@IHME_UW (Institute for Health Metrics and Evaluation) and @UWMedicine (University of Washington’s School of Medicine), no lightweights, have come out with
global projections of #COVID19 by nation.
Short summary 👇

healthdata.org/news-release/f…
They modelled 3 scenarios:
1. Worse case:
- mask usage stays at current rates, and,
- governments continue relaxing social distancing requirements.
This leads to 4.0 million total deaths by the end of the year.
Best case:
- mask usage is near-universal, and,
- governments impose social distancing requirements when their daily death rate exceeds 8 per million.
This leads to 2.0 million total deaths if by the end of the year.
3. Most likely:
- individual mask use and other mitigation measures remain unchanged.
This leads to approximately 2.8 million total deaths by the end of the year.
Heavy humanistic, societal and economic burden, no matter which scenario you look at.
"To date, COVID-19 has followed seasonal patterns similar to #pneumonia, and if that correlation holds, northern countries can anticipate more cases in the late fall/winter.
Can any experts weigh in here? @MarionKoopmans @AlexWFriedrich1 @c_drosten @CiesekSandra
Then comes the swift kicks to the nether regions.
Under the most likely scenarios, the nations with the highest per capita total deaths would be the US Virgin Islands, the #Netherlands (#NL, #nederland), and #Spain.
@C19RedTeam @rivm @MinVWS
By @WHO regions, projected death by Jan 1
- 959,685 in #Americas,
- 667,811 in #European region,
- 79,583 in the #African Region,
- 168,711 in the Eastern #Mediterranean region,
- 738,427 in the South-East #Asia region, and,
- 191,598 in the Western #Pacific Region.
Massive.
The authors on #HerdImmunity:
The “worse-case” scenario in these projections reflects a situation where leaders allow transmission to run through their population, resulting in significant loss of life.
#UK #SWEDEN #HerdMentality
The authors on #Containment:
“We all must learn from those leaders of nations where the virus has been contained, or where second waves of infections have occurred, and where swift action has been taken to prevent loss of life.
#Germany #NewZealand #Denmark #SouthKorea
Methods:
Projections based on epidemiological model that includes data on cases, deaths, antibody prevalence, as well as location-specific COVID-19 testing rates, mobility, social distancing mandates, mask use, population density and age structure, and pneumonia seasonality.
Finally,
New projections, including forecasts of daily infections, are available at covid19.healthdata.org
@mzelst @edwinveldhuizen @BDDataplan @pesla
(For Europe-based journalists: Cathy Bartley, cathy.bartley@bartley-robbs.co.uk )

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More from @phenomstruck

23 Sep
Have we misjudged the role of children in spreading #COVID19?
COVID19 research in to kid, especially younger ones, is not perfect. It has gaps, it is evolving and we are learning more by the day.
A short summary of evolving role of children 👇
cmaj.ca/content/192/38…
Statement from Ontario’s science advisory table:

- Kids may play a bigger role in the spread of #SARSCoV2 than initially suspected.

- Early suggestions that children are considerably less important drivers of transmission are not confirmed by more recent research.
Children less susceptible?
1. Contact tracing studies reported that children<10 years old are less likely to test positive.

Limitations: Studies underestimate infection rate in children if infected children are more likely to be asymptomatic than infected adults.
Read 16 tweets
27 Aug
Huge respect for Aura but some of her responses are contentious. I thank her for the work that she and her team are doing in this ever developing #covid19 pandemic. But one didn't need to understand #coronavirus to implement certain rules.
volkskrant.nl/ts-b73f5cef
Question: Maar anderzijds had u ook best kunnen adviseren: bescherm jezelf nou maar, voor de zekerheid.

Aura: Zeker. Maar dat is met de kennis van nu. Wat we in maart, april dachten te weten over het virus is achterhaald door de snelheid waarmee het zich bleek te verspreiden.
Has any of the field epidemiologists been involved in the decision making, they would have insisted on PPE/masks in healthcare/nursing homes.

Crisis management experts would have insisted it is better safe than sorry.
Read 4 tweets
26 Aug
A descriptive analysis of existing literature presented a #SARSCoV2 risk-chart from asymptomatic people in different settings and for different occupation times.
Lead authors (@trishgreenhalgh) noted that this is an indicative table; and not quantitative or predictive. Image
Great overview of occupancy (indoors/outdoors), ventilation (well/poorly), type and level of group activity (silent, speaking, shouting), time duration and face coverings --> and risk of #SARSCoV2 transmission.
Variation in susceptibility, viral shedding rates were not looked at.
An indicative, traffic-light like chart for an overview of transmission risk. Other take home messages:
1. Distribution of viral particles affected by air flow too.
2. #SARSCoV2 may travel >2m through coughing,shouting.
3. Rules should reflect ventilation,occupancy,exposure time.
Read 4 tweets
20 Aug
Debate (#NL) over face covering or not. On #RIVM/#OMT's advice, @MinPres and @hugodejonge from @MinVWS have unequivocally told us that there is little conclusive evidence (agree) and masks do not work (do not agree).
Great @bmj_latest article, a summary:
bmj.com/content/370/bm…
Face masks have been framed largely as a medical intervention.
Many countries/agencies now mandate/recommend masks against #covid19.
Narrative of face masks as a medical intervention ignores the social practice of this act, and the behaviours associated with it.
Masks as medical intervention (1/2):
Almost all evidence comes from healthcare facilities and addresses the efficacy in protecting the wearer from infection, not as source control.
Using evidence based from healthcare and using it to address community settings? Apples and Oranges
Read 10 tweets
18 Aug
So who is surprised? Rhetorical question. (Mini thread)
Researchers analysed differing policy responses and total #Covid19 cases and deaths until 19 May A number of variables were used to help analyse the raw data and draw reliable country comparisons.
theguardian.com/world/2020/aug…
Datasets/variables considered were GDP, total population, population density and proportion of elderly residents, as well as annual health spending per head, openness to international travel and level of gender equality in society in general.
Since only 19 of the nearly 200 countries were led by women, the authors also created so-called “nearest neighbour” countries to offset the small sample size, pairing Germany, New Zealand and Bangladesh with male-led Britain, Ireland and Pakistan.
Read 5 tweets
17 Aug
Been meaning to write a thread about this pre-print (literature review, opinion piece) on #COVID19, children and #schools. (Very likely I am replicating somebody's efforts already). A lot of it in there made sense to a lay-person like me so here it is:
mja.com.au/journal/2020/c…
Are children less susceptible to infection? Research is ongoing and no definitive evidence either way yet.
From 61K people in #Spain, 3.4% of children and teenagers had antibodies against SARS-CoV-2 (point-of-care test) vs 4.4-6.0% of adults.
In the same study, in a subset of 52K people with immunoassay testing, the children-adult "gap" narrowed to 3.8% vs 4.5-5.0%. T
Are children less susceptible to infection than adults, or does it reflect shielding? Schools closed in March and haven't opened as of early August.
Read 15 tweets

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