Please read.

[jenjen76]

www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

@xtinak

It's not really a second peak so much as a delayed peak, I think. The black line in the graph shows what would happen if we do nothing. The green line does have a little 'peak' in April (p.10, figure B) but it's not significant enough that I'd describe the big green peak (figure A) as a second one.

Also important to note is that the green line adds school and university closures, but removes household quarantine measures. The graph doesn't tell us what closures and household quarantine would do, so it's not possible to tell whether (or to what extent) the closures or the lack of quarantine are causing the big peak later in the year. (It might be possible to do so with the tables on page 13 but I don't have time to look at those in detail right now).

Interestingly, we have this in the discussion:

"We predict that school and university closure will have an impact on the epidemic, under the assumption that children do transmit as much as adults, even if they rarely experience severe disease. We find that school and university closure is a more effective strategy to support epidemic suppression than mitigation; when combined with population-wide social distancing, the effect of school closure is to further amplify the breaking of social contacts between households, and thus suppress transmission. However, school closure is predicted to be insufficient to mitigate (never mind suppress) an epidemic in isolation; this contrasts with the situation in seasonal influenza epidemics, where children are the key drivers of transmission due to adults having higher immunity levels" (pp. 15-16)

I wonder if that graph is trying to tell us not that school closures cause a massive peak, but that closures without other effective measures won't have any impact.

@PegasusReturns

Please explain how I have bullied anyone.

I asked you to stop attacking me. It won't bother me in the slightest if you continue but you aren't presenting yourself as someone people should listen to.

@Titslikepicassos

Are you able to explain why your first response is abuse?

If everybody is like you, it doesn't bode well for the months ahead of us.

Why are most people being a dick to the original poster?

Please understand that it is your perogative not to be able to comprehend the gravity of the situation at hand. Totally logical if you are under 60 years old and lived in a peacefully coconed country your whole life.

Shit has just got real so I implore you find a way to deal with it.

Thanks for the info @jenjen76

First HIV came to the gays, and I did not speak out—
Because I was not at risk of HIV.

Then SARS came to Asia, and I did not speak out—
Because I was not Asian.

Then MERS came to the Arabian Peninsula, and I did not speak out—
Because I was not from the Arabian Peninsula.

Then Ebola came to the African's and I did not speak out—
Because I was not an African.

Then H1N1 came to the world and I did not speak out—
Because I was from the Uk.

Then Zika came to the world and I did not speak out—
Because I was from the Uk.

Now Covid19 is coming for me—and there was no one left to speak for me.

@SuckingDieselFella I think it’s clear who is doing the attacking and it’s not me

Enjoy the rest of day telling people on the internet that they stupid and accusing them of trying to frighten people. This is not the only thread you’ve done the same on. It’s tiresome.

Im not interested in you responding - perhaps just read the other posts that are telling you the same and reflect that a bit of kindness wouldn’t go amiss.

JIDEA has a youtube channel. The information and their output has been freely available for the last six or so weeks.

You can see Neil Ferguson talking here. He looks exhausted. What's a shame is that in his earlier videos he was far more direct. Now in the latest one he's more cagey.

Whatever happened to #bekind?

Mumsnet can be extraordinarily supportive and then at times in equal measure off the charts shitty.

Please, more than ever we need to take a step back and move from the need to be 'right' to the need to just share and allow everyone time to process all of this. Don't leap to conclusions. Don't jump down other people's throats. Keep talking. Keep being civil. Keep being kind. Please.

@PegasusReturns

You call me a dick and ask for kindness in return.

Strange logic, to say the least!

Something I've been wondering about....it seems like a large (and understandable) worry for a lot of people is children not being able to see grandparents / older relative for potentially 18 months.

If it can be established that you can only catch this strain once, would it be possible to test people/children to see if they have already had it? That way you could safely resume contact with people in the vulnerable category.

I know nobody really knows, just thinking out loud really as I'm sure people could put up with keeping away from crowds of strangers for 18 months....but not seeing loved ones is going to be gut wrenching.

No one here has said that this model is definitely going to happen because no one can possibly know for definite unless they possess the gift of visions of the future but it is a reasonable projection on the perceived outcome using other countries and scientific knowledge and mathematics as way to create what is likely if we follow different options.

It is not scaremongering, it is information.

I have no idea what the motives of the op are of sharing it but it doesn't actually matter because as adults surely we can read this with a logical eye and use it as a way to keep ourselves and others safe.

would it be possible to test people/children to see if they have already had it?

