Disclaimer: I don’t know if this is right, I’m reasoning entirely from first principles.
If there is dispersion in R0, then there would likely be some places where the virus survives even if you take draconian measures. If you later relax those draconian measures, it will begin spreading in the larger population again at the same rate as before.
In particular, if the number of cases is currently decreasing overall most places, then soon most of the cases will be in regions or communities where containment was less successful and so the number of cases will stop decreasing.
If it’s infeasible to literally stamp it out everywhere (which I’ve heard), then you basically want to either delay long enough to have a vaccine or have people get sick at the largest rate that the health care system can handle.
If it’s infeasible to literally stamp it out everywhere (which I’ve heard), then you basically want to either delay long enough to have a vaccine
South Korea, Singapore, Italy
or have people get sick at the largest rate that the healthcare system can handle.
The UK.
We’re running an interesting experiment to see which approach works. One potential benefit is that the world will be able to observe which of the two strategies is viable and switch between them, at least theoretically. Practically, switching from ‘suppress/contain’ to ‘flatten curve’ seems a lot more feasible than the alternative of trying to suppress after not taking tough measures, as the UK will have to do if its strategy means cases grow out of control. South Korea could still try to use curve-flattening as a backup plan.
However, for the reason given in the blog post, suppression will be a viable backup even if switching from curve-flattening to suppression is intrinsically harder than the other way round.
The interventions of enforced social distancing and contract tracing are expensive and inevitably entail a curtailment of personal freedom. However, they are achievable by any sufficiently motivated population. An increase in transmission *will* eventually lead to containment measures being ramped up, because every modern population will take draconian measures rather than allowing a health care meltdown. In this sense COVID-19 infections are not and will probably never be a full-fledged pandemic, with unrestricted infection throughout the world. It is unlikely to be allowed to ever get to high numbers again in China for example. It will always instead be a series of local epidemics.
Still seems to me like you should be able to isolate those problem areas from the rest of the country. Then even if you can’t contain the epidemic inside, you spare most of the country (for the moment). But I think we mostly agree. A scenario that seems increasingly likely to me is that governments will intervene in increasingly strict ways until we get very close to true containment (before ~15% of the world is infected), and then will loosen movement restrictions in more-contained areas while playing whack-a-mole with a sequence of localized outbreaks for 1-2 years until a vaccine is ready.
soon most of the cases will be in regions or communities where containment was less successful and so the number of cases will stop decreasing. If it’s infeasible to literally stamp it out everywhere (which I’ve heard),
Borders, travel restrictions, cancellation of large events, contact tracing and testing will solve this.
Borders are necessary precisely because of this dispersion issue.
Disclaimer: I don’t know if this is right, I’m reasoning entirely from first principles.
If there is dispersion in R0, then there would likely be some places where the virus survives even if you take draconian measures. If you later relax those draconian measures, it will begin spreading in the larger population again at the same rate as before.
In particular, if the number of cases is currently decreasing overall most places, then soon most of the cases will be in regions or communities where containment was less successful and so the number of cases will stop decreasing.
If it’s infeasible to literally stamp it out everywhere (which I’ve heard), then you basically want to either delay long enough to have a vaccine or have people get sick at the largest rate that the health care system can handle.
South Korea, Singapore, Italy
The UK.
We’re running an interesting experiment to see which approach works. One potential benefit is that the world will be able to observe which of the two strategies is viable and switch between them, at least theoretically. Practically, switching from ‘suppress/contain’ to ‘flatten curve’ seems a lot more feasible than the alternative of trying to suppress after not taking tough measures, as the UK will have to do if its strategy means cases grow out of control. South Korea could still try to use curve-flattening as a backup plan.
However, for the reason given in the blog post, suppression will be a viable backup even if switching from curve-flattening to suppression is intrinsically harder than the other way round.
Still seems to me like you should be able to isolate those problem areas from the rest of the country. Then even if you can’t contain the epidemic inside, you spare most of the country (for the moment). But I think we mostly agree. A scenario that seems increasingly likely to me is that governments will intervene in increasingly strict ways until we get very close to true containment (before ~15% of the world is infected), and then will loosen movement restrictions in more-contained areas while playing whack-a-mole with a sequence of localized outbreaks for 1-2 years until a vaccine is ready.
Borders, travel restrictions, cancellation of large events, contact tracing and testing will solve this.
Borders are necessary precisely because of this dispersion issue.