Thread by @jeffreytran

0/ *brief* summary and implications of imperial.ac.uk/media/imperial… , a preprint from imperial college in December on evolution of b117 during the second English lockdown of November of 2020.

1/ The key finding was they looked at 42 regions for the 4 weeks of lockdown in Nov.. so 168 samples, and tracked b117 and non-b117 cases. In 34 both increased, in 36 both decreased. In 97 non-b117 increased and b117 increased. In only ONE did b117 decrease and non-b117 increase.

2/ They concluded that b117 had a transmission advantage large enough to frequently continue to grow even in situations in which non-b117 declined. They also tested, and rejected, other explanations such as being able to reinfecting previously infected individuals.

3/ This data was largely confirmed early in the year in Europe, for example in Denmark which also has good surveillance. Germany and France thought that they had the variant under b117, eased restrictions, then were forced to lock down again after cases soared.

4/ The United States has the advantage of seasonality, increasing vaccination coverage, large previously infected population. B117 achieved dominance in the last month, and cases are flat in many places, so if restrictions stay similar, we should expect cases to decline.

5/ If restrictions are lifted, and vaccinations continue these may offset each other in the short term.. cases may increase or decrease, but as long as vaccinations continue, cases will eventually decrease, probably substantially.

6/ However, no matter what, b117 will become almost all cases, increasing the overall infectiousness of the virus. In some populations (e.g. counties or specific populations) where vaccination progress stalls and/or restrictions/behavior are eased..

7/ .. cases will increase possibly quickly, and severely enough to overwhelm local hospital systems, causing unnecessary deaths and more severe illnesses. Fortunately deaths will be greatly mitigated by substantial vaccinations for the most vulnerable.

8/ However we should expect cases to increase, particularly, in children, who will not be vaccinated for some time. As a result many will suffer long term disability. The End.

Prompted by someone who asked for my predictions.. I don’t believe I have any special insight. As nearly as I can tell this within the general consensus.

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