September 24, 2020

# “In 18 years we have had SARS, MERS and COVID-19, there is no reason why another virus should not emerge”

Adam Kucharski’s task is to observe the behavior of viruses to establish mathematical models that “help make sense of the knowledge and data available” and adopt the best solutions, over and above the obvious ones, to overcome an epidemic . His work as an associate professor and member of the Department of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine researching influenza, Ebola, dengue and Zika and his outreach work in publications, conferences and TED talks has become a household name in the UK.

The opportunity of his latest book, The rules of contagion (Captain Swing), it’s obvious. Written before the outbreak of the coronavirus, this epidemiologist, who studied exact sciences and worked for investment funds before dedicating himself to viruses, addresses what makes something – from diseases to financial crises, fake news or violence – spread and by that the shoots take certain forms.

What parameters are important to consider when observing COVID-19?

The parameters depend on the question that a model is trying to answer. For example, if you are trying to understand how much the epidemic is growing or decreasing, it is important to take into account the reporting delays, because the cases that appear today reflect the transmission of about a week ago. When building models, we often look at the fundamental parameters and check whether changing these assumptions would change the conclusion of the model.

Why do some models fail or do not fit with the evolution of epidemics?

Mathematical disease models are not like a weather forecast, where a bad forecast will not change the weather. In the case of diseases, if people perceive that they are dangerous, they will change their habits. Models are often helpful because you can ask “what if …?” But sometimes people forget it and then ask why the model’s “prediction” doesn’t come true. It is very difficult to predict exactly what will happen with the COVID-19 pandemic, because it depends on what governments do and how the population changes their habits.

Has Europe had the capacity to respond appropriately to the COVID-19 pandemic?

I think the response in Europe has been influenced by several factors. One is basic public health capacity, such as the ability to increase the number of tests and respond quickly to outbreaks. Another is the culture and behavior of the population and the will to comply with control measures. The political situation is also important, as various governments have prioritized control and reopening measures in different ways.

How do you rate sprouts that are being produced in Spain?

We have always expected new outbreaks when control measures were relaxed, because the evidence suggested that a large part of Europe was still susceptible to the virus. The more society opens up, the more opportunities there will be for the virus to spread.

Will we have to go back to restrictions like the ones that were imposed in April? Would lockdown be the most effective measure at this time?

We hope the measures don’t have to be so harsh, like keeping everyone at home, because we now know more about broadcasting than we did in April. Many ‘super spread events’ can take place indoors, such as offices and bars. Areas such as Hong Kong and South Korea have been able to combine selective closures with testing to control outbreaks.

It is important to ensure that local transmission is low before opening schools and to closely monitor the situation

What will happen when the children return to school?

It is not yet clear how much children contribute to the transmission of the virus, particularly older age groups, so it is important to ensure that local transmission is low before opening schools and closely monitoring the situation.

And when flu season rolls around?

The risk of flu season is that it creates symptoms similar to COVID-19, which will make testing much more difficult. It will also place an additional burden on the healthcare system.

How would COVID-19 change our way of life in the long term?

To reduce the impact of COVID-19, we must keep the infection away from the most vulnerable groups. There are a number of ways to do it, from border restrictions and social distancing, to testing and contact tracing. We are likely to see measures implemented in one form or another until a vaccine is available.

What vaccination strategy is the most appropriate for this virus?

Ideally, we would have a highly effective vaccine that provides long-term immunity, but we have to be prepared for the possibility that we have an imperfect vaccine, in which case it would be important to ensure that it is distributed in a way that protects those most at risk. .

Models show that small changes in people’s behavior can have a big impact on virus transmission

In his book he also explains how ideas spread. Could a model be established that would make the population aware of the importance of individual responsibility in the face of the pandemic?

Models can show how small changes in people’s behavior can have a big impact on virus transmission. As the pandemic continues, it will be important to provide the population with good information about what their risks are, so that they can adjust their habits.

Since the beginning of the health crisis WHO has warned of an increase in fake news related to COVID-19. How does this false information influence measures to stop the pandemic?

Misinformation about COVID-19 can also affect the disease in real life, because it means that there may be people who do not take precautions to reduce transmission of the virus or who underestimate their risk. As the pandemic continues and people tire of the situation, the spread of misinformation could be a major problem.

With all the expectations placed on finding a vaccine, the anti-vaccines have also had a speaker on social networks. What is the mask against these messages?

Traditionally, the goal was to remove harmful information, but for platforms this is difficult, because online content spreads widely and quickly. Instead, we should look at how we fight real viruses: changing the structure of online interactions could make it harder for people to be exposed to harmful information, and warning messages from trusted sources could reduce susceptibility to anti-vaccination content.

How is infectious disease transmission dynamics applied to analyze violent episodes?

Research has increasingly shown that violence can spread through networks of social interactions. If these pathways can be identified, it creates an opportunity to intervene, just as trackers try to stop disease transmission. These ‘public health’ approaches to violence have been used in various cities, from Glasgow to Chicago, as I explain in the book.

How do these patterns fit with the privacy of citizens?

It is easier to control an infection when we have information about where the outbreak is and who is at risk. For example, countries like South Korea have relied heavily on data to investigate coronavirus outbreaks. But, considering the privacy risk this brings, I think it’s important to be transparent about what information is needed to address outbreaks and what the tradeoffs are.

When and what will the next pandemic be?

There is always the threat of another flu pandemic. The avian flu virus, such as H5N1 or H7N9, has spread over the past decades from birds to people in several countries, causing some deaths, but has not yet acquired the necessary mutations to be transmitted effectively from person to person. It is likely only a matter of time before we see a new and dangerous pandemic flu or influenza virus. Of course, we can also see other coronaviruses with pandemic potential. In the last 18 years we have had SARS, MERS and now COVID-19. There is no reason why another new virus should not emerge in the next few years. We need to be prepared.