For countries able to achieve it, this leaves suppression as the preferred policy option. [...] 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. We show that intermittent social distancing—triggered by trends in disease surveillance—may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound.
So it’s not really saying “lock down for 18 months or do nothing”. It’s saying lock down until the problem is controlled and then squash new outbreaks quickly. The Hammer and the Dance article makes this point more clearly in my opinion, especially pointing out that a temporary lockdown would give us time to build up test and treatment capacity, protective equipment supplies, etc, and implement strategies for tracing and suppressing the new cases that arise after it’s lifted. However it does say “a few weeks” of strict lockdown will be enough without really supporting it well, and that seems optimistic (Bill Gates, for instance, has been saying 6-10 weeks).
Hm. Doesn’t the paper go on to say that full lockdowns would need to be in effect for 2⁄3 of those 18 months? I will read that article, but I don’t think the paper is saying that we could return to normal with monitoring and case tracing and localized lockdown to quash outbreaks for the remainder of the 18 months.
e: Okay, read the paper. Respectfully, many of the estimated numbers there seem entirely inconsistent with the literature that I’ve been reading from epidemiology experts. I haven’t seen a single paper estimating 10 million deaths in the United States, and I’m not inclined to trust an uncredentialed medium post (I know this is relevant to the OP topic).
I also really value modeling. Ferguson ran the numbers and seems to suggest that “the dance” would not be an effective approach for suppression long term and that we would need to go under frequent shelter-in-places again. This medium article doesn’t seem to cite any sort of number crunching that the hammer followed by the dance would work for long-term suppression.
It said the fraction would be a bit lower for the US because local outbreaks could be dealt with by state-level lockdowns, but I didn’t see a hard number. Still, intermittent lockdowns for 18 months seems much more achievable than a continuous lockdown. The Hammer article is definitely more optimistic than the Imperial paper, though it still doesn’t quite imply “return to normal”.
Since “do nothing” is not a real option, what will actually happen in the US (I’m moderately confident) is some degree of lockdown for several weeks to several months depending on how effective it is. The sooner we start it the better it will work. After that we will either: 1) give up, if the lockdown was ineffective and a large fraction of the country is infected (this is “flattening”), or 2) if the lockdown succeeded in reducing the number of cases substantially, we’ll move into a period of intermittent and possibly localized lockdowns interspersed with trying to test and contact trace. The fraction of time we spend in intermittent lockdowns will depend on how effective the testing and tracing is.
From the Imperial College paper:
So it’s not really saying “lock down for 18 months or do nothing”. It’s saying lock down until the problem is controlled and then squash new outbreaks quickly. The Hammer and the Dance article makes this point more clearly in my opinion, especially pointing out that a temporary lockdown would give us time to build up test and treatment capacity, protective equipment supplies, etc, and implement strategies for tracing and suppressing the new cases that arise after it’s lifted. However it does say “a few weeks” of strict lockdown will be enough without really supporting it well, and that seems optimistic (Bill Gates, for instance, has been saying 6-10 weeks).
Hm. Doesn’t the paper go on to say that full lockdowns would need to be in effect for 2⁄3 of those 18 months? I will read that article, but I don’t think the paper is saying that we could return to normal with monitoring and case tracing and localized lockdown to quash outbreaks for the remainder of the 18 months.
e: Okay, read the paper. Respectfully, many of the estimated numbers there seem entirely inconsistent with the literature that I’ve been reading from epidemiology experts. I haven’t seen a single paper estimating 10 million deaths in the United States, and I’m not inclined to trust an uncredentialed medium post (I know this is relevant to the OP topic).
I also really value modeling. Ferguson ran the numbers and seems to suggest that “the dance” would not be an effective approach for suppression long term and that we would need to go under frequent shelter-in-places again. This medium article doesn’t seem to cite any sort of number crunching that the hammer followed by the dance would work for long-term suppression.
It said the fraction would be a bit lower for the US because local outbreaks could be dealt with by state-level lockdowns, but I didn’t see a hard number. Still, intermittent lockdowns for 18 months seems much more achievable than a continuous lockdown. The Hammer article is definitely more optimistic than the Imperial paper, though it still doesn’t quite imply “return to normal”.
Since “do nothing” is not a real option, what will actually happen in the US (I’m moderately confident) is some degree of lockdown for several weeks to several months depending on how effective it is. The sooner we start it the better it will work. After that we will either: 1) give up, if the lockdown was ineffective and a large fraction of the country is infected (this is “flattening”), or 2) if the lockdown succeeded in reducing the number of cases substantially, we’ll move into a period of intermittent and possibly localized lockdowns interspersed with trying to test and contact trace. The fraction of time we spend in intermittent lockdowns will depend on how effective the testing and tracing is.