The next 18 months for all of us - here is the science

[EasterEggz]

If you haven't read this, now is the time. It explains exactly what the next 18 months are going to look like, why the government has switched from 'mitigation' to 'suppression', and what it means for all of us.

www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf?fbclid=IwAR3PQSzpObyq-ULWzwsNKvDHwPhri47wEsJSDqEJYX0dTzIw1JQc6wVSGCE

To crudely summarise... Be prepared for a long term change in our lifestyles, lasting until Summer 2021. The first wave will be suppression until July 2020, including school and university closures after Easter. There will then be a brief respite over late July / August to allow people a few more freedoms before the suppress measures come back in the Autumn. The suppress measures will be implemented thereafter on a rolling basis for shorter intense periods throughout the following year, all in a bid to keep the ICU need below the maximum capacity. It is all explained here.

I think of China - they have suppressed so the health facilities can cope again, now they will go back to normal living, virus will start to spread again, they’ll have to lockdown again as numbers get too high again

That’s my thinking - it’s very unlikely to have disappeared

@claireb707 So the report suggests that the initial spike goes away, followed by further spikes in the Autumn onwards. The plan in the UK (as it stands) would be to suppress until the summer, then have a respite, followed by more suppression to manage the next spikes in the Autumn. The scientists behind the report therefore predict that China is currently experiencing the downward trajectory of their first spike, but that further spikes will happen again after a brief respite. They are saying that China are essentially a few months ahead of UK but the pattern will be the same. I hope it isn't true but that is what the report says, to answer your query.

I trust they know what they are doing and will follow all government guidelines to the best of my ability.

@Bluntness100 the report states the timeframe over rolling out of vaccines and there was another article in the Guardian going into the details on that, in terms of drugs / 'cures' or vaccines. They are all on the same timeframe of approx 18 months (minimum), and that is very fast. Apparently 10-20 years would be the normal timeframe for a new vaccine. 18 months is unheard of.

Op, not if it is a drug already approved and in use. That changes the time frame and game completely. You’re talking about something new. I’m talking about something that already exists, is produced and fda approved, and may have rh benefit of also curing corona.

They think an anti malaria drug and the hiv drugs cure it.

Agree with Snowy that we need to watch how China gets on for a bit longer before deciding whether they're back to normal.

@Bluntness100 that would obviously be wonderful if they could develop that, licence it and get it manufactured in enough quantities soon. 🙏

I don't think they're saying HIV or Malaria drugs can be used for protection against Corona virus, are they. I thought they were being considered as therapeutic options to treat people against the most adverse harmful symptoms of the virus.

If they get a vaccine out there in 18 months that'll be great but very racy timelines. The clinical trials process, even if accelerated, still takes many months for each round of testing as they ramp up from Phase I single numbers healthy volunteers through Phase III and IV introduction and large populations.

That is the thing, they are already licensed and being manufactured. And fda approved.

The drugs exist, they are commonly used to treat malaria and hiv. It seems the inhibitors that prevent hiv and malaria potentially also prevent corona taking hold further. They need to roll it out across other patients and trial it, And see if one works better than the other, or if both together work. But they are saying there may be a cure in existing drugs and we don’t need something new to cure.

So the whole point is they are tying to find a drug already in existance, that also cures corona and they think they could have found it. If they do, the time frame shortens hugely.

I don't think they're saying HIV or Malaria drugs can be used for protection against Corona virus, are they

No they are not saying it protects. It’s not a vaccine. A vaccine protects. They are saying it potentially cures. So if you get it, these drugs may cure. It is not for therapeutic use. They are saying they think it cures it.

Easter thanks. Goes a long way to explain the change of tack in last two days.

The other thing that is not being factored in is deaths due to delayed treatment.

The hospital I am being treated at is only doing emergency surgery. As I am stable my ‘urgent’ surgery is now delayed for months because 1) It requires an ITU stay and 2) My surgeon and his team are being redeployed into coping with C19.

I don’t want to live like this. I don’t know how I’m going to come to terms with it. I know that’s selfish but getting out to work and seeing people keep me sane.

I’m sitting here in floods of tears looking at my toddler thinking we were on a wee holiday this time two weeks ago. When is that going to happen again?

What is striking is that someone has commented above that they are concerned about their young child's socialization! We need to accept that the situation is clearly undesirable but the lack of playdates and social opportunities for kids is not the main cause for concern when reading the linked document predicting the death of thousands of people!

I don’t want to live like this. I don’t know how I’m going to come to terms with it. I know that’s selfish but getting out to work and seeing people keep me sane.

I'm the same. My mental health which isn't great at the best of times is really spiraling. I won't survive 18 months of this. I don't want to survive 18 months of this.

I live in China, not Wuhan, and a new phase has started. Relaxation of controls eg restaurants open, but increased controls re people returning to the country as they want to avoid a second wave of infections. I can’t get back home at the moment, but some of my friends have and are generally reporting it’s taking 10 hours from landing at the airport to get home due to form filling, temp checking, health declaration etc. You may be allowed to self isolate at home (compulsory for all arrivals) for 14 days or may have to go to a quarantine facility. This is for people with no symptoms.
Schools are still shut.

I sort of understand the policy adapted by government only yesterday, this is based on this virus can't be contained.

This virus is not like any other virus, there are lots of people carry it without symptoms and can pass the virus around without knowing it. And we are highly globalized. Unless every country on the earth do a thorough lock down, otherwise, even UK get to 0 case, then you might have another case come from somewhere. Then the circle start again.There is another horrible possibility, someone carry the virus, but no symptoms, and the virus stay with this person and can pass to other person a long time later. Lets hope this is not the case.

And , it seems very difficult to have a real lock down in UK anyway. So government is trying to control the rate that sick people flow to NHS and wait for the Vaccine.

So no school closures until after Easter? Why?
If I've understood it correctly;

1. The trigger level of occupied ICU beds has not been reached yet.
2. Closing schools will have a negative effect on NHS staff levels.
3. Closing schools will move the transmission of infection from amongst themselves in school to more spread in the community. (children seem not to have severe symptoms).

Surely once people are getting some immunity there will be no need for such drastic measures. At the moment no one has immunity so we could all go down at once.

It will be really really interesting to see what happens in China as normal life very gradually resumes. That should tell us most of what we need to know.

I think that’s why they think the tests to tell if someone has had it or not is critical, because then they get a better view of immunity, right now they don’t know.

I should clarify, that this assumes we will have a vaccine by Summer 2021.

Might be sooner;!

www.cam.ac.uk/research/news/cambridge-research-team-working-towards-vaccine-against-covid-19

DIOSynVax’s approach is much faster than current vaccine development technologies, says Heeney, which means that even allowing for essential pre-clinical mouse studies, his vaccine candidate could be ready for human clinical trials as early as June. He is currently seeking funding to pursue his work further and a pharmaceutical company with whom to partner on clinical trials.

Even with the suppression measures the govt predict that at the peak we will have around 12,000 COVID deaths per day. It's horrific to think about.

Hopefully hopefully they will build more hospitals and prioritise ICU beds and training of HCP. We need massive amounts of investment in the NHS.

The chief medical officer is hoping with the measures we can keep deaths below 20,000 if people comply.

And yes, scientists around the world are racing to find both a vaccine and a cure. Ideally from existing approved licensed drugs.