Project Simulation Pandemics Jonathan Thaler Department of - - PowerPoint PPT Presentation

Project Simulation Pandemics

Jonathan Thaler

Department of Computer Science

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Pandemics History

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Pandemics History Diseases and illnesses have plagued humanity since the earliest days and are killer number one (by far)!

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Pandemics History

They have always been there but... Shift to agrarian communities (∼ 10,000 years ago) increased scale and spread.

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Pandemics History

They have always been there but... Shift to agrarian communities (∼ 10,000 years ago) increased scale and spread. Widespread trade created new opportunities for human and animal interactions that sped up such epidemics.

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Pandemics History

They have always been there but... Shift to agrarian communities (∼ 10,000 years ago) increased scale and spread. Widespread trade created new opportunities for human and animal interactions that sped up such epidemics. Malaria, tuberculosis, leprosy, influenza, smallpox, and others first appeared during these early years.

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Pandemics History

They have always been there but... Shift to agrarian communities (∼ 10,000 years ago) increased scale and spread. Widespread trade created new opportunities for human and animal interactions that sped up such epidemics. Malaria, tuberculosis, leprosy, influenza, smallpox, and others first appeared during these early years. The more civilized humans became - with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems - the more likely pandemics would occur.

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Pandemics History

Antoninue Plague: 165 - 180 A.D. Cause: Believed to be either smallpox or measles Death Toll: 5 Million Began with the Huns → Germans → Romans Roman troops returning home from war against Parthia spread it throughout the Roman empire. Contributed to the end of the Pax Romana (the Roman Peace), a period from 27 B.C. to A.D. 180, when Rome was at the height of its power. After A.D. 180, instability grew throughout the Roman Empire. Christianity became increasingly popular in the time after the plague occurred.

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Pandemics History

Plague of Cyprian: 251 - 266 A.D. Cause: A second outbreak of what may have been the same disease as the Antonine Plague. Death Toll: killed 5,000 people a day in Rome. Possibly starting in Ethiopia. Passed through Northern Africa, into Rome, then onto Egypt and northward. 444 A.D., it hit Britain and obstructed defense efforts against the Picts and the Scots, causing the British to seek help from the Saxons, who would soon control the island.

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Pandemics History

Justinians Plague: 541 - 542 A.D. Cause: Yersinia pestis bacteria / rats, fleas Death Toll: 30-50 Million (estimated to be half of world population) Byzantine historian Procopius of Caesarea traced the origins of the plague to China and northeast India, via land and sea trade routes to Egypt where it entered the Byzantine Empire through Mediterranean ports. Procopius laid blame for the outbreak on the Emperor Justinian. The plague changed the course of the empire, squelching Emperor Justinian’s plans to bring the Roman Empire back together and causing massive economic struggle. Historians found that this event could have dashed Emperor Justinian’s efforts to reunite the Western and Eastern remnants of the Roman Empire, and marked the beginning of the Dark Ages. It is also credited with creating an apocalyptic atmosphere that spurred the rapid spread of Christianity.

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Pandemics History

The Black Death: 1346 - 1353 A.D. Cause: Yersinia pestis bacteria / Rats, fleas Death Toll: 200 Million (estimated to be 1/3 of world population) Changed the course of Europe’s history. Labor became harder to find, bringing about better pay for workers and the end

• f Europe’s system of serfdom (Leibeigenschaft).

Studies suggest that surviving workers had better access to meat and higher-quality bread. Lack of cheap labor may also have contributed to technological innovation. England and France were so incapacitated by the plague that the countries called a truce to their war. British feudal system collapsed when the plague changed economic circumstances and demographics. Vikings lost the strength to wage battle against native populations, and their exploration of North America halted.

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Pandemics History

American Plagues: 16th Century A.D. Cause: Smallpox and others Death Toll: killed 90% of the indigenous population in the Western Hemisphere was killed off. Helped a (small) Spanish force led by Hern´ an Cort´ es conquer the Aztec capital

• f Tenochtitl´

an in 1519 Another Spanish force led by Francisco Pizarro conquer the Incas in 1532. 1520, the Aztec Empire was destroyed by a smallpox infection. Research in 2019 even concluded that the deaths of some 56 million Native Americans in the 16th and 17th centuries, largely through disease, may have altered Earth’s climate as vegetation growth on previously tilled land drew more CO2 from the atmosphere and caused a cooling event. Various research concludes that Syphilis was brought from the Americas to Europe, killing many people especially during the Renaissance.

