May 5, 2020

expert reaction to preprint modelling of segmenting and shielding scenarios to exit lockdown

Researchers at the University of Edinburgh have produced a preprint report on the modelling of segmenting and shielding scenarios to exit lockdown.

This Roundup accompanied an SMC Briefing 

Prof Sarah Harper, Clore Professor of Gerontology, University of Oxford, said:

“This preprint categorises all those aged 70 or above as vulnerable and therefore in need of shielding. The use of age alone as a criteria for vulnerable has some concerns.

“Importantly we know that while at the population level age is a good general predictor for vulnerability this appears (at this stage and with our current evidence) to be related to underlying health conditions. There is considerable variation in the presence of underlying health conditions in the over 70s. Using chronological age without taking into account individual’s health conditions will confine healthy active older individuals to their homes.While there is a clear association between age and the efficiency of our immune systems, we do not have sufficient data to make an explicit judgement and the variability is likely to be considerable.

“In addition, the impact of confinement for these healthy older adults in terms of isolation, reduced mental well-being, and reduced physical activities will have long term health impacts. There is also a considerable possibility that many of these older individuals will ignore the advice. 

“Most people are aware that they have a chronic condition – such as a respiratory illness, cardio-vascular disease, cancer, diabetes. They also know if they are overweight/obese or smoke.  These seem to be contributory factors to vulnerability.  Easing lockdown might be more effective if the risks were explicitly explained to the population, the possible range of vulnerabilities highlighted and individuals asked to take appropriate action.  These are sensible public health approaches which might have a better chance of being complied with.”

‘Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown’ by van Bunnik et al have being released as a report. It has been submitted to the pre-print server MedrXiv and will be submitted for publication by an academic journal later this week. It has been anonymously peer-reviewed by the Royal Society’s RAMP initiative.

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.