Thread by @andrewflood

Post this lockdown we are going to again be faced with a lobbyist demand for careless rushed opening based this time on the idea that IFR will have fallen because those most at risk have been vaccinated. This sounds sensible but is another recipe for disaster /1

Core problem is that over half those who were hospitalised were under 65 & about 60% of those who went into ICU. The 6k cases a day peak in January exhausted ICU capacity, forcing cancellation of routine surgery & turning operating theatres into surge ICU. /2 ht @1987Andrewk

161 under 65s had died to December, stats on ICU admission to that date suggest that without such access for 385 who needed it 2 to 3 times as many would have died. 2768 needed hospitalisation from those ages, presumably without access many (50%) would also have died. /3

This outcomes by age for cases from when testing was not constrained, July to November allows us to approximate demand if a premature opening up meant large numbers in under 65 age groups became infected. 76k hospitalisation, 7700 ICU, 2,000 plus deaths (next tweet for calc) /4

Assuming rapid 80% infection of the segments of the under 65s populations but no infection of those over 65s we need 76k hospital beds, 7,600 ICUs & even with those get 2,000 deaths. But as we only have 11k bed and 350 surge ICUs deaths can exceed 20k due to denial of care /5

That's a 'not going to be that bad' worst case. However it doesn't factor in that every bed and ICU being used for Covid would mean a lot of deaths due to other causes because those people can't access a hospital bed or ICU. There is no need to do a precise calculation here /6

The earliest significant risk taking by this timetable is July as vaccinating everyone over 55 reduces these totals by at least 1/3 & presuming some level of protection against infection R at that point should be reducing. But still need under 100 cases a day /7

But really the hospital situation only becomes anyway realistic for a back to normal once you have everyone over 19 vaccinated. The coping level is pretty much the hoped for herd immunity level. gsd

All approximations above can be argued about which will push number up or down 10 or 30%. However the outcomes of a 'everyone over 65 is vaccinated so its grand' projection are bad enough that enhanced precision wouldn't add anything. The idea is a non runner /8

The main takeaway from this thread is that any schemes to experiment with opening up on the basis of vulnerable groups having been vaccinated are high risk & so should only happen if cases are very low AND there is agreement that as soon as they start to rise things shut down /9