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20th / 21st Centuries

Pandemic Time Cause Death Toll Spanish Flu 1918-1919 H1N1 virus / Pigs 40-50M Asian Flu 1957-1958 H2N2 virus 1.1M Hong Kong Flu 1968-1970 H3N2 virus 1M HIV/AIDS 1981-present Virus / Chimpanzees 25-35M Swine Flu 2009-2010 H1N1 virus / Pigs 200,000 SARS 2002-2003 Coronavirus / Bats, Civets 770 Ebola 2014-2016 Ebolavirus / Wild animals 11,000 MERS 2015-Present Coronavirus / Bats, camels 850 COVID-19 2019-Present Coronavirus 851.352 (1/9/20)

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Pandemics Today

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Pandemics Today

Plague is still occuring with the last epidemic in 2017 in Madagascar an Seychelles.

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Pandemics Today

Plague is still occuring with the last epidemic in 2017 in Madagascar an Seychelles. A 7th Cholera pandemic is ongoing since 1961 and causes 100,000 global victims each year.

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Pandemics Today

Plague is still occuring with the last epidemic in 2017 in Madagascar an Seychelles. A 7th Cholera pandemic is ongoing since 1961 and causes 100,000 global victims each year. There are 3,000,000 Leprosy patients world wide.

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Pandemics Today

Plague is still occuring with the last epidemic in 2017 in Madagascar an Seychelles. A 7th Cholera pandemic is ongoing since 1961 and causes 100,000 global victims each year. There are 3,000,000 Leprosy patients world wide. Seasonal Flu and Malaria kills about 500,000 people annually.

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Pandemics Today

Since 1980, the number of outbreaks per year has more than tripled. This has multiple reasons:

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Pandemics Today

Since 1980, the number of outbreaks per year has more than tripled. This has multiple reasons: The population on the planet has doubled over the last 50 years, leading to more susceptible people and more densely populated areas.

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Pandemics Today

Since 1980, the number of outbreaks per year has more than tripled. This has multiple reasons: The population on the planet has doubled over the last 50 years, leading to more susceptible people and more densely populated areas. There is more livestock now than over the last 10,000 years of domestication up to 1960 combined. Viruses can leap from those animals to humans.

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Pandemics Today

Since 1980, the number of outbreaks per year has more than tripled. This has multiple reasons: The population on the planet has doubled over the last 50 years, leading to more susceptible people and more densely populated areas. There is more livestock now than over the last 10,000 years of domestication up to 1960 combined. Viruses can leap from those animals to humans. The interconnected global ecnomoy helps spread new infectious diseases.

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Pandemics Today

Since 1980, the number of outbreaks per year has more than tripled. This has multiple reasons: The population on the planet has doubled over the last 50 years, leading to more susceptible people and more densely populated areas. There is more livestock now than over the last 10,000 years of domestication up to 1960 combined. Viruses can leap from those animals to humans. The interconnected global ecnomoy helps spread new infectious diseases. Human psychology with vaccine sceptisism has lead to the resurrection of long-conquered diseases like measles, leading the WHO in 2019 to name the antivaccination movement one of the world’s top 10 public-health threats.

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COVID-19

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COVID-19

November 17, 2019: first reported case in China appeared in the Hubei Province but went unrecognized.

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COVID-19

November 17, 2019: first reported case in China appeared in the Hubei Province but went unrecognized. 30th December 2019: Dr. Li Wenliang defied government orders and released safety information to other doctors in December. China informed WHO and charged Li with a crime. Li died from COVID-19 on 7th February 2020.

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COVID-19

November 17, 2019: first reported case in China appeared in the Hubei Province but went unrecognized. 30th December 2019: Dr. Li Wenliang defied government orders and released safety information to other doctors in December. China informed WHO and charged Li with a crime. Li died from COVID-19 on 7th February 2020. 31 December 2019, the World Health Organization (WHO) was formally notified about a cluster of cases of pneumonia in Wuhan City, home to 11 million people and the cultural and economic hub of central China.

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COVID-19

November 17, 2019: first reported case in China appeared in the Hubei Province but went unrecognized. 30th December 2019: Dr. Li Wenliang defied government orders and released safety information to other doctors in December. China informed WHO and charged Li with a crime. Li died from COVID-19 on 7th February 2020. 31 December 2019, the World Health Organization (WHO) was formally notified about a cluster of cases of pneumonia in Wuhan City, home to 11 million people and the cultural and economic hub of central China. 11 January 2020 WHO tweeted that it had received the genetic sequences for the novel coronavirus from the People’s Republic of China and expected these to soon be made publicly available. Chinese media reported the first death from the novel coronavirus.

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COVID-19

November 17, 2019: first reported case in China appeared in the Hubei Province but went unrecognized. 30th December 2019: Dr. Li Wenliang defied government orders and released safety information to other doctors in December. China informed WHO and charged Li with a crime. Li died from COVID-19 on 7th February 2020. 31 December 2019, the World Health Organization (WHO) was formally notified about a cluster of cases of pneumonia in Wuhan City, home to 11 million people and the cultural and economic hub of central China. 11 January 2020 WHO tweeted that it had received the genetic sequences for the novel coronavirus from the People’s Republic of China and expected these to soon be made publicly available. Chinese media reported the first death from the novel coronavirus. 13 January 2020 The Ministry of Public Health in Thailand reported their first confirmed case.

