The arrival of a vaccine in the context of COVID can be modeled using game theory as a gamble over the expectation of the final death toll. Most countries will have negative payoff after August 2020. Change my mind. cc @LDjaparidze
Let's make it more interesting... Do you agree?
Context is king. For a gamble to exist we need to define clearly the parameters to observe the likely expected result. Let's start with vaccine efficacy (VE). What do you think is the range most manufacturers are looking for?
I am not an expert, but I happen to talk with people that are on the business. They tell me for a respiratory virus a 55% target is quite good. But, let's figure out if that is true. This is Moderna protocol: modernatx.com/sites/default/… Image
But you know why we would trust one manufacturer when we can get another one. This is Pfizer protocol: pfe-pfizercom-d8-prod.s3.amazonaws.com/2020-09/C45910… Image
If we modeled such a vaccine then, would be fair to use VE of 77% then?
Interesting. I was going to go god mode, but now I am interested. Do you believe the gamble should consider the vaccine VE should be:
Ok, so you choose to go lower than 77% will go 70%. To please the other side, I will make one more assumption to equalize. You can apply the vaccine to a 100% population overnight.
Let's say we have a time machine and we can come back to March when mitigations started to happen all over the world. How long would you be willing to mitigate before coming back to normal life in order to protect the vulnerable? Real Normal Life!!! January.
We are all burned out by mitigations. I get it, and yet we keep doing it for our vulnerable. So as context is king. This is what our most likely scenario is for Madrid with data until July looks observing continuous mitigations and the expected summer behavior observed at London. Image
The big question is how that scenario looks like in terms of what is really happening. Fitted from data up to July 9th, as you can see for September it predicts roughly 22 deaths per day. Currently is around 30 per day. comunidad.madrid/sites/default/…
If our 70% vaccine would be applied tonight to 100% of the population after 199 days after the initiation of lockdown. Do you think it would be able to beat 90 days of Sweden fitted trajectory?
OK, I have all people with yellow and blue shirts here it seems. Given the Stockholm trajectory was estimated to have the following isolation parameters:
- Vulnerable: 0.95
- Healthy: 0.2
Stockholm looks like this: Image
With under 1 deaths per day on average. Does that looks endemic to you?
Do you think the Sweden strategy is optimal?
What I can say is this: The optimal strategy for Stockholm no matter when the vaccine comes for our model does not exist. But, if the vaccine does not arrive before December there is a better strategy:
Vulnerable: 0.95
Healthy: 0.16 Image
Does that looks like right there on the margin of error?
OK. For all uses and purposes, the Sweden strategy under our isolation model is optimal; unless of course you want to fix bad government policies. That's for another thread. Do you think the Madrid strategy would stand a chance against it?
The last graph of this series and the one that solves the gamble under our isolation model is quite complex. It is a level of abstraction on top of this linear thinking. We will respond to the following question:
If an oracle would tell me when the vaccine will be available. Is there an optimal strategy that would minimize the death toll given that date?
But, it doesn't end there. At the same time is good to know how other usual strategies found in the wild would fare under the model.
Isolations:
- Very strict: 0.9 (Sweden on vulnerable)
- Strict: 0.65 (Lockdown on average, Masks)
- Moderate: 0.4 (No Schools, Masks)
- Almost normal life: 0.13 (Schools, No Masks, No stadiums [???]).
QED. With very general assumptions (remember I wanted to go god-mode), after August on Madrid even if our magik vaccine comes; under our epidemic model from the point of view of game theory the expectation is that it will be a losing proposition. Image
Do you want to know if it is possible in 90 days to correct government policy mismanagement?

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More from @federicolois

7 Nov
1/ The first rule of Lockdown Club is: You do not talk about deaths per million. The second rule of Lockdown Club is: You do not talk about deaths per million.
2/ Third rule of Lockdown Club: someone yells Sweden or herd immunity, you point out the other Nordics. Fourth rule: only two metrics to a discussion, cases and cases.
3/ Fifth rule: one lockdown per season, fellas. Sixth rule: no deaths, no herd. Seventh rule: lockdowns will go on as long as they have to.
Read 4 tweets
17 Oct
Controversial opinion: those that say its not possible to shield the vulnerable, also won't be able to prove if there is a difference (or lack of it) between the trajectory of the virus at Madrid and Stockholm. Who do you think has let it rip?
1/ There were many "Eureka" moments while working on our paper, but probably the most important of all happened pretty early. Non-linear models are highly sensitive to:
2/ We decided early on to eliminate as many parameters as possible. Location parameters are simple to fix, they are location parameters. Viral parameters also, you can go and say R0=3.3 and you made a choice. How many parameters are left if you do that?
Read 32 tweets
13 Oct
1/ Our preprint with @LDjaparidze is online at @medrxivpreprint
"SARS-CoV-2 waves in Europe: A 2-stratum SEIRS model solution"
medrxiv.org/content/10.110…
2/ We extended the SEIRS model to support stratified isolation levels for healthy <60 and vulnerable individuals.
3/ We forced the model to predict daily deaths curves and the reported age serology ratio for key metropolitan areas in Europe. The immunity level estimations obtained were: Madrid 43%; Catalonia 24%; Brussels 73%; and Stockholm 65%.
Read 11 tweets
2 Oct
0/n Thank all of you who participated in 'The demon game'. I am taking a screenshot because when knowing the whys it loses all value (there is no more asymmetry of information). These 182 responses are 'The sample'.
1/n You may have already known about this thought experiment you just run on, mainly because there are many different variants of it in the literature. This is the one that I have seen lately:
2/n This example is good because the results are clear-cut to show 2 typical sources of error. Poor experimental setups are the bain of our existence and there are myriad ways they can go wrong.
Read 13 tweets
1 Oct
I have my badge of honor. At this rate, the fat tail event is there won't be more twitter to block. :D Image
For context, this is why he got mad with me.
And I love the depth of the rebuttal. Image
Read 4 tweets
25 Sep
[1/n] Preparing everything to respond to the question: "Under our isolation epidemic model. Is it possible to correct government policy mismanagement starting at the end of July in 90 days for Madrid, Catalunya and a few other cities?" What do you think? Answers in an hour or so.
[2/n] For those that are new to this thread, you can prepare and hone your skills in modeling with the Harmless Virus Game:
[3/n] And the more difficult but also important for this new thread "The Vaccine Gamble" game:
Read 20 tweets

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