Epidemiologist Neil Ferguson caught coronavirus!

by Brian Bamford

YESTERDAY's editorial in the Financial Times declared 'Johnson is coming to grips with the virus'.  Yet only a week ago the same FT editor had argued that 'The [then] UK approach is ... potentially more costly in human lives than strict containment measures, if the latter do succeed in stopping the virus in its tracks.'  The FT editor was concerned, a week ago, that if Chris Whitty, England's chief medical officer, was right in estimating a 'reasonable worst-case scenario' was that 80% of Britain's 66m people would be infected then the death toll could be 500,000 - almost doubling the UK's normal annual death rate.

Last week it also turned out that the epidemiologist Neil Ferguson had reported having a 'dry cough' and a high fever; the classic symptoms of the coronavirus.  Last Wednesday he tweeted that he felt 'a bit grotty'.

A test soon showed he had been infected by the virus he was modeling.  At this time it's a sobering thought!


Ferguson is a mathematician and an epidemiologist whose work on the spread of Covid-19 is informing policy in not only the UK but also France, the US and other countries as well.  The centre he founded with colleagues at Imperial College, the MRC Centre for Global Infectious Disease Analysis, collaborates with the World Health Organization.

This week the massive swift shift in the UK response from essentially letting the virus spread through the population to the wholescale stay-at-home policy now in place has resulted from Ferguson’s work, supported by other modellers especially at the London School of Hygiene and Tropical Medicine.

Ferguson has taken a lead, advising ministers and explaining his predictions in newspapers and on TV and radio, because he is that valuable thing, a good scientist who is also a good communicator.

Naturally mathematical modelling is only as good as the data fed into the computers. It was new information on the high rate of patients needing critical care in Italy and on the limited ability of the NHS to respond to the pandemic that caused Ferguson and colleagues to recommend a switch from what they called scenario 1 – mitigation – to scenario 2 – suppression of the virus, including the drastic measures that have emptied the pubs, closed theatres and is now to shut all schools.

The latest analysis comes from a team modelling the spread and impact COVID-19 and whose data are informing current UK government policy on the pandemic.

The findings are published in the 9^th report from the WHO Collaborating Centre for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London.

Professor Neil Ferguson, head of the MRC GIDA team and director of the Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), said:
“The world is facing the most serious public health crisis in generations. Here we provide concrete estimates of the scale of the threat countries now face.
“We use the latest estimates of severity to show that policy strategies which aim to mitigate the epidemic might halve deaths and reduce peak healthcare demand by two-thirds, but that this will not be enough to prevent health systems being overwhelmed. More intensive, and socially disruptive interventions will therefore be required to suppress transmission to low levels. It is likely such measures – most notably, large scale social distancing – will need to be in place for many months, perhaps until a vaccine becomes available.”

He is a workaholic, according to his colleague Christ Donnelly, a professor of statistical epidemiology based at Oxford University most of the time, as well as at Imperial.  “He works harder than anyone I have ever met,” she said.  “He is simultaneously attending very large numbers of meetings while running the group from an organisational point of view and doing programming himself.  Any one of those things could take somebody their full time.

“One of his friends said he should slow down – this is a marathon not a sprint. He said he is going to do the marathon at sprint speed. It is not just work ethic – it is also energy.  He seems to be able to keep going. He must sleep a bit, but I think not much.”

Donnelly met Ferguson when they were both working for Prof Roy Anderson’s epidemiology group at Oxford University.  Their first project together was modelling the BSE epidemic in cattle in 1996 and then the variant CJD (Creutzfeldt-Jakob disease) outbreak in humans.

They came up with an estimate that was incredibly broad for the likely number of human deaths – between 50 and 50,000 – but that was at a time when some were predicting 2 million people would be infected. There were calls for the sort of NHS resources now going into Covid-19 to be directed towards vCJD. Ferguson and Donnelly’s modelling helped defuse that. In the end the UK had about 170 cases.

Next came foot and mouth, then Sars, then pandemic influenza. With every disease outbreak, governments have turned to the modellers. While Donnelly, with her statistical training, could have had a quiet life as a researcher in the pharmaceutical industry discovering new drugs, she is instead watching the predictions she and Ferguson have made hit the headlines on the TV news. She says both of them were attracted to “high-impact” projects.
Ferguson may have the symptoms of Covid-19 but he is still working. At 9am he joined an online meeting with his colleagues as usual. The stakes are too high for somebody with his dedication and central role in the crisis to stay in bed.

Slowing and suppressing the outbreak

The report details that for the first scenario (slowing the spread), the optimal policy would combine home isolation of cases, home quarantine and social distancing of those over 70 years.  This could reduce the peak healthcare demand by two-thirds and reduce deaths by half.  However, the resulting epidemic would still likely result in an estimated 250,000 deaths and therefore overwhelm the health system (most notably intensive care units).

The world is facing the most serious public health crisis in generations. Prof. Neil Ferguson Director, J-IDEA

In the second scenario (suppressing the outbreak), the researchers show this is likely to require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members (and possible school and university closure).  The researchers explain that by closely monitoring disease trends it may be possible for these measures to be relaxed temporarily as things progress, but they will need to be rapidly re-introduced if/when case numbers rise.  They add that the situation in China and South Korea in the coming weeks will help to inform this strategy further.

**************************