said.
Modeling Is An Inexact Science
CNN points out that epidemiological studies are based on modeling from available data and rely on assumptions that can later prove false. Mitigation “focuses on slowing but not necessarily stopping epidemic spread,” while suppression, “aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.”
The study says “the most effective mitigation strategy” would still lead to hospitals — even at surge capacity — needing eight times as many intensive care unit beds as they could provide in the UK. Yet the study also notes that “optimal mitigation policies” — such as combining the home isolation of suspected cases, home quarantine of those living with suspected cases and social distancing among the elderly and others at high risk of severe disease — might reduce peak health care demand in the UK by two-thirds and deaths by half. “For countries able to achieve it, this leaves suppression as the preferred policy option,” it concludes.
No Time To Relax
The most troubling finding is that relaxing the mitigation and/or suppression measures at any time may give the virus a chance to come roaring back.
“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.”
Input From WHO
It is important to keep in mind that this is a report based on preliminary data and there are other epidemiologists who believe it is either too tepid or too extreme in its recommendations. The World Health Organization has its own take on the situation. In a recent statement, it said, “Data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen, and 5% are critical infections, requiring ventilation.”
Last week, WHO Director-General Tedros Adhanom Ghebreyesus told the press that countries should tailor their responses to address the spread of disease seen specifically in their nations. “This is an uneven epidemic at the global level. Different countries are in different scenarios, requiring a tailored response. It’s not about containment or mitigation — which is a false dichotomy. It’s about both,” Ghebreyesus said.
“All countries must take a comprehensive blended strategy for controlling their epidemics and pushing this deadly virus back. Countries that continue finding and testing cases and tracing their contacts not only protect their own people, they can also affect what happens in other countries and globally.”
We aren’t in Kansas anymore, people. Everything that we thought we knew has been upended. The virus will be a change agent that forces people to think of globalization, capitalism, and patriotism in a new light. On one hand, it could force nations to work more closely with each other to bring about the technical revolutions needed to address the existential crisis presented by a warming planet. On the other hand, it could pit nations against each other, making the chances for international cooperation even lower than they have been and condemning us to internecine fighting on a global scale.
The only constant in life is change, and it seems clear COVID-19 is going to alter the status quo and the “business as usual” mind set in ways that few can predict at the moment. 2020 will likely be remembered as a year that shaped the history of the world. The sun still rises in the east, but everything else we thought of as normal is likely to be substantially altered.