Seite - 326 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE326 Biological Models at the Individual Level Aside from the precedent set by China, another impetus for the plausibility or necessity of national lockdowns was the application of infectious disease epidemiological models and modelling. A few models gained prominence, including those used at Imperial College, the London School of Hygiene & Tropical Medicine, and Oxford in the United Kingdom, and at Harvard University in the United States.24 In mid-March the modellers at Imperial projected 500,000 deaths in the U.K. and 2.2 million deaths in the U.S. if no action were taken. Furthermore, and most importantly, the modellers were able to share their projections directly with the U.K. Prime Minister’s Office as well as U.S. Presidential advisors. The influence of the projections was enormous, and resulted in lockdown policies in the U.K. They also may have propelled the U.S. President to take the pandemic more seriously. The models used to simulate new diseases are informed by characteristics of previous epidemics, but are unique to each research group. Even when differ- ent research groups try to produce forecasts of the same epidemic, their modelling can vary in numerous ways, including the assump- tions for regarding transmission rates, incubation periods, case fatal- ity rates, and so forth. Some groups may add more complexity such as geographical space, density, age, and so forth. Different projections reflect all the underlying differences in assumptions and informa- tional bases. But what seems to be true, at least of the Imperial Model, are the types of assumptions made and narrow informational bases used. For example, in the initial Imperial Model, all individuals are equally susceptible to risk to infection, equally infectious when they do become infected, and completely immune when they recover. Two aspects of such assumptions in the models are worth remark- ing on, as they have direct bearing on the unequal burdens and vulner- abilities people are facing. First, vulnerability to infections is clearly not equal among all human beings, or even within a country. Such differences in vulnerability can be created from existing health condi- tions, frailty from being older, as well as from social conditions such as lack of clean water or the inability to afford soap. The evening-out of inequality of vulnerability to infection, in turn, also produces an analy- sis that erases the unequal abilities, thus indicating a benefit from the intervention to reduce transmission. This evening-out obfuscates the 24. Adam, supra note 16.