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Histograms of estimated numbers of infections worldwide
Estimated total number of infections (A), individuals requiring hospitalisation (B) and critical care (C) and deaths (D) in unmitigated and mitigated scenarios by World Bank region.

The Imperial College Report

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The Imperial College COVID-19 Response Team published Report 12: The Global Impact of COVID-19 and Strategies for Mitigation and Suppression on 26th March 2020.

This report [1] jolted many governments into action including helping to precipitate a change to the ‘lockdown’ policy of the UK. This step summarises the content of the report.

Summary from the report

The world faces a severe and acute public health emergency due to the ongoing COVID-19 global pandemic. How individual countries respond in the coming weeks will be critical in influencing the trajectory of national epidemics. Here we combine data on age-specific contact patterns and COVID19 severity to project the health impact of the pandemic in 202 countries. We compare predicted mortality impacts in the absence of interventions or spontaneous social distancing with what might be achieved with policies aimed at mitigating or suppressing transmission. Our estimates of mortality and healthcare demand are based on data from China and high-income countries; differences in underlying health conditions and healthcare system capacity will likely result in different patterns in low income settings.

We estimate that in the absence of interventions, COVID-19 would have resulted in 7.0 billion infections and 40 million deaths globally this year. Mitigation strategies focussing on shielding the elderly (60% reduction in social contacts) and slowing but not interrupting transmission (40% reduction in social contacts for wider population) could reduce this burden by half, saving 20 million lives, but we predict that even in this scenario, health systems in all countries will be quickly overwhelmed. This effect is likely to be most severe in lower income settings where capacity is lowest: our mitigated scenarios lead to peak demand for critical care beds in a typical low-income setting outstripping supply by a factor of 25, in contrast to a typical high-income setting where this factor is 7. As a result, we anticipate that the true burden in low income settings pursuing mitigation strategies could be substantially higher than reflected in these estimates.

Our analysis therefore suggests that healthcare demand can only be kept within manageable levels through the rapid adoption of public health measures (including testing and isolation of cases and wider social distancing measures) to suppress transmission, similar to those being adopted in many countries at the current time. If a suppression strategy is implemented early (at 0.2 deaths per 100,000 population per week) and sustained, then 38.7 million lives could be saved whilst if it is initiated when death numbers are higher (1.6 deaths per 100,000 population per week) then 30.7 million lives could be saved. Delays in implementing strategies to suppress transmission will lead to worse outcomes and fewer lives saved.

We do not consider the wider social and economic costs of suppression, which will be high and may be disproportionately so in lower income settings. Moreover, suppression strategies will need to be maintained in some manner until vaccines or effective treatments become available to avoid the risk of later epidemics. Our analysis highlights the challenging decisions faced by all governments in the coming weeks and months, but demonstrates the extent to which rapid, decisive and collective action now could save millions of lives.

Summary

Imperial College London is highly influential and the reports of its COVID-19 Response Team had a direct influence in changing UK Government policy from herd immunity to lockdown. More details are given on this in the next step.

Reference

[1] The Imperial College COVID-19 Response Team, Report 12 - The global impact of COVID-19 and strategies for mitigation and suppression,, Imperial College London, 26th March 2020. https://spiral.imperial.ac.uk:8443/bitstream/10044/1/77735/10/2020-03-26-COVID19-Report-12.pdf

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This article is from the free online course:

COVID-19: Pandemics, Modelling, and Policy

UNESCO UNITWIN Complex Systems Digital Campus