Tonight #DeborahBirx stated that models anticipating large-scale transmission of COVID-19 do not match reality on the ground. Our modeling (done by @StephenKissler based on work with @ctedijanto and @yhgrad and me) is one of the models she is talking about.
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We received a request to model dozens of scenarios from the US government at 5pm on Tuesday. We responded to many of these on Wednesday evening, thanks to fast and careful work by
@StephenKissler. This was done in good faith in order to help support the USG response.25 replies 589 retweets 3,791 likesShow this thread -
Modeling the scenario of intense social distancing for a temporary period, followed by a letup, produces predictions of resurgent transmission and large epidemics, with the exact consequences depending on the degree and duration of reduced transmission during social distancing.
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Dr. Birx's statements today https://www.realclearpolitics.com/video/2020/03/26/dr_birx_coronavirus_data_doesnt_match_the_doomsday_media_predictions_or_analysis.html … indicated that "when people start talking about 20% of a population getting infected, it's very scary, but we don't have data that matches that based on our experience."
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True. We are near the beginning of the epidemic, with most people still susceptible. China and Korea have suppressed transmission by massive testing, combined in China with far more intense distancing than here and in Korea with significant distancinghttps://learningenglish.voanews.com/a/south-korea-tries-social-distancing-to-prevent-coronavirus-spread/5316633.html …
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If our social distancing works it is possible we will not just flatten the curve, but get a decline in cases. Under a best-case scenario, we will keep that policy in place long enough to get down to very, very few cases domestically.
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If at the same time we ramp up testing capacity and the ability to trace contacts, in a very best-case scenario, we might conceivably be able to turn to a Korea- or Singapore-style mix of less intense distancing combined with super-intense contact tracing, isolation, quarantine
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That will not be easy with this virus as our
@CCDD_HSPH analysis has shown https://www.medrxiv.org/content/10.1101/2020.03.05.20031088v1 … but as some (mainly island) countries have shown, it may be just possible. We should do everything we can to reach for this goal, even if it is unattainable.14 replies 476 retweets 2,984 likesShow this thread -
But here's why it is a best-case, likely unattainable scenario. 1) We have not proven that US-style social distancing can produce R_effective<1 (declining case numbers). On this I'm hopeful, but it's a hope not a fact.
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Replying to @mlipsitch
If preventing most everyone in US from being infected before vaccine comes is most likely unattainable, why not start in on variolation, which has cut death rate of infected by x3-30 for other viruses?
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I think at this time we do not know enough about viral load at time of transmission, ergo, we can’t because of the Hippocratic oath, “first do no harm”. I agree with should be experimenting with variolation but that’s basically what vaccine testing is.
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To be clear, I mean whether or not a small amount of the virus can snowball into a bad infection. We don’t know.
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