Model showing significant changes in peak
IHME Model showing significant changes in peak resource use.
The Murray model is making significant adjustments daily in individual state projections so don’t just follow the media for what is happening nationally. Overall estimates of national ventilator needs have dropped significantly. As of today:
- Florida projections of peak resource is April 21st
- United Kingdom projections of resource is April 17th
- California projections of peak resource is April 13th
- National projections of peak resource use is April 11th
- New York projections of peak resource use is April 8th today
- Washington State projections of peak resource was April 2nd
Asian countries are showing some second bumps in cases, notably Singapore that has a very effective public health response. It announced that there were 142 new cases today and the reimposition of full lockdown.
Moving from a population-based containment model to a case-based containment model
As we move through the peak, there will be a vigorous national debate on how to restart the economy and still have an effective public health strategy.
The 25% sudden drop in economic output is unprecedented, it is larger than the Great Depression and comparable to war within a country. There is a considerable body of literature to show that unemployment and economic distress has its own impact on health outcomes that are considerable.
The critical question we will need to figure out in the next few weeks is how to move our public health strategy from a population-based containment model (e.g., same rules for everyone) to a case-based containment model (i.e., specific rules for those who are actively infected.) An approach that will preserve our civil liberties and privacy.
More on this to come but a couple of principles will be critical
- We need an effective IgG and IgM test to see whether citizens are actively infected or immune. Ideally this is a point of care, reliable and with rapid turnaround time.
- We need effective surveillance processes to find new infections. Digital apps will be critical. As a public service announcement please take a look at www.detectstudy.org for a research study by Scripps that is looking at how to use apps to best monitor health anonymously.
- We will need a significant deployment of newly trained caseworkers to follow-up newly infected individuals to trace contacts (new opportunities for those who are unemployed).
- We need to have rigorous self-isolation for citizens that are newly infected which is actively reinforced.
- Janlert U, Winefield AH, Hammarström A Length of unemployment and health-related outcomes: a life-course analysis. Eur J Public Health. 2015 Aug;25(4):662-7. doi: 10.1093/eurpub/cku186. Epub 2014 Nov 23.PMID: 25417939