Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Revisiting Early-stage COVID-19 Strategy Options

Version 1 : Received: 12 April 2020 / Approved: 20 April 2020 / Online: 20 April 2020 (06:18:33 CEST)

A peer-reviewed article of this Preprint also exists.

Machanick P. Revisiting early-stage COVID-19 strategy options [version 3; peer review: 2 approved]. F1000Research 2021, 9:327 (https://doi.org/10.12688/f1000research.23524.3) Machanick P. Revisiting early-stage COVID-19 strategy options [version 3; peer review: 2 approved]. F1000Research 2021, 9:327 (https://doi.org/10.12688/f1000research.23524.3)

Abstract

Background: Early-stage interventions in a potential pandemic are important tounderstand as they can make the difference between runaway exponential growththat is hard to turn back and stopping the spread before it gets that far. COVID-19 is an interesting case study because there have been very different outcomesin different localities. These variations are best studied after the fact if precisionis the goal; while a pandemic is still unfolding less precise analysis is of value inattempting to guide localities in the early stages to learn lessons of those that pre-ceded them. Methods: I examine three factors that could differentiate strategy: asymptomaticspread, differences in use of the Bacillus Calmette-Guerin (BCG) tuberculosis vac-cine and cloth face masks.Results:Differences in disease progression as well as the possibility of alternativestrategies to prevent COVID-19 from entering the runaway phase or damping itdown later can be elucidated by a study of asymptomatic infection. A study todemonstrate not only what fraction are asymptomatic but how contagious they arewill also inform policy on universal mask wearing. Conclusions: While a COVID-19 outbreak is at a level that makes accurate trace-and test possible, investigation of asymptomatic transmission is viable and shouldbe attempted to enhance understanding of spread and variability in the disease aswell as policy options for slowing the spread.

Keywords

COVID-19; pandemic; asymptomaticspread; early-stage COVID-19 mitigation

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Comments (5)

Comment 1
Received: 20 April 2020
Commenter: (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: I corrected a typo in the Abstract: obviously, COVID-9 should be COVID-19. That should reflect once the revision I posted appears.
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Response 1 to Comment 1
Received: 23 April 2020
Commenter: (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: The typo is now corrected.
Comment 2
Received: 20 April 2020
Commenter: (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: One more thing: here is where I graph herd immunity vs. $$R_0$$.
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Comment 3
Received: 21 April 2023
Commenter: Damian T. Rafal
The commenter has declared there is no conflict of interests.
Comment: I think that the first thing always to do is to measure the real risk originating from a pathogen, and only then considering anything else. About Covid-19 -it is a mortality untruth, what is proven directly by the original math method:
https://zenodo.org/record/7372672 =it could be said that in 2020 there still was a net increase, caused by Covid-19, in the number of yearly deaths ...but if there were in real importantly over 10,000 deaths caused by the limited usage of antibiotics in patients with Covid-19 and so they died due to bacterial superinfections (instead of Covid-19) then the net Covid-19 impact could have been even about zero.
Kind regards,
Rafal
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Response 1 to Comment 3
Received: 24 April 2023
Commenter: (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: While there is no doubt that some extra deaths were caused by either or both of: health facilities being overwhelmed and patients being reluctant to seek care for fear of infection, there is no evidence that this effect is anywhere near to that of covid deaths. Even if that number is 10,000, there are very few countries that has such a low number of covid deaths. It certainly would not bring the toll down to zero if that was the true number of extra deaths caused by lack of access e.g. to antibiotics.

In South Africa, excess deaths statistics show that about three times as many people died as those officially reported but this is explained by inadequate testing. These deaths are highest in parts of the country with inadequate health services. In those regions, people with a life-threatening condition where antibiotics or other intervention could save them would die anyway, pandemic or not. So you cannot blame covid for an increase in other types of deaths in those regions.

The notion that thousands of scientists and medical experts who are dedicated to saving lives could be so stupid as to miss something so obvious is ridiculous. You need solid evidence for such an argument. Your claims, despite pumping them up with words like “math-logic”, do not fit the facts: in the US, there is a significant drop in life expectancy during the covid years.

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