UK cranks up social distancing a notch

Written 16 March 2020, 6pm UK time. Any errors or poor interpretation of the modelling data, please shout, this is very much a rapid review on my part.

From the CMO today, we have seen social distancing cranked up a notch or two, but not the mass lockdowns we’ve seen elsewhere. As per a previous post of mine, I’m still cautiously thinking this is the correct move. To quote from the paper I talk about below “The choice of interventions ultimately depends on the relative feasibility of their implementation and their likely effectiveness in different social contexts.”
That may well at some point include large scale lockdowns, but that doesn’t mean it’s the thing to do right now. And by right now, I mean today. Outbreaks move fast, and interventions will also be scaled up and changed as we go through the next few weeks. That’s an important point to remember.

But it would be so useful to see that underlying data that is making up the decisions by the government. I’d really like to see a dashboard, a little like the visualisations of case numbers and deaths per country, that stores the evidence base behind each country’s government policy. Not just the UK, but as many countries as possible. It’s not as headline-grabbing as discussing mortality rates, but no less important.

Speaking of some underlying data — today’s press conference coincides with the release of this paper from Neil Ferguson and colleagues, from Imperial College London (who are world leaders and very much worth taking notice of what they say), and clearly the Ferguson paper has informed CMO thinking.

See the image, this is figure 2 from their paper, https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/ (do give the whole article a read, there’s a huge amount to unpick there).

The measures put in place now (and future measures) appear to be aimed at getting as close to meeting the blue curve as possible. In this modelling paper, the measures are assumed to be in place for 12 weeks. They also speak of ‘switching on and switching off’ interventions. So again, important not to make poor interpretations of any policy change being a ‘failure’ or ‘U-turn’, because we will see these revisions as part of planned and responsive policy measures.

There is mention that stopping mass gatherings will have limited impact because ‘because the contact-time at such events is relatively small compared to the time spent at home, in schools or workplaces and in other community locations such as bars and restaurants.’

There are added assumptions around compliance from the population, that these the models are based on. So for example, the researchers are assuming 50% compliance with the new household quarantine measures put in place.

There is also a somewhat sobering reminder in their concluding sentences that ‘Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over.’

Which brings us back to the issues of appropriate interventions at the right time. Would you want to be responsible for making these decisions right now?

Clearly, levels of compliance will be so important to make these measures a success. But for us researchers, they will be fascinating to observe as we go through the spring and summer, both to inform this pandemic, and also the next one (whenever that be)

Michael Head
University of Southampton,
Twitter — @michaelghead