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Save Two Million American Lives—Social Distance for Two Years

Did these 31 scientists save millions of lives?

Neil M Ferguson, Daniel Laydon, Gemma Nedjati-Gilani, Natsuko Imai, Kylie Ainslie, Marc Baguelin, Sangeeta Bhatia, Adhiratha Boonyasiri, Zulma Cucunubá, Gina Cuomo-Dannenburg, Amy Dighe, Ilaria Dorigatti, Han Fu, Katy Gaythorpe, Will Green, Arran Hamlet, Wes Hinsley, Lucy C Okell, Sabine van Elsland, Hayley Thompson, Robert Verity, Erik Volz, Haowei Wang, Yuanrong Wang, Patrick GT Walker, Caroline Walters, Peter Winskill, Charles Whittaker, Christl A Donnelly, Steven Riley, and Azra C Ghani are listed as the authors of “Impact of Non-Pharmaceutical Interventions to Reduce COVID-19 Mortality and Healthcare Demand,” Monday’s report from Imperial College London on computer models of the spread of the novel cornoavirus and the impact of public health interventions. The report, which apparently roused the White House and 10 Downing Street to more serious responses to the pandemic, makes clear why we are shutting down our schools and businesses and staying home and why we will continue staying away from each other like this for the next two years, until scientists develop an effective vaccine.

The Imperial College COVID-19 Response Team calculates that if we all acted like Donald Trump in February or spring breakers last week in Florida, if we just let coronavirus run its course like any other disease, 510,000 Brits and 2.2 million Americans would die by August of covid-19:

UK/US mortality from unmitigated covid-19, from Ferguson et al., "Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand," Imperial College London, 2020.03.16.
UK/US mortality from unmitigated covid-19, from Ferguson et al., “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand,” Imperial College London, 2020.03.16, p. 7.

…and that’s “not accounting for the potential negative effects of health systems being overwhelmed on mortality”—folks with other maladies who won’t be able to get normal treatment because doctors and nurses are swamped treating covid-19 patients with jerry-rigged ventilators.

We’ve already lost 260 Americans and 177 Brits to the coronavirus, and we will lose more. But how many lives can we save?

The Imperial College team does not recommend complete and continuous lockdown. If none of us stepped out of our houses for two years, sure, none of us would get coronavirus, but we’d also eat our couches.

Nor do the researchers say we can solve the problem with one short suppression period. If we all stay home and live on Amazon delivery for a few weeks or a few months, then go right back to normal life, we just shift the sickness and hospital overload to fall or winter:

Ferguson et al., graph of critical care usage under one-time suppression measures, 2020.03.16 p. 10.
Ferguson et al., graph of critical care usage under one-time suppression measures, 2020.03.16 p. 10.

Instead, the researchers model “adaptive triggering of suppression strategies” that kick in when the number of coronavirus patients admitted to intensive care units each week climbs above a certain threshold and end when those society-wide isolation measures reduce ICU cases to some fraction (like a quarter) of that trigger value. The model assumes that universal social distancing and school and university closure switch on and off, while “home isolation of suspect cases, home quarantine of those living in the same household as suspect cases” continue uninterrupted.

This adaptive triggering results in several sharp but manageable spikes of ICU usage:

Ferguson et al., ICU usage under adaptive triggering, 2020.03.16, p. 12.
Ferguson et al., ICU usage under adaptive triggering, 2020.03.16, p. 12.

The Imperial College scientists run a lot of numbers and produce a wide range of possible impacts based on varying on/off triggers and contagion rates and intensity of suppression measures. If covid-19 is slightly less contagious, the model predicts that nationwide social distancing and school closures imposed 64% of the time over the next two years in conjunction with continuous case isolation and home quarantine would reduce deaths in Great Britain from the do-nothing 460,000 to 17,000. That’s a 96% reduction on fatalities. If covid-19 is slightly more contagious, those same suppression measures would be triggered more frequently—83% of the time—and would reduce deaths from 550,000 to 30,000.

“Results are qualitatively similar for the U.S.,” says the report, so staying away from each other for eight to ten months of the year could save 1.8 million to 2.1 million American lives.

The Imperial College team says nationwide social distancing, school closures, and home isolation of cases constitute “a minimum policy for effective suppression.” The scientists note that infection rates vary from place to place—South Dakota might see a surge in ICU cases while Iowa sees a decline, or Minnesota might hit an “on” trigger while Wisconsin is still below the threshold—so national suppression policies need to allow local flexibility for greater efficiency.

But two million lives. Two million American lives.

