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Reflections of a novice COVID-19 researcher

Mike Cates is Lucasian Professor of Mathematics and Royal Society Research Professor at the Department of Applied Mathematics and Theoretical Physics at Cambridge. He co-founded the Rapid Assistance for Modelling the Pandemic (RAMP) project and will appear in BBC2’s Horizon Coronavirus Special – Part 2, on Tuesday 19 May.

The scale of the COVID-19 problem was publicly laid bare on 16 March when  the MRC Centre for Global Infectious Disease Analysis at Imperial College London published ‘Report 9’. The epidemiological modelling used in this report suggested that 250,000 UK deaths were in prospect unless a lockdown was imposed. While much has been said about this report, similar outcomes were found from many other models. Indeed, such predictions depend on only two pieces of information: first, without intervention a highly infectious disease will not die down until most people have had it; and second, COVID-19 has a fatality rate of about 0.5 percent.

On 20 March, Daan Frenkel, who is an Honorary Fellow of Trinity, and I proposed to the Royal Society that we start an initiative in Rapid Assistance for Modelling the Pandemic (RAMP). We thought that the highly skilled epidemic modelling teams currently offering advice to Government were at or beyond full stretch. They needed hands-on reinforcement with additional skilled staff; creation of some new modelling teams to help corroborate – and hopefully extend – their predictions; and a system of accelerated peer-review of their own and other’s work to make best use of the large amount of COVID-19 research now underway.

Professor Mike Cates was appointed Lucasian Professor of Mathematics in 2015, the 19th person to hold the role, which was established in 1663.

The Royal Society embraced our efforts, and asked me to chair RAMP’s Steering Committee.  I thought this would be a full-time job, and so it has turned out. RAMP’s call for assistance brought in over 1800 responses, about half from individuals but many from large teams of researchers in universities, public-sector bodies and commerce.

RAMP has so far harnessed the efforts of hundreds of volunteers to the COVID-19 pandemic modelling effort. We have not only seconded people to existing groups and created new ones, but initiated a project to integrate models of disease spread with ‘urban analytics’ models. The latter describe the movement of people through mass-transport networks, between homes and workplaces, shops and other shared spaces. This integrated approach is being led for RAMP by Professor Mark Birkin of the Alan Turing Institute.

Another new line of enquiry is to ask how people move within buildings and how social distancing can change this. A third is to look more closely at how the transmission of virus is mediated by the fluid dynamics of aerosols and droplets, from coughing or exhalation, within the surrounding air. Further avenues include the role of pre-existing medical conditions, and how the disease develops differently within each individual.

In collaboration with Cambridge’s Newton Institute, RAMP has instigated a new pandemic modelling programme, set up in a month rather than the usual planning period of a year or more. As well as fostering online scientific discussion and collaboration among leading experts in the field, this will create pedagogical materials to help modellers from other disciplines learn more about epidemics.

Finally, RAMP has set up online forums where RAMP volunteers can nominate and discuss papers from the emerging literature on COVID-19 for possible attention of the expert pandemic modellers. A first stage of filtering is crowd-sourced: contributors are asked whether the work is credible and of possible policy impact. Later stages involve moderators who report promising items to the RAMP Rapid Review Group, run by the University of Oxford. This group then asks expert volunteers for rapid assessment before drawing key findings to the attention of those working in official scientific advisory roles.

For the past two months, my time has been spent setting into motion, and keeping track of, all these various activities. It has been interesting work! I have of course been working online from home, but these new habits are doubly strange, since my usual scientific interests have been set aside. I have not engaged as I should have with my PhD students and postdocs, many of whom are themselves working hard as RAMP volunteers. We still hold our group seminars at the usual time, by Zoom, and I attend these whenever I can.

My new workload is large, but dwarfed by those of the scientists who are working flat out to provide the best, evidence-based policy advice that they can. And even their burden doesn’t match that of the NHS staff who daily allow themselves to be placed directly in harm’s way. Like many others, I have been troubled at night by recurrent thoughts. What vital task did I forget today? Are we going about things the right way? And especially: surely there must be a simple way out of this problem, if only we could find it?

The last of these questions marks the first step along the ‘denial, anger, acceptance’ sequence familiar to psychologists. I hope that, whatever grief COVID-19 causes (and for those who lose loved ones the grief is unimaginable), society as a whole can pass from denial to acceptance with as little anger as possible. In an emergency, things go wrong – often very wrong – and mistakes will be made, even though everyone is doing their utmost. It would be good to hear that admission more often, from those in power.

COVID-19 will continue to cause trouble and grief for some time yet, but perhaps we can learn a lesson from it. The ecosystem that supports us has no morals of its own: viruses, like heatwaves and hurricanes, will come and go, with no regard for human life.  But some of the risks we face are made vastly more serious by our own actions – the most pressing example being climate change. Living with the virus teaches us that there are some things we really need – contact with those whom we love – and others that we don’t need, but take for granted, such as unlimited travel for both work and leisure; unlimited dietary choice at every meal; and unlimited new stuff whenever we want it, wherever it comes from. We are often told that to abandon these luxuries will wreck the economy and leave us all impoverished. But, faced with COVID-19, a new viewpoint can be found: ‘our health matters more than our wallets; the economy will suffer, but our society will pull through, so long as we all look after those worst affected’.  Perhaps the time has come to prioritize the health of our planet in exactly similar terms.

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