COVID-19 modelling reports

From the Ministry of Health:

These modelling reports were commissioned by the Ministry to help us understand the health outcomes and impacts on New Zealand of COVID-19 and to inform the response strategy.

The reports have been completed by Wellington researchers from the University of Otago in collaboration with university colleagues from Germany. The models have been revised based on feedback from peer reviewers, the Ministry of Health’s Chief Science Advisor and public health officials.

Modelling will help inform Government decisions on when, how much, and for how-long, the country can ease the lockdown and other measures.

It’s critical to understand that each of the models presents a number of potential future scenarios; there are no “predictions”.

Each model has its own degree of uncertainty determined by the assumptions required for any modelling work, and those assumptions are based on the best information available from overseas evidence.

Downloads

 

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18 Comments

  1. Duker

     /  31st March 2020

    If models are not predictions, how about checking what the weekly death rates normally are for this time of the year and how they rise over winter.
    If NZ has 1000 per week deaths over winter , with considerable variation either way of that, would even 100 extra deaths per week be noticeable when looking at the whole year. The elderly of course may only have their deaths ‘brought forward’ over winter or due to Covid 19.
    The numbers show that an extra 5000 deaths per week in Europe isn’t even statistically significant for this time of the year

    Reply
  2. Alan Wilkinson

     /  31st March 2020

    An interesting column in the UK Telegraph:
    This new development could also explain Italy’s high death rate

    With the death toll rising and no end in sight to coronavirus lockdown, it might seem that several dark weeks lie ahead. As well as claiming over 1,000 lives here, the Covid-19 crisis has shown how vulnerable my frontline colleagues in the NHS are. But a possible development may offer a chink of light.

    As a cancer immunologist, I have been involved with a number of clinical trials involving vaccines and other immune therapies. One of these is a mycobacterial product known as IMM-101, which has proved an effective treatment in both melanoma and pancreatic cancer studies. Intriguingly, a number of participants in trials I have worked on have remarked that, since taking this “vaccine”, they have not suffered any flu or cold symptoms, often having succumbed every winter previously. Many were elderly, with more than one serious illness.

    More recently, I was asked by colleagues in Norway, with whom I have collaborated on a therapeutic HIV vaccine programme, to help with a Covid-19 inoculation they have manufactured, and which is being produced for trials. I suggested swapping the vaccine’s current adjuvant (an ingredient added to boost the immune response) with IMM-101. The result has now been supplied for pre-clinical studies.

    It is encouraging that our candidate vaccine – along with several others around the world – is being made and tested, but, soberingly, it will not be available for some months. That’s why I would like to propose that, as a short-term immunity boost, NHS workers should be provided with IMM-101 shots.

    IMM-101 is available immediately, and is safe, having been approved for cancer trials. It could quickly be used on frontline staff and I have asked colleagues to help design and agree on the best form a trial could take.

    There will be obstacles to progress. There is no proof that this will work on Covid-19, I am told repeatedly when I have proposed this. Statisticians tell me that anecdotes are meaningless. But IMM-101 shares properties with the BCG vaccine, which protects against tuberculosis, and may help us fill in the gaps.

    My colleagues and I have dissected the mechanism of action of IMM-101 and have shown that it stimulates the innate immune system that protects us from attack by viruses. The cells stimulated by IMM-101 include natural killers (NKs) and secrete cytokines which are known to kill viruses.

    Many of these properties are shared with the BCG vaccine. BCG is not as effective, nor as safe, as IMM-101 in the context of immune-boosting clinical trials (unlike the BCG, an IMM-101 shot can be given again if the reaction fades; the BCG can also cause ulcers and infections at the injection site). Nonetheless, given its common basic properties with IMM-101, BCG does provide some fantastic statistical support for our proposal.

    In particular, colleagues from America have published a paper in which they have tried to address a question that has been puzzling us all. Why are the mortality rates so different from country to country? For Covid-19, it appears that there may be a relatively simple answer. In the US, Italy and Spain, there have never been comprehensive BCG vaccine programmes, whereas countries like Japan, with a strong programme, have a low mortality rate. The UK used to have a programme when I was young but stopped it. We may therefore have a very mixed mortality rate depending on BCG exposure.

