The Imperial College Report on COVID-19 Based on Epidemic Modeling

There have been more threads and hot takes about COVID-19 on WSO than I can count, but I thought it was important to cut through the noise and go over the findings from the WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics, and Imperial College London along with the historical context of the results. The group modeled different scenarios and extrapolated the impact each would have on America.

  1. The first scenario would be treating COVID-19 like the flu, a strategy advocated for on right-wing media for some time now up until a few days ago. In this scenario, "80% of Americans would get the disease. 0.9% of them would die. Between 4 and 8 percent of all Americans over the age of 70 would die. 2.2 million Americans would die from the virus itself. People with severe COVID-19 need to be put on ventilators. 50% of those on ventilators still die, but the other 50% live. But in an unmitigated epidemic, the need for ventilators would be 30 times the number available in the US. Nearly 100% of these patients die. So the actual death toll from the virus would be closer to 4 million Americans -- in a span of 3 months. 8-15% of all Americans over 70 would die. How many is 4 million people? It's more Americans than have died all at once from anything, ever. It's the population of Los Angeles. It's 4 times the number of Americans who died in the Civil War...on both sides combined. It's two-thirds as many people as died in the Holocaust. Americans make up 4.4% of the world's population. If we extrapolate these numbers to the rest of the world (warning: MOE is high here), this gives us 90 million deaths globally from COVID-19, in 3-6 months. 15 Holocausts. 1.5 times as many people as died in all of World War II."

  2. The second scenario is the mitigation strategy - quarantining people with the virus, social distancing, "flattening the curve," all to avoid overwhelming the hospitals. "And it does flatten the curve -- but not nearly enough. The death rate from the disease is cut in half, but it still kills 1.1 million Americans all by itself. The peak need for ventilators falls by two-thirds, but it still exceeds the number of ventilators in the US by 8 times. That leaves the actual death toll in the US at right around 2 million deaths. The population of Houston. Two Civil Wars. One-third of the Holocaust. Globally, 45 million people die: 7.5 Holocausts, 3/4 of World War II. That's what happens if we rely on mitigation & common sense.

  3. The third scenario is the suppression strategy, or "shut everything down." This has been decried as authoritarian or un-American by some. To date, this has been implemented haphazardly across the country, if at all. The thing is - "The death rate in the US peaks 3 weeks from now at a few thousand deaths, then goes down. We hit but don't exceed the number of available ventilators. The nightmarish death tolls from the rest of the study disappear. But here's the catch: if we EVER relax suppression before a vaccine is administered to the entire population, COVID-19 comes right back and kills millions of Americans in a few months, the same as before. After the 1st suppression period ends in July, we could probably lift restrictions for a month, followed by 2 more months of suppression, in a repeating pattern without triggering an outbreak or overwhelming the ventilator supply. Staggering breaks by city could do a bit better. But we simply cannot EVER allow the virus to spread throughout the entire population in the way other viruses do, because it is just too deadly. If lots of people we know end up getting COVID-19, it means millions of Americans are dying. It simply can't be allowed to happen."

Finally, there is the time period - which is approximately 18 months until vaccines are created, tested, confirmed safe, and widely distributed.

I want everyone who is currently downplaying this, whining about not being about to go out to eat, talking about this is purely economic terms with the assuming that makes them more elevated than all of the "emotional" people concerned with the human toll, to read those numbers again and realize how dramatically they change based on steps taken. America has the option of killing 4 million Americans, 1.1-2 million Americans, or a few thousand Americans. America has the option of a death toll at 2/3 of the holocaust, two Civil Wars, or less than the seasonal flu.

 

In somewhat positive news, I've been following the discussion of the report online and found this response from Bill Gates of all people on it.

Bill Gates:
Fortunately it appears the parameters used in that model were too negative. The experience in China is the most critical data we have. They did their "shut down" and were able to reduce the number of cases. They are testing widely so they see rebounds immediately and so far there have not been a lot. They avoided widespread infection. The Imperial model does not match this experience. Models are only as good as the assumptions put into them. People are working on models that match what we are seeing more closely and they will become a key tool. A group called Institute for Disease Modeling that I fund is one of the groups working with others on this.

I am personally highly suspicious of any data from China, but I also trust Bill Gates to be a bit more dialed in than I am.

Commercial Real Estate Developer
 

I just read this article last night. Interested to hear your thoughts.

“The three most harmful addictions are heroin, carbohydrates, and a monthly salary.” - Nassim Taleb
 
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This quote certainly makes logical sense:

Michael Levitt:
The reason for the slowdown is due to the fact that exponential models assume that people with the virus will continue to infect others at a steady rate.

I would certainly be interested in learning more about this part though:

Michael Levitt:
But on February 7, something changed. “The number of new infections started to drop linearly and did not stop," Levitt said. "A week later, the same happened with the number of the deaths. This dramatic change in the curve marked the median point and enabled better prediction of when the pandemic will end. Based on that, I concluded that the situation in all of China will improve within two weeks. And, indeed, now there are very few new infection cases.”

His point on how economic models work could be an explanation, but it could also not be the explanation or the only explanation.

Commercial Real Estate Developer
 

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