Current Response to COVID-19 is Not the Best Response
By Barry Farah
Guest Editorial in The Gazette, March 25, 2020
The Imperial College of London produced a report released March 16. In this report, an impressive team of pandemic experts used mathematical models to predict the outcomes of three potential responses to COVID-19. Those responses are do nothing, suppression or mitigation.
Informed in part by this study and using the levers of emergency powers, a rendition of the suppression response has been imposed upon us. After a deep dive into the data, here is a summary of the three potential responses and the reasons why I recommend mitigation instead of suppression.
Do nothing. If we do nothing and let the virus run its course, hospitals will be overrun in April to a peak of 30 times capacity by June. After two months of chaos in May and June, the nation will be effectively immunized by late summer.
The alarming concern with this option is the prediction of 2.2 million deaths in the U.S. However, the death rate is likely less than predicted with the do nothing strategy since millions of people are doing something, like washing hands, using Lysol and social distancing.
Suppression. This is the current approach and includes general quarantine, except for food and medicine, self-distancing, closure of schools, businesses and potential lockdowns. With suppression, we are counting on having a vaccine. If an effective vaccine is developed in 12 to 18 months, it could reduce deaths to below mitigation. But it is a long slog with a huge negative impact socially and economically. The Imperial College admits that this strategy has “enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term.” The suppression strategy also seems to be driven by ICU bed capacity.
Suppression involves the quarantine approach until September, and then rotating quarantines through September 2021. It doesn’t allow for a process to build “herd immunity,” and likely results in 1.3 million deaths from November through December of this year. It could become the worst Christmas in American history!
The Imperial College recommends that the quarantines be turned on and off until the immunizations are in full swing.
So, after five months of initial lockdown (which we are in) you relax things for a week and then lock everything down again for three weeks on a rotating basis. In many instances this just delays deaths by a few months. Yet, it crushes the economy and the human spirit as the world shuts down.
Mitigation. If we mitigate by urging those with symptoms or who have tested positive for the virus to self-quarantine, the projected death toll is 1.1 million (or less with better general hygiene). It would also decrease ICU demand by 67% over the do nothing strategy.
According to Imperial College, the most effective mitigation strategy is limited to these three tactics:
Home isolation for people with symptoms for seven days after symptoms are gone
Home quarantine for the other members of the household where one or more people have symptoms or have been diagnosed, for 14 days after the onset of the symptoms
Social distancing relative to those over the age of 70 especially those with preexisting conditions
In addition, with mitigation we should reopen schools, allow businesses to be back in business, and permit people to fly within the U.S. We will see some slowdown of the advance of the disease and relatively quick “herd immunity.”
Closing schools, as in the suppression approach, actually increases the death rate. Keeping schools open allows younger people to get infected faster and recover faster, while using the home isolation/home quarantine approach.
Note that with any of the three options, the vast majority of the deaths will occur with people over the age of 70.
If we act now and change to a mitigation strategy, we can reverse the economic free fall caused by suppression.
We also need to clearly articulate — so businesses can rely upon it — that government authority can no longer expand emergency powers beyond mitigation.
Barry Farah is a business executive, author and speaker and previous candidate for governor of Colorado.
The following long version of Barry’s comments on the response to COVID-19 along with graphs is provided here:
The Best Response to COVID-19 is Mitigation, not Suppression
By Barry Farah
The Imperial College of London produced a report released March 16, 2020. In this report, an impressive team of pandemic experts used mathematical models to predict the outcomes of three different potential responses to COVID-19. Those responses are Do Nothing, Suppression or Mitigation.
Informed in part by this study and using the levers of emergency powers, a rendition of the Suppression response has been imposed upon us. After a deep dive into the data, here is a summary of the three potential responses and the reasons why I recommend Mitigation instead of Suppression.
Do Nothing. If we do nothing and let the virus run its course, hospitals will be overrun in April to a peak of thirty times capacity by June. After two months of chaos in May and June, the nation will be effectively immunized by late summer. (See Graph A below with Do Nothing info box)
The alarming concern with this option is the prediction of 2.2 million deaths in the U.S. The graph demonstrating this approach is included in option three below. As a comparison, the flu took 61,200 in the US in the 2018-19 season. And, the 1918 H1N1 took the lives of 675,000. At that time, the population of the US was 103 million. That is the same death rate of 0.6% of the population that is predicted here. This assumes: “…the (unlikely) absence of any control measures or spontaneous changes in individual behavior…”Therefore, it would likely be much less, since the prediction does not factor in new hygiene, cleaning and social distancing.