Time to shut the stable doors.

Be prepared: COVID-19 coming to a neighbourhood near you

[iamlost]

Given the increasing spread outside of China it may be helpful to work from a solid information foundation:
* CDC (Centre for Disease Control) index page on Coronavirus Disease 2019 (COVID-19) [cdc.gov] information.

* COVID-19 Pandemic Preparedness Resources [cdc.gov]

While the content at the links provided below was developed to prepare for, or respond to, an influenza (“flu”) pandemic, the newly emerged coronavirus disease 2019 (COVID-19) is a respiratory disease that seems to be spreading much like flu. Guidance and tools developed for pandemic influenza planning and preparedness can serve as appropriate resources for health departments in the event the current COVID-19 outbreak triggers a pandemic.

Be safe
Be well

[lammert]

Death ratio is a difficult statistic to look at in this case. Cruise ship populations tend to be older on average for example.

The death rate in China was influenced in the first part of the epidemic when there weren't enough hospital beds and medics available to care for all the severe cases and there was no knowledge yet about usable treatments.

In some countries the number of available test kits and the capacity of laboratories may also not be adequate to find the larger part of the infected population, resulting in a relatively high death to infected ratio.

Health protocols may also limit the number of tests administered. Korea has done mass testing from the early beginning to find all potential cases, while in other countries only people with direct suspicion through travel or infected relatives are eligible for testing.

[graeme_p]

@lucy24 I think deaths to recoveries is an upper bound because some people are never diagnosed and people in high risk groups are more likely to be tested.

Some places in China are showing <2% death to recovery rates. Possibly with a high rate of testing? Still scarily high.

Italy has nearly as many deaths as recoveries.

[Mark_A]

Hi Lucy24 yes that is interesting. Also the number of tests being done. Some countries don't seem to want to find cases at all, whereas others seem determined to find all of them.

[Dimitri]

To see positive things, with more and more people "encouraged" to stay at home, they are spending more time browsing the Internet to spend time, visiting our sites.

[iamlost]

Note: it has been reported that this modelling was the fulcrum that shifted President Trump’s public position.

Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand [imperial.ac.uk] (PDF, 20 pages)

Summary

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.