Yes, epidemics may well decline in some locations because of infection-acquired immunity, but a lot of countries are currently making the assumption that they will be able to find a better option (treatment, vaccine etc.)
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Replying to @AdamJKucharski
The realistic outcome is at neither extreme; we will hopefully have better treatments and vaccines that help, but immunity will also probably affect trajectories in the meantime, which means it is likely dangerous to ignore the effects policies have on age-distributions, etc.
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Replying to @WesPegden @AdamJKucharski
Wes Pegden Retweeted Wes Pegden
Basically I think we are making an unjustified implicit assumption that immunity will not affect trajectories until a game-changing development. Immunity undercuts a monotone relationship between mitigations/outcomes, and calls for strategic thinking.https://twitter.com/WesPegden/status/1293279894743457793 …
Wes Pegden added,
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Replying to @WesPegden
Think it’s matter of aim vs outcome. There’s difference between working to protect risk groups from local transmission (e.g. https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 …) vs assuming epidemic can be tailored to build high level of infection in some without having high level of disease in others...
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Replying to @AdamJKucharski @WesPegden
Basically, countries have to decide if they want high prevalence & high disease burden (+ restrictions to stop runaway hospitalisations) while post-infection immunity builds (and hopefully persists). Or keep R<=1 with low prevalence while awaiting better options for immunity.
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Replying to @AdamJKucharski
I disagree with the dichotomy in the 1st of these two tweets. Also I don't think what matters is whether countries "want" high prevalence and disease burden or "want" low prevalence and better options. Planning should account for likely outcomes, not just what we ideally want.
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Replying to @WesPegden @AdamJKucharski
In particular, if we "want" low prevalence, but nevertheless *think* that significant future case increases are probable, then it is a mistake not to account for immunity phenomena when making plans.
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Replying to @WesPegden @AdamJKucharski
What would be the practical effect of accounting for immunity? What would we do different?
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Replying to @zeynep @AdamJKucharski
One example of a simple principle is that any time relaxations are planned, we should aim to have them happen earlier for younger people. E.g., we could have had leniency for collecting UI after being called back to work, based on age. More generally, it is particularly...
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important to focus on sustainable measures for young adult populations. Decision-makers currently believe that even temporary transmission reductions can only help. But particularly for young adult populations, this can be false It's fine to say it's best to just depress...
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Age-gradations can make sense for many contexts, but they don’t pertain to existing levels of prior immunity? I thought you were arguing places with prior outbreaks should have different policies.
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Replying to @zeynep @AdamJKucharski
I was actually not talking about different policies for different locations based on prior outbreaks, but I can see why it looks like that given how it started.
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I'm really just saying that if we think immunity matters, the implications of this should be discussed as part of policy strategy.
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End of conversation
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