Reading the Imperial College report, it’s easier to see why the U.K. government has been tossing out a raft of ideas—even the patently ridiculous thought of allowing millions to become infected to generate a kind of fast herd immunity. Because the report’s predictions are somewhere beyond appalling.

Focusing almost exclusively on just the effects of the pandemic on health and the healthcare system, the researchers behind the report (including a lead investigator who is himself now in isolation after displaying symptoms of COVID-19) provide information that paints a bleak picture of where we're going. What that report makes clear is that none of the half measures that have been taken so far, on either side of the Atlantic, are sufficient. The effects on people’s lives may already seem extreme, but what’s been done so far isn’t nearly enough to dent the rising arc of new cases.

The report breaks the possible strategies down to two: mitigation strategies (those that try to slow the spread of the epidemic), and suppression efforts that try to keep overall case levels low. Most of what has been done so far in the U.S., from closing schools to halting meetings, really falls on the “suppression” side of the line. But what the report finds is that, at this point in the epidemic, the best outcome—the outcome that says the government immediately implements an optimal mix of both mitigation and suppression—“might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over.”

The report concludes that an extreme level of suppression, essentially a lockdown on the most restrictive level possible, is the “only viable option.” And it makes a painful admission about how long everyone is going to need to practice social distancing and home isolation for these tools to be effective. Any break in harsh procedures would allow the epidemic to “quickly rebound.” As a result, there is no option but to hold those procedures in place … until a vaccine is available. Even if that takes 18 months or more. The only other option is to accept additional hundreds of thousands, if not millions, of deaths.

The Imperial College report even casts doubt on what seem to be the good-news stories of China and South Korea, in which the curves genuinely were flattened and active case counts driven down. “While experience in China and now South Korea show that suppression is possible in

the short term,” says the report, “it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.”

The HHS report makes some of the same assumptions about the extent and effects of the coronavirus itself:

The fact that no one is immune makes it nearly impossible to prevent, or even slow, the spread of the disease.

We still don’t have enough information to accurately define the spread, or the severity of the overall epidemic in the U.S.

State, local, and tribal authorities are going to need federal assistance and look to the federal government for consistent guidance.

The epidemic in the United States will likely last 18 months, or longer, and could include multiple waves of illness.

That last point, laid on top of similar predictions from the Imperial College report, is more than daunting. Both reports are calling for a “lost year,” and then some. A year in which many of the wheels of everyday life grind to a halt. A year in which no one—no one—can determine the economic or societal fallout.

But there’s one more major point in the HHS report that has to be discussed. The points above have been paraphrased, but on this issue … this is the exact language of the report.

“Supply chain and transportation impacts due to ongoing COVID-19 outbreak will likely result in significant shortages for government, private sector, and individual U.S. consumers.”

Read that again. The Department of Health and Human Services is predicting significant shortages across our economy. Over a period of 18 months. And that’s probably the biggest reason this report is stamped “Not for public distribution or release.”

This is a report that demands not only the attention of every department in government, it demands extraordinary leadership and willingness to rethink everything. Where will we find that?