    Support for this hypothesis comes from another source. A recent study showing that prior BCG exposure boosted the response to flu vaccination has led to colleagues proposing to inoculate frontline workers in the Netherlands. This has already been approved by their government. We have an even better product in IMM-101; it boosts the antiviral defences more effectively than BCG without the latter’s negative effects.

    Here is an opportunity for Britain to make a significant contribution to the scientific battle against Covid-19 – and protect thousands of the country’s health workers at the same time. We can’t let it pass us by.

    Angus Dalgleish is professor of oncology at St George’s University of London, and the principal of the Institute for Cancer Vaccines and Immunotherapy

    Reply
    • Gezza

       /  31st March 2020

      That sounds plausible & intriguing.

      Reply
      • Alan Wilkinson

         /  31st March 2020

        Yes, wonder what the stocks of it are like.

        Reply
        • Duker

           /  31st March 2020

          Wasn’t the BCG vaccine a thing in NZ a while back..I still have the small scar on the shoulder. I wonder if we stopped it because….
          https://www.health.govt.nz/our-work/preventative-health-wellness/immunisation/immunisation-programme-decisions/bcg-vaccine-and-vaccinator-endorsement

          Reply
        • Gezza

           /  31st March 2020

          Stocks were globally scarce from 2015 – 2018 & are still limited.

          Possibly mass innoculation stopped because of that mentioned scarcity of supply, but we only have about 300 active cases a year, so targeted vaccinations of high risk children may also have been considered sufficient then.

          Latent TB in adults is a problem I became aware of in my former work. Several of those diagnosed with it in NZ were in populations that didn’t adhere to the lengthy regime of treatment.

          Reply
        • Gezza

           /  31st March 2020

          Or did you mean stocks of IMM-101 ?

          Reply
          • Alan Wilkinson

             /  31st March 2020

            Yes of course. That is what is being proposed to deploy.

            Reply
            • Gezza

               /  31st March 2020

              Sorry. Dunno. An acquaintance died not too long ago of pancreatic cancer, IIRC.
              I note the article says IMM-101 is available immediately, and is safe, having been approved for cancer trials

              I understand that Pharmac fund a more limited range of cancer treatments than the NHS. Certainly the case with bowel & endocrine cancer treatments.

              Wonder who would know if trials are also underway in NZ.

  3. david in aus

     /  31st March 2020

    The most remarkable thing is the lack of modelling of different options.

    We know what will happen with no measures: Italy or Spain. You don’t need sophisticated modelling for that.

    There are different measures and degrees of responses. That is what is missing in the releases. It is an all or nothing approach.

    I have a suspicion that either didn’t ask perceptive questions of all options or released documents that supported their narrative.

    That being said, the numbers of unexplained outbreak clusters probably forced their hand.

    Reply
    • Duker

       /  31st March 2020

      It’s like asking how long is a piece of string…it’s only an answer will have afterwards, and that likely to still be highly variable.
      That’s when you pivot to what is the risk and the baseline numbers we are already living with

      Reply
  4. Alan Wilkinson

     /  31st March 2020

    I read the papers. As I expected the models are fully dependent on known unknown parameters which could be anywhere from 50-100% wrong. They are not predictions, merely maybes. The whole schematic could be turned on its head by changes in medical treatments or knowledge. The hypothetical flattening of the curve by lockdown for 12+ months is economically and socially infeasible.

    Reply
    • Alan Wilkinson

       /  1st April 2020

      The media are being lazy as describing it as the worst case option. It is actually the worst assumptions case.

      Reply
      • Last night One news headline an item with the worst case projection as if it was the only projection, but eventually in the item revealed that no one was predicting the worst case projection and there was also a best case projection that was obviously far better, and we may get close to if we do things well from here.

        Terrible reporting.

        I can’t find that on their site now.

        Reply
    • Blazer

       /  1st April 2020

      ‘ The hypothetical flattening of the curve by lockdown for 12+ months is economically and socially infeasible.’

      after all of your relentless critique have you actually formulated a response to C19 that you think would be…effective?

      Reply
      • Alan Wilkinson

         /  1st April 2020

        Sensible and focused social distancing combined with proper control of international arrivals as I’ve outlined, ramping up medical resources and trialling promising medical interventions – all done to fullest extent possible.

        Reply

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