Boris JohnsonEvery day brings a new set of screaming headlines.

Just moments ago I learn the death toll in Italy has increased by a shocking 16% in just 24 hours.  

And earlier today I read the chilling report from the expert team of epidemiologists at Imperial College, London which predicts in an unmitigated epidemic

“approximately 510,000 deaths in Great Britain and 2.2 million in the United States, not accounting for the potential negative effects of health systems being overwhelmed on mortality.”

Fortunately, in countries around the globe - including here in Canada - steps are being taken to arrest the spread of the coronavirus. Today Ontario declared an emergency.

But why are schools still open in the UK when every other country in Europe (other than Belarus) has closed theirs. What am I missing here?

This glaring loophole must surely be closed soon. 

Keynes famously observed that: 

“When the facts change, I change my mind. What do you do Sir?”

It seems some dummies carry on regardless.

I include in this category Boris Johnson’s high risk 79 year old father, Stanley, who vows to ignore advice and go off to the pub if he wants to. 

The Imperial College report estimates that 24.3% of 70-79 years olds with symptoms will require hospitalisation. And, of those, 43.2% will need critical care. For the over 80s the figures are even more alarming. 

Someone should whisper in Stanley's ear. 

COVID 19 is nothing to joke about. 

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Yesterday’s report (Monday 16 March 2020) from Imperial College says this: 

Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely. Each policy has major challenges. 

We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option. 

We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed.