How can we know when the pandemic has topped out?

Assessing the top 

Is there a guideline heuristic?

So far, no guidelines have been established on how to judge whether the epidemic has stabilised in any country or whether lockdowns can be lifted. Part of the problem is a fear that much larger numbers of untested symptomless cases are out there, ready to launch new rounds of infection as soon as anyone walks out the door and breaks quarantine.

In the meantime governments have been prepared to adopt huge financial packages to support lockdowns and closures, with numbers that would have been unthinkable even a few weeks earlier. Everyone is flying by the seat of their pants, and as one pundit put it, "nobody was ever punished for overreacting to an emergency." Damage to the economy is vast and immediate, enormously in excess of any normal budgetary consideration, and decisions must be made equally rapidly as to when to remove lockdowns or limit economic stimulus.   

The dirtiness of data on the incidence of the disease or the rate of new cases has meant that conventional epidemiological models are of little use. In any case, they were never really intended to model or track data at the level of detail now available, and were more intended to demonstrate general principles.

What we are first looking for is the 'point of inflection' - the time at which daily new cases reached a maximum.

Accordingly we are left with pattern matching to decide , or simple mathematical heuristics for decision making. For example, in our Press Release we gave a possible rule for deciding the local pandemic had been slowed, .

At or lower than the maximum for five days, then an exponential fall-off for two days. 

Does it work? Or do we 'need more time', as everyone seems to think - when we did not need more time to turn the tap on and if we did, like the hardest hit countries, we regretted it? We look at the evidence in a separate analysis.

Even if you have reached a top - what do you need to do to make sure it stays that way?

Nobody has ever really thought about these questions because there has never been the data to begin to answer them. Now there is.

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