It is mind-boggling how fast one’s worldview needs to adapt to changing reality during this pandemic.

Taking stock of some new realities:
🧵
1) Delta is tougher than we thought. It is now safe to say that, even at current vax, delta is marginal to escape optimal TTI + lockdown. Some outbreaks fizzle out. But when they don’t, short/sharp lockdowns have become long at best, uncontrolled outbreaks at worst...
...This is ultimately inevitable, and your risk analysis for vax should account for the fact that everywhere is either in outbreak now or only months/weeks from outbreak. Get whatever vax is available to you, as soon as possible, and encourage everyone you know to do the same.
2) NSW will leave lockdown at high caseloads (few 100/Mpop/day) and seems unlikely to return to low cases w/o significant infection-acq immunity. But, vax uptake is extraordinary; I am optimistic vax will be extremely high. Outcomes will be much better than most Western nations.
3) VIC is at max restrictions with rising cases. It is well past the knife edge. Even if VIC miraculously brings its outbreak under control in the next two weeks it would take a further 6+ weeks to bring cases to near zero...
...I think the plausible range of scenarios for VIC are from a SG-style slow easing of restrictions at high vax %, keeping cases low, to a loss of control and eventual NSW-style scenario.
4) Likely VIC under major restrictions through November at least. VIC gov’t will face enormous pressure to relax some restrictions once it is clear lockdown has failed. I think there is room to relax some onerous but ineffective measures, and I won’t be surprised if it happens...
...Those who advocated a maximum approach in NSW even after containment failed may need to do a rethink about what it is possible to ask people to do.
5) ACT and NZ appear to be on the knife edge. Maybe they’ll get lucky. ACT has very high vax working in their favour.
6) QLD/NT/SA/TAS/WA should hold on, but know that zero covid lives on borrowed time, persisting by luck, not choice or strategy. It will fail eventually. Sounds pessimistic, but the sooner everyone appreciates this reality, the sooner everyone will get vaxxed.
7) If there is one thing that has held constant:

It is absolutely, 100%, a race.

Get whatever vax is available to you, as soon as you can. Tell everyone you know to do the same.

end

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More from @MichaelSFuhrer

15 Sep
The UK is often held up as a cautionary tale regarding covid and re-opening.

Let's have a look at what happened in the UK and see if there are parallels to what is happening in Australia.

Thread.
1/🧵 Image
At the beginning of 2021 the UK was fighting a crushing wave of alpha with months of lockdown. As that wave receded, the UK began to release restrictions.

2/🧵
Restrictions were released at a very early stage of the vaccination program:

The UK "picnic day" and end of local-area restrictions to movement occurred on 29 March at 5.6% of total population vaxxed.

Outdoor dining/pubs opened 12 April at 11.5% vax.

3/ 🧵
Read 12 tweets
13 Sep
Some first impressions from the OzSAGE model (ozsage.org/icu-modelling/):

1)Not enough info is given to understand how the model works. They don’t explain how R_eff is calculated, for example, from the restriction settings.

@RichardfromSyd1 @OrinCordus @RageSheen @Globalbiosec
2)They don’t explain their assumptions about ongoing vaccination beyond 80%. This is key to understanding the model and it’s left unstated.
3)They say they adapt a peer-reviewed model, but that model was not used to model time-varying restrictions, and in fact did not include masks or lockdowns at all.
Read 12 tweets
1 Sep
Here is a long/technical thread on my attempt to reverse-engineer the assumptions from the Doherty Institute report to the National Cabinet (linked) regarding delta severity, PHSM effectiveness, and vaccine effectiveness to match observations.
1/🧵
doherty.edu.au/uploads/conten…
Here are the figures from the Doherty Institute report. Note that there are a couple versions of these figures in the report; these assume the “all adults” strategy for vaccination.
2/🧵
The figures attempt to show graphically the effect of various interventions on the transmission potential (TP). TP is in essence R_eff, but calculated on the population level, as I understand it. When TP>1, cases grow, and TP<1, cases decline.
3/🧵
Read 34 tweets
28 Aug
This blog post has received a lot of attention.

A thread.
🧵
In short, the blog post takes public misconceptions about the technical report from Doherty, makes a cursory read of the report, repeats misconceptions, accuses Doherty of intentional scientific misconduct to lead Australia to disaster.

Crackpot stuff.
2/🧵
Not really worth taking apart. But it’s been retweeted by a number of figures who should really know better. So let’s take a look.

Doherty Institute report is here if you want to read along.

3/🧵
doherty.edu.au/uploads/conten…
Read 24 tweets
21 Aug
10 days ago it was conceivable that NSW could control delta and reach low covid (by int'l standards) well before 80% vax, safely open and reduce covid simultaneously.

Now appears that NSW will barely control covid, at high caseloads (~500/Mpop/day) when reaching 80% vax.
1/ Image
Lines on the graph are extrapolations from 9, 14, and 20 August. In 11 days the extrapolated date of effective* 80% vax of 16+ has moved forward 15 days, and the date of achieving R=1 through vax has moved backwards by 22 days. Separation has gone from 6 weeks to 4 days.
2/
This is a result of the higher observed R, which seems robust.

Likely scenario: NSW will achieve 80% vax of 16+ in October after 3.5 months lockdown, with cases in several 1,000s/day. Pressure to remove lockdown will be intense.
3/
Read 6 tweets

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