Dr. Joel C. Miller Profile picture
Sep 7, 2020 19 tweets 3 min read Read on X
A thread on how the lockdown in Victoria has affected Victoria and Australia.
First to anyone who argues that "lockdowns don't work", objective observations disagree.

We need reasonable discussion about whether lockdowns are justified, but if your starting point is "lockdowns don't work", you've disqualified yourself from reasonable discussion.
What has been gained from lockdown in Aus & Victoria:

The first round of lockdowns successfully eliminated disease from most of Australia. (New Zealand had similar success) It has meant that most states have had much more normal life than most of the world.
Economically and mental health-wise there is no question that most of Australia and New Zealand has been in a better economic/social position than most of the world.

Sweden is often used as an example of a place that "does it right" by no locking down.
Sweden's death totals are much higher than Australia.

And anyone who tells you that Sweden hasn't had restrictions either doesn't do his homework, or is lying.

Much of Australia currently has fewer restrictions than Sweden.
My understand is visits to aged care facilities in Sweden were banned from Apr 1 - Aug 31 (not sure if this has been extended, or if it may have been relaxed early).

Large gatherings in Sweden are restricted to about 1/20 of what Australian football crowds are currently allowed.
Obviously Victoria is currently much stricter. What has that done?

As restrictions ramped up, counts increased, exceeding 700 in a day. After stage 3 + facemasks was introduced, they quickly increased to stage 4. Shortly thereafter counts started falling quickly.
I don't know enough to say whether stage 3 + facemasks might have been enough for a slow decline (I hope so), but it's clear that stage 4 has led to dramatic decreases.

I did not support going to stage 4-like restrictions when the initial stage 3 restrictions came in.
However, with hindsight:

- about a week into July VIC put in place stage 3 lockdowns - case counts were under 200
- 2 Aug VIC had 670 new cases and went to stage 4.
- just over a month later we have about 40 new cases.
Had they jumped straight to stage 4 in early July rather than early August, we would have seen similar reductions, and a month ago we would have been commenting on the drop from 200 to single digits, rather than from 700 to double digits.
That's a lesson for the rest of Australia.
What would have happened without lockdown?

No question growth would have continued for quite a bit longer. We would have seen well over 1000 cases a day for an extended period, and the disease would have been seeded in the rest of Australia many times.
The rest of Australia would be in the midst of an outbreak similar to what I'm describing would have happened in VIC.
Lockdowns and border controls combined have kept this away from the rest of Australia so far.

As long as the seeding events are rare, states have had the capacity to respond with aggressive tracing to keep them under control.
It hasn't been pleasant in VIC. These restrictions are putting a huge cost on the state. Without these restrictions, the rest of Australia would be facing a large epidemic.

A few more weeks should get numbers down low enough that a long-term return to normal is plausible.
It's a terrible balancing act for the government to face.

There is uncertainty about whether we can control the disease when lockdowns are removed. Our control is much better when counts are very low.
If we reopen and lose control, the cost to the economy will be much worse than the cost of a few more weeks of lockdown.

When people say "rip the bandaid off", what they are actually recommending is more akin to dropping your hands while in a fist fight to get it over with.
Last few comments for now: we need to get out of lockdown, but if we get out without a plan to control the disease, that is simply accepting a huge amount of death and massive economic hardship.

The rest of Australia is reasonably normal b/c of the lockdown we went through.
That's what we want to replicate now.

[got work to do now]

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More from @joel_c_miller

Jun 4, 2024
Reading the @nytimes article on COVID origins.

I'm not going to try to rebut the whole thing (I don't have relevant expertise on most of it), but let me address the final point made because it's close to my area of expertise. This is a bit technical, but please bear with me.
Here's the claim I want to address: Quote:  "With today’s technology, scientists can detect how respiratory viruses — including SARS, MERS and the flu — circulate in animals while making repeated attempts to jump across species. Thankfully, these variants usually fail to transmit well after crossing over to a new species and tend to die off after a small number of infections. In contrast, virologists and other scientists agree that SARS‑CoV‑2 required little to no adaptation to spread rapidly in humans and other animals. The virus appears to have succeeded in causing a pandemic upon its only detected jump into humans."
This seems to be suggesting that if COVID-19 came directly from animals,
- there should have been many small outbreaks in humans,
- these dead-end outbreaks would trigger evolution resulting in better spread in humans,
- and we should have detected some of those outbreaks.
Read 13 tweets
Dec 16, 2021
So I've got a new preprint out. medrxiv.org/content/10.110… developing mathematical disease models that are appropriate for ethical analysis.

Most of the work done by Daniel Roberts. Help from @ID_ethics, George Heriot, Michael Selgelid, and Anja Slim 1/22
There's some beautiful mathematics in it, but I'll save that for a different thread. Here I'm going to focus on the results.

Our goal is to build a framework that lets us evaluate the ethics of policies for infectious disease policies that try to enforce compliance. 2/x
Let me first say a bit about why this work cannot be applied directly to COVID (not to say it doesn't give insights, but you need to be careful):

We've assumed SIR disease with a single wave. No variants. Importantly, we've assumed that the interventions remain constant. 3/
Read 23 tweets
Aug 27, 2021
A comment on whether the "Doherty Model" is appropriate if case counts are high when threshold of 70% or 80% is met:

[note - this is my personal opinion without consulting collaborators, should not be taken as official statement of any group I'm affiliated with]
These thresholds provide valuable guidance to policy makers and the public to help them develop plans, and to see that vaccine is the best tool to get us out of our current predicament.
Modelling always involves assumptions, and there is always a risk that an assumption is wrong in a way that materially affects the outcome.

In this case a key question has been raised: might the case count be so high that contact tracing and similar interventions can't keep up?
Read 8 tweets
Jun 9, 2021
Why do lockdowns become more important just before or in the midst of a vaccine rollout?

1/n
First, let me both dispel and validate one criticism of lockdowns: "you're just delaying the infections - they will happen later"

2/n
If lockdowns or any other intervention happen but at the same time some immunity builds up, then the epidemic peak will be lower and the total number infected will be smaller.

(seasonal effects may complicate this claim).

Flattening the curve does reduce total infections

3/n
Read 13 tweets
Mar 3, 2021
In the thread below, the claim is made that COVID-19 is only hypothetically worse than common cold and that the deaths are a result of lockdown and fear rather than COVID-19.

Let's see what data there is to test this...
But, let's clearly state the two hypotheses we'd like to compare and look for the available data and compare their predictions against the data

A) lockdown and fear is responsible for deaths
B) COVID-19 infection is responsible.
First let's look at the people who are dying:

They are dying of a specific set of symptoms that are consistent with respiratory infection, and they are testing positive for a specific virus.

Invariably rise in diagnoses is followed by a rise in deaths.
Read 16 tweets
Feb 6, 2021
Let's talk about how a scientist should make and then test a hypothesis.
When one makes a hypothesis, one should look for other, simpler hypotheses which could also explain the data.

In this case, perhaps one might think that the interventions done to control COVID-19 might also control influenza. Since flu has a lower R0, this might be enough.
Another thing a scientist should do is to look for other data that might refute or support the hypothesis.

In this case, perhaps one might look at countries that didn't have a large COVID-19 epidemic. For example Australia and New Zealand.
Read 11 tweets

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