Strategic approach to COVID-19: Making sense of the ‘knowns unknowns’

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For a government’s strategic planners, what is not known is as important as what is known, when it comes to thinking about the coronavirus, writes The Daily Telegraph. The strategic planners hunkered down in Whitehall will have at the core of their operation a long list headed “known unknowns”. It will help to inform virtually every decision they make. The concept was popularised by the former US defence secretary Donald Rumsfeld in the run up to the invasion of Iraq and although he may have given the concept a bad name, listing known unknowns continues to be used by strategic planners across the globe.

The report says anxiety over the UK response to the new coronavirus has been caused in part by poor communication but also because we all want certainly in an area where – if the truth be known – there still exists very considerable doubt. But paradoxically perhaps, it is calming to know what is not known because it helps us understand the decision making of others. So here are what experts believe are the key known unknowns about the coronavirus as things stand.

Professor Francois Balloux, chair in computational biology at University College London, says that for an epidemiologist, the two biggest unknowns are the virus’s ability (or not) to adapt to the seasons and the immunity (if any) it gives those who are infected and recover. “There are two major unknowns at this stage. We don’t know to what extent COVID-19 transmission will be seasonal. And we don’t know if COVID-19 infection induces long-lasting immunity”, he said. Balloux said there was some indication that the virus may wax and wane with the seasons but that it would be at least a year before that could be said with any real certainty. But the “critical variable” in predicting the course of the pandemic was acquired immunity – how long you are protected once you are recovered.

Viruses of all types are known to mutate over time, some becoming more virulent and infectious. This is also a major known unknown for coronavirus but most experts think it unlikely to mutate at the same pace as viruses like influenza.

Michael Tildesley, associate professor in infectious disease modelling at the University of Warwick, said that another known unknown was the mortality rate for COVID-19. “One of the key challenges that we have with trying to predict the future spread of the disease is that there is still significant uncertainty regarding the number of individuals in the population who may only have mild symptoms (or no symptoms at all) and do not report infection.

“This impacts our estimates of the mortality rate of the disease as if the number of mild, undetected, cases is high, then the true mortality rate is significantly lower than one has been reported.”

Full report in The Daily Telegraph

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