Two million lives is why we’re taking classes online. Two million lives is why we’re not having graduation ceremonies or receptions for the Class of 2020… and maybe not for the Class of 2021. Two million lives is why we’re not eating out or going to see Night Ranger at the Aberdeen Civic Arena on May 22. Two million lives is why we’re working at home. Two million lives is why we’re going to shut down a lot of small and large businesses and ration groceries and see dollar-a-gallon gasoline and still not go on any long roadtrips. Two million lives is why we are going to ride out an economic depression with socialist interventions, just like we had to in the 1930s.

Two million lives is why we will not shake hands or socialize or live normally for the rest of this year, or next year.

Two million lives is why we must listen to those 31 scientists and follow their advice. It’s our duty to throw out our normal way of life to save those lives… and give scientists time to save the world again with a vaccine.

15 Comments

  1. jerry 2020-03-21

    12 years ago, when we were Great. remember that? We would’ve jumped on the idea of taking care of one another and abide by social distancing for the good of everyone. We had hope because we had done something no other western country had done, we had enough of what was done to us and we put someone we trusted as our leader.

    The republican could not stand that a black man was leading us and did everything they could to make him a one term president, they failed and we still led the world. In 2020, we have a failed and flawed federal government that does all it can to destroy everything it can get it’s soiled hands on for their own profit.

    China now leads the world, where we used to. As we are now seeing, more country’s are tiring of our sanctimonious sanctions that only deal death to country’s poor and nothing to make anyone’s situation better but the big oil company’s. These solve nothing.

    “We are seeing it right now with China, which, after the fact, has responded more aggressively to the pandemic at home and abroad. Note what Ursula von der Leyen, the president of the European Union Commission, tweeted on March 18: “Spoke to Chinese PM Li Keqiang who announced that China will provide 2 mil surgical masks, 200,000 N95 masks and 50,000 testing kits. In January, the EU helped China by donating 50 tons of equipment. Today, we’re grateful for China’s support. We need each other’s support in times of need.”

  2. Debbo 2020-03-21

    Dr. David S. Jones has written a very thoughtful piece in the New England Journal of Medicine about the history of epidemics.

    “Rosenberg argued that epidemics put pressure on the societies they strike. This strain makes visible latent structures that might not otherwise be evident. As a result, epidemics provide a sampling device for social analysis. They reveal what really matters to a population and whom they truly value.”

    There’s lots of good stuff and it’s not very long. I found that putting more context around the trump/GOP virus was helpful to me. It might be for you too.
    is.gd/yxpWAk

  3. John 2020-03-21

    While this, COVID-19, is not a that, Spanish Flu; they have similarities in the pandemic world. While our information, transportation, and medicine is FAR faster and better than it was in 1918-19; human nature is unchanged. We still strive to hide inconvenient truths, foolishly using hope as a method that things may get better.

    Consider reading: https://www.amazon.com/Great-Influenza-Deadliest-Pandemic-History/dp/0143036491.

    My grandfather (b. 1894) discussed the Spanish Flu with me. That WWI vet, later college professor and department head, turned ashen recalling events 50-60 years earlier in his life. I was a teen, then early college student. My recall of his exact recollection is unreliable, other than his responses and Spanish Flu experiences had a profound impact on his life.

    Yet COVID-19 is not the Spanish Flu. The Flu often killed people in a day. The Flu attacked all ages and genders. COVID-19 kills more males and generally more over 50 — but a significant number under 50 succumb. Certainly COVID-19 will kill tens of thousands, perhaps low millions. Yet, the reports from government and western business sources from China are that Chinese factories and businesses are largely back to work at near capacity or will be in weeks. We will have to practice social distancing until the widespread administration of vaccinations. (Hopefully this will ‘kill’ the anti-vac’ nonsense.)

    The Imperial College study is a wake up call to the deniers and ‘hoax’ promulgators. Yet, this, COVID-19, need not be, a that – the Spanish Flu — if we pay attention and care for our fellow wo/man.

    For a glance of our world beyond COVID-19, especially for our kids and grandkids, consider these thoughts: https://www.politico.com/news/magazine/2020/03/19/coronavirus-effect-economy-life-society-analysis-covid-135579

  4. Debbo 2020-03-21

    Good comment John. As a history teacher I became fairly familiar with the devastation of the Spanish Flu.

    I read the Politico piece earlier today and it left me shaken. I find myself looking for the space between facing reality head on and needing a modicum of denial to maintain a positive mental attitude and the energy needed to stay above debilitating depression and anxiety. I’m certain there are millions of Americans and others all around the globe in similar circumstances.