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COVID-19

16 January 2020 The Japanese Ministry of Health reported their first confirmed case.

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COVID-19

16 January 2020 The Japanese Ministry of Health reported their first confirmed case. 21 January 2020 The United States of America (USA) reported its first confirmed case.

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COVID-19

16 January 2020 The Japanese Ministry of Health reported their first confirmed case. 21 January 2020 The United States of America (USA) reported its first confirmed case. 13 March 2020 Europe had become the epicentre of the pandemic with more reported cases and deaths than the rest of the world combined, apart from the People’s Republic of China.

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COVID-19

16 January 2020 The Japanese Ministry of Health reported their first confirmed case. 21 January 2020 The United States of America (USA) reported its first confirmed case. 13 March 2020 Europe had become the epicentre of the pandemic with more reported cases and deaths than the rest of the world combined, apart from the People’s Republic of China. 16 March 2020 Austria issued a nationwide curfew.

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COVID-19

16 January 2020 The Japanese Ministry of Health reported their first confirmed case. 21 January 2020 The United States of America (USA) reported its first confirmed case. 13 March 2020 Europe had become the epicentre of the pandemic with more reported cases and deaths than the rest of the world combined, apart from the People’s Republic of China. 16 March 2020 Austria issued a nationwide curfew. As of 14nd Sept 2020 the number of people infected with COVID-19 has reached 29M worldwide, of whom 19,6M have recovered. The death toll is 925K.

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Corona Hospitalisation

Figure: Age-specific hospitalisation rates among all reported cases of COVID-19, data from 14 countries in the European Surveillance System up to 22 April 2020.

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Corona Fatalities

Figure: Age-specific crude case fatality (deaths/all reported cases of COVID-19), data from 13 countries in the European Surveillance up to 22 April 2020.

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Corona Age Distribution

Figure: Age distribution of COVID-19 cases based on composite data from around the globe.

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Corona Mortality

Figure: Mortality associated with COVID-19 infections by age. Composite global data compiled from multiple sources.

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Corona Mortality by Sex

Figure: Comparison of composite global mortality rates by patient sex.

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Interventions

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Interventions

Containment Undertaken in the early stages of the outbreak, including contact tracing and isolating infected individuals to stop the disease from spreading to the rest of the population.

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Interventions

Containment Undertaken in the early stages of the outbreak, including contact tracing and isolating infected individuals to stop the disease from spreading to the rest of the population. Mitigation Used when containment is failing. Slow the spread of the disease and mitigate its effects on society and the healthcare system, while the basic reproduction number is still above 1. Examples for such interventions are reduction of public transport, shutdown of public flights.

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Interventions

Containment Undertaken in the early stages of the outbreak, including contact tracing and isolating infected individuals to stop the disease from spreading to the rest of the population. Mitigation Used when containment is failing. Slow the spread of the disease and mitigate its effects on society and the healthcare system, while the basic reproduction number is still above 1. Examples for such interventions are reduction of public transport, shutdown of public flights. In reality, containment and mitigation measures may be undertaken simultane-

• usly.

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Interventions

Suppression Requires more extreme long-term non-pharmaceutical interventions so as to re- verse the pandemic by reducing the basic reproduction number to less than 1. Includes stringent population-wide social distancing, home isolation of cases, and household quarantine.

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Interventions

Suppression Requires more extreme long-term non-pharmaceutical interventions so as to re- verse the pandemic by reducing the basic reproduction number to less than 1. Includes stringent population-wide social distancing, home isolation of cases, and household quarantine. Undertaken initially by China and then the rest of the world during the COVID-19 pandemic where entire cities and whole countries were placed under lockdown. Such strategy carries with it considerable social and economic costs.

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Interventions

Flattening the epidemic curve A key part of managing an infectious disease outbreak by trying to decrease the epidemic peak. This helps decrease the risk of health services being over- whelmed, and provides more time for a vaccine and treatment to be developed.

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Interventions

Social Distancing History shows that these techniques are only effective in areas where transmission rates are still low - in other words, where the epidemic’s effects haven’t really been felt yet. As social distancing becomes a part of everyday life, it is important to consider that what seem to be premature closings are the only ones that really

• work. This was one of the reasons why Austria imposed a curfew that early.

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Interventions

Social Distancing History shows that these techniques are only effective in areas where transmission rates are still low - in other words, where the epidemic’s effects haven’t really been felt yet. As social distancing becomes a part of everyday life, it is important to consider that what seem to be premature closings are the only ones that really

• work. This was one of the reasons why Austria imposed a curfew that early.

