One argument put forward for July 19th UK reopening is to bring infections forward to reduce winter wave. To be honest, I’ve always found idea that we could tailor a pandemic to get 'better' sized future waves a bit absurd - whether in spring 2020 or now. A few thoughts... 1/
For me, main issue now is medium term disruption vs medium term epidemic size. Many people now seem OK with R>1 in countries with relatively high vaccination % (at least implicitly, given they aren’t advocating for the strong measures required to guarantee R<1). 2/
Given R>1, much of Europe faces large epidemics likely to end with accumulation of immunity in next few months - much of it from infections. Reopening would accelerate this, but won't be difference between epidemic & no epidemic (unlike, say, reintroducing measures to get R<1) 3/
That doesn’t mean we should be fatalistic and say ‘well if R>1 anyway it doesn’t matter how big’. Having R=1.4 rather than R=2 in short term (as hypothetical e.g.) would allow more people to be vaccinated before they get exposed. But still need to think through tradeoffs… 4/
As a *very rough* illustrative example, if R=1.4 currently, a simple model would predict epidemic resulting in around 50% of remaining susceptible population being infected (here 'susceptible' includes any breakthrough infections in vaccinated groups). 5/
If R=2, then this *very rough* example has around 80% of remaining susceptible population being infected. Detailed models would give more robust estimates, but punchlines are: i) both scenarios mean large numbers infected ii) epidemic smaller in scenario where R kept lower. 6/
But, of course, keeping R lower requires ongoing measures. Some wouldn't be so disruptive, e.g. masks on public transport, rapid tests to check infection status. But some more disruptive, e.g. keeping venue capacities constrained, quarantining large numbers of contacts. 7/
Some measures, such as testing symptomatic cases, also provide important situational awareness about epidemic and variants - which is particularly crucial if we want to track new variants spreading among vaccinated individuals. 8/
Everyone will have different preferences about what medium term measures are appropriate to prevent a given number of medium term cases. To some extent, it's also possible to work out 'revealed preferences' by comparing what people are and aren't arguing for. 9/
How countries approach next steps will depend on where they are with cases, vaccine roll out etc, but worth reading up on international situation to get idea of how tradeoffs viewed elsewhere, e.g. Singapore: straitstimes.com/opinion/living… & Australia: theguardian.com/australia-news… 10/10
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