    The most heartening and encouraging thing I see is the eagerness of humans to be of service to one another in this pandemic. I find people being kinder, more helpful and patient. It’s a beauty I see that far overwhelms the hoarders, the deniers, the troublemakers.

    We humans really are marvelous creatures and I am so grateful it brings tears to my eyes.

  5. John 2020-03-22

    Debbo: consider hosting a small virtual Facetime cocktail party.
    We partook in one last evening with just 2 couples lasting about 90 minutes. The experience was uplifting, reduced anxiety, and brightened my outlook.

  6. Cory Allen Heidelberger Post author | 2020-03-22

    Denial will kill two million people. Covid-19 will not be the Spanish flu only if we change how we behave and plan to maintain those changes for months, not weeks.

  7. o 2020-03-22

    Is the United States a nation that looks forward long-term and is willing to make individual sacrifice for the betterment of others – even others we do not even know? When this pandemic has passed, will the US look like post-hurricane Puerto Rico?

  8. jerry 2020-03-22

    Graph shows that by April 12, 2020, our hospitals will be overloaded and that we can expect 18,000 deaths here in South Dakota due to Covid-19 if we continue to do nothing. https://covidactnow.org/state/SD

    We should start a pool to bet how close this graph is to the real thing. Kind of like sport’s betting. The problem with that would be, who knows who will survive to make make the payoff or even if there will be a payee.

  9. Cory Allen Heidelberger Post author | 2020-03-22

    Jerry: continue to do nothing? Aren’t we doing something? Aren’t we already bending the death curve and the hospital overloading curve?

  10. jerry 2020-03-22

    Alas Cory, we continue to do nothing. As an example, we had a person who came by air and left by air from Rapid City that was contaminated. That person stayed in a hotel in Rapid City and ate in restaurants in Rapid City and then went to classes in the Security First Bank building in Rapid City. The bank claims 4 people were in contact with the person, then those 4 went out and about and came into contact with whomever and on it goes for all of these cases in South Dakota, including the Pennington County dead guy, that we know of a week or so ago. No details so we can protect ourselves, we’re on our own.

    No, we are doing absolutely nothing. We still go out to the same places these infected people were and we still freely move in the same circles as those infected. The only thing bending is us bending over to accept the poor leadership along with the half baked idea that we are somewhat isolated. How can that be for a plane load of people coming to Rapid City and then dispersing and a plane load of people leaving Rapid City and dispersing? We are failing bigly.

    Let us see how the projections come out. My guess is that the overloading will come sooner.

  11. jerry 2020-03-22

    Cory, finally, some leadership!! We may have just bought some more time! This will also tend to keep outside visitors out of Rapid City’s establishments and only come to the city for needed goods and medicines. Bravo Mayor, thanks for being a leader. GNOem, and the rest, where the hell are ye?

    “Rapid City Mayor Steve Allender said Sunday he is recommending a city ordinance that would close public bars, restaurants and other recreational facilities because of the coronavirus outbreak. The Rapid City Common Council will meet in an emergency session at 6 p.m. Sunday to discuss the ordinance.

    In a Sunday afternoon news conference, Allender said the proposed ordinance would impact the following types of businesses for a period of at least 60 days:

    Restaurants;
    Food courts;
    Coffee houses;
    Bars;
    Breweries;
    Distilleries;
    Wineries;
    Clubs;
    Cafes;
    Other similar places of public accommodation offering food and beverage for on-site consumption, including any alcohol license with on-site consumption privileges, including casinos;
    All recreational facilities;
    Pools;
    Health clubs;
    Athletic facilities;
    Theaters, including movie theaters;
    Music entertainment venues;
    Hookah lounges;
    Cigar lounges;
    Vaping lounges;
    Other similar businesses which allow for on-site consumption;
    Arcades;
    Bowling alleys;
    Bingo halls;
    Indoor climbing facilities;
    Skating rinks;
    Trampoline parks;
    Other similar recreational or entertainment facilities.
    Allender said the ordinance would allow restaurants to continue providing drive-through, outside pick-up and delivery services.” Rapid City Journal 3.22.20

  12. Debbo 2020-03-22

    Thanks for an excellent suggestion John. ❤

    Good for Allender!

    I watched most of Klueless Kristi’s last presser and came away completely uninspired. She didn’t seem to be offering Liar-in-Chief level bs and KK did seem very willing to share the mic with state government officials. I guess I can say she showed mediocre competence. 🙄

  13. Debbo 2020-03-23

    I heard about that Mike. They’re doing a variety of images now, calling it a scavenger hunt. That Spencerian/Spencerite had a great idea.

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