During the Spanish Flu 1918 - 1919, St. Louis applied social distancing (gathering bans, school closures) before the epidemic hit the city. Many lives were safed. Pittsburgh lagged behind with banning public gatherings and school closures, and suffered therefore far worse with a death rate 3x of St. Louis.

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Interventions

Isolation Separation of people who constitute a confirmed case from the rest of the pop- ulation.

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Interventions

Isolation Separation of people who constitute a confirmed case from the rest of the pop- ulation. Quarantine Separation of people who had contact with other people which are a confirmed case.

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Interventions

School Closures There is no definitive consensus among epidemiologists about the benefits and limitations of school closures. To make matters worse, preventing millions of children from accessing necessities such as the food and warmth they receive at school also carries potentially devastating social costs.

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Interventions

School Closures There is no definitive consensus among epidemiologists about the benefits and limitations of school closures. To make matters worse, preventing millions of children from accessing necessities such as the food and warmth they receive at school also carries potentially devastating social costs. In the end social distancing is a pareto optimisation problem: governments will not be able to minimise both deaths from an infectious disease and the economic impact of viral spread.

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Interventions

Contact Tracing It involves tracking the dissemination of a disease within a community, and then using isolation and individual quarantines to keep people who have been infected by or exposed to the disease from spreading it.

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Interventions

Contact Tracing It involves tracking the dissemination of a disease within a community, and then using isolation and individual quarantines to keep people who have been infected by or exposed to the disease from spreading it. Most effective at the start of an outbreak or when it has subsided and reduced to traceable numbers. Model-based estimates suggest, with an R0 value of 2.5, that about 70% of contacts will have to be successfully traced to control early spread.

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Interventions

Digital Contact Tracing Use of mobile apps to trace potential contacts automatically.

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Interventions

Studies have shown that that 56% of the general population must use the app to halt the outbreak which has been equated to 80% of all existing smartphone

• wners.

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Interventions

Studies have shown that that 56% of the general population must use the app to halt the outbreak which has been equated to 80% of all existing smartphone

• wners.

People might abandon it due to repeated notification of false warnings.

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Interventions

Studies have shown that that 56% of the general population must use the app to halt the outbreak which has been equated to 80% of all existing smartphone

• wners.

People might abandon it due to repeated notification of false warnings. People which work in precarious working situations might simply ignore the call for quarantine as they might lose their job.

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Interventions

Studies have shown that that 56% of the general population must use the app to halt the outbreak which has been equated to 80% of all existing smartphone

• wners.

People might abandon it due to repeated notification of false warnings. People which work in precarious working situations might simply ignore the call for quarantine as they might lose their job. Ethical issues about the use of smartphone data by central governments to track and direct citizen behaviour.

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Interventions

Studies have shown that that 56% of the general population must use the app to halt the outbreak which has been equated to 80% of all existing smartphone

• wners.

People might abandon it due to repeated notification of false warnings. People which work in precarious working situations might simply ignore the call for quarantine as they might lose their job. Ethical issues about the use of smartphone data by central governments to track and direct citizen behaviour. Although it is believed that digital contact tracing could be very effective, its main obstacles are of social and ethical nature.

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Interventions

Herd Immunity How a society collectively fights off infections to keep the transmission of disease low.

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Interventions

Herd Immunity How a society collectively fights off infections to keep the transmission of disease low. The more people who are immune, the fewer people a virus can jump to, and the fewer it can infect. For example, if 90 out of 100 people in a room are immune to measles, the other 10 people are not likely to get the disease even if they aren’t immune.

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Interventions

Herd Immunity How a society collectively fights off infections to keep the transmission of disease low. The more people who are immune, the fewer people a virus can jump to, and the fewer it can infect. For example, if 90 out of 100 people in a room are immune to measles, the other 10 people are not likely to get the disease even if they aren’t immune. With the novel corona virus, experts predict at least 70% of the population will need to be immune to the virus in order to achieve herd immunity.

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Interventions

Sweden and UK attempted to deal with COVID-19 through herdimmunity, to reduce economic costs.

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Interventions

Sweden and UK attempted to deal with COVID-19 through herdimmunity, to reduce economic costs. Both had to relax their attempts due to uncertainty of dynamics.

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Interventions

Sweden and UK attempted to deal with COVID-19 through herdimmunity, to reduce economic costs. Both had to relax their attempts due to uncertainty of dynamics. The preferred way to build herd immunity is through vaccination.

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Interventions

Sweden and UK attempted to deal with COVID-19 through herdimmunity, to reduce economic costs. Both had to relax their attempts due to uncertainty of dynamics. The preferred way to build herd immunity is through vaccination. Without vaccination, the essential question in developing a herd immunity in a population is whether recovered patients are immune or not (or whether the immunity wears off over time), how high the death toll is going to be when going through a controlled herd immunisation period and whether the health care system can deal with the increased load.

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