3/22/2020

Prediction of the peaked outbreak

In Japan, PCR tests are limited only for those in close contact with an infected person as already reiterated in this blog. Only 5% of requests for tests are allowed to be tested. That is told the main reason why the number of infected people remains rather small compared with the other countries.

Researchers of Imperial College London has published prediction of the infected cases in UK and USA. It is a horrible forecast. Without considering the overwhelmed healthcare especially for severe respiratory failure, the peak of the outbreak comes from May to June. Eighty one % of the population is expected to be infected. The expected deaths are 2.2 millions in US and 0.51 millions in UK in total.  

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf?fbclid=IwAR2pHXimauFMaS0MiA2tGlial7ed8tfCxR7K3HzvU420nYAAxLpUHwajvbs

The non pharmaceutical interventions could reduce the death rate. They include case isolation, household quarantine, social distancing especially of elderly and closing schools/universities. Among them case isolation seems to work best.

Case isolation depends on the right diagnosis. We should depend it on PCR tests result however the test's sensitivity is not ideal and could yield false negatives/positives if it is done as a screening test. History taking and examination by doctors may enhance accuracy of the diagnosis.

There are a lot of people insisting that PCR test is of limited value to mitigate the outbreak. They forget the fact we need to make case isolation by any means. We may utilize such as LAMP method for gene detection or immunochromatographic method for antibodies. PCR should be improved as well. Despite of the test defect at present, we should diagnose infected cases and put them in isolation as soon as possible.

Needless to say we should get ready for respiratory care intensive facilities to do with the peaked outbreak or overshoots coming up soon. 

2 comments:

  1. What a trade off that will be required of our world. The Research Document clearly defines the only short term mitigation mechanism is to shut down the World's economy (or substantially so) and go to potentially complete isolation. Absent an effective vaccine, it appears to be the only answer. I cannot envision sufficient governmental funding to be able to offset the financial impact (short term and long term) to the working population or the retirees depending on income from other sources (including social security). This is a hard document to read.

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    1. Don,

      The mitigation policy is the only way to reduce the damage. It won't last too long. They expect vaccine could be completed in a year and half. Curative drugs should be found very soon. Until then, we should put up with the impact of the non pharmaceutical interventions and their effect on our lives.

      Shin

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