It is not possible to do this as yet. Chris Whitty said yesterday in the press conference that's it's not yet possible to do this, but would be a game changer if they could.

First HIV came to the gays, and I did not speak out—
Because I was not at risk of HIV.

Then SARS came to Asia, and I did not speak out—
Because I was not Asian.

Then MERS came to the Arabian Peninsula, and I did not speak out—
Because I was not from the Arabian Peninsula.

Then Ebola came to the African's and I did not speak out—
Because I was not an African.

Then H1N1 came to the world and I did not speak out—
Because I was from the Uk.

Then Zika came to the world and I did not speak out—
Because I was from the Uk.

Now Covid19 is coming for me—and there was no one left to speak for me.

????

In the case of every one of those disease outbreaks, the outbreak in question prompted a huge wave of media, discussion and international assistance, with scientists funded by international organizations and money donated by governments all over the world converging on the area in question to help quell the outbreak and treat patients.

Take ebola for example---the whole world has made heroic efforts with every outbreak, right back to the 70s, investigating the outbreaks, working out where it came from and how it spread, stopping the outbreaks quickly, and now developing a vaccine.

The development of the modern international scientific community, which predicts and monitors emerging diseases and quickly shares expertise on treatment and prevention, is one of the triumphs of the modern world.

I was listening to R4 today and the fastest vaccine for CV that has been tested on a human was possible due to previous viruses. So we learn together and go on.

Can someone explain why school closures seem to make things worse?

Does anyone understand the second peak predicted at the end of this year?

@xtinak @MarshaBradyo @DentalPatient

The graph that xtinak posted models what is likely to happen if the measures are in place for 5 months. The paper models lots of different scenarios and compares them.

What it is illustrating is:

Black line: If we do nothing, the peak of the epidemic will be in mid May and we will require 280 critical care beds per 100k people.

Green line: If we close schools and universities and practice social distancing and isolate the unwell for 5 months but do not impose household quarantine, cases will start to rise again in October after the schools and universities have returned from holiday, reaching a peak in mid November that requires 295 critical care beds per 100k people - worse than doing nothing now.

Orange line: If we practice social distancing, isolate the unwell and impose household quarantine for 5 months but do not close schools and universities, cases will start to rise again after restrictions have been lifted and peaking at the end of November, requiring 120 critical care beds per 100k people.

There are not enough critical care beds to cope with any of these scenarios which is why they are advising that measures may need to be in place for much longer, although different measures may become possible - eg intensive contract tracing.

The reason there is a peak later in the year is because they are modelling what would happen if restrictions were lifted in 5 months.

Why is there is a larger peak in November if schools and universities reopen and restrictions are lifted than there would be if we did nothing now? I assume because without household quarantine, many students may be infected (and possibly asymptomatic) when they return to school and university, large numbers of university students will be relocating to different parts of the country so potentially introducing the virus to areas where it is no longer in the population, and, most importantly, the starting number of people who are infected and infectious who are now mixing with no social distancing to slow transmission is far greater than the starting number of people who came back from China or Italy etc infected with the virus at the start of the epidemic.

@goingoverground Thank you that's very helpful. So why have they not then modelled school/university closure plus household quarantine do you think?

@SuckingDieselFella - I don’t think you understand logic do you?! I called you out for being a dick towards people who are anxious.

Couldn’t care less whether you’re being kind to me I just don’t understand the need to follow people round the internet picking on them

They have modelled that @xtinak if you look at table 4, along with other strategies.

The paper is a summary of the relevant results rather than every last detail.

The figure you asked about is to illustrate that although closing schools and universities (plus social distancing and case isolation) is more effective than household quarantine (plus social distancing and case isolation) in keeping number of people who require a critical care bed under the number of beds available while restrictions are in place but once restrictions are lifted the peak would be much higher, even higher than doing nothing. It is also to illustrate what would happen once the restrictions are lifted if there is no herd immunity (from a vaccine or natural) or effective drug treatment.

jenjen76

Oh look isn't this the document that has been splashed across the news all day today?

I wonder if all your detractors will give you kudos now?

Methinks not

Please, do you have any more documents for me to have a read of?

Thanks in advance

It is the paper being reported in the news today, adiposegirl2, so thanks and kudos to @jenjen76

Thanks for posting OP. They mentioned this on Sky News on Monday night and I noticed the guy giving a summary of it looked really shaken so I went to have a read of it myself and started sending to a few people. I firmly believe everyone should have the chance to read it. What they do with the info or what weight they give it is up to them.
And yes it is a sobering read.