Don't "Flatten the Curve," stop it! - Joscha Bach - Medium - 1 views
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What all these diagrams have in common:
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They have no numbers on the axes.
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They don’t give you an idea how many cases it takes to overwhelm the medical system, and over how many days the epidemic will play out.
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They suggest that currently, the medical system can deal with a large fraction (like maybe 2/3, 1/2 or 1/3) of the cases, but if we implement some mitigation measures, we can get the infections per day down to a level we can deal with.
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They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy.
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nstead, we let the infection burn through the entire population, until we have herd immunity (at 40% to 70%), and just space out the infections over a longer timespan.
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The Curve Is a Lie
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suggestions are dangerously wrong, and if implemented, will lead to incredible suffering and hardship.
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Let’s try to understand this by putting some numbers on the axes.
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California has only 1.8.
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The US has about 924,100 hospital beds (2.8 per 1000 people)
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Germany have 8
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South Korea has 12
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Based on Chinese data, we can estimate that about 20% of COVID-19 cases are severe and require hospitalization
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many severe cases will survive if they can be adequately provided for at home
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by some estimates can be stretched to about a 100,000, and of which about 30,000 may be available
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mportant is the number of ICU beds
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oxygen, IVs and isolation
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About 6% of all cases need a ventilator
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if hospitals put all existing ventilators to use, we have 160,000 of them
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CDC has a strategic stockpile of 8900 ventilators
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number of ventilators as a proximate limit on the medical resources, it means we can take care of up to 170,000 critically ill patients at the same time.
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Without containment, the virus becomes endemic
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Let’s assume that 55% of the US population (the middle ground) get infected between March and December, and we are looking at 180 million people.
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the point of my argument is not that we are doomed, or that 6% of our population has to die, but that we must understand that containment is unavoidable, and should not be postponed, because later containment is going to be less effective and more expensive, and leads to additional deaths.
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About 20% will develop a severe case and need medical support to survive.
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Severe cases tend to take about 3–6 weeks to recover
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6% may need intubation and/or ventilation
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Once a person is on the ventilator, it often takes about 4 weeks for them to get out of intensive care again.
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The “flattening the curve” idea suggests that if we wash our hands and stay at home while being sick aggressively enough, we won’t have to stop the virus from becoming endemic and infecting 40% to 70% of all people, but we can slow the spread of the infection so much that out medical system can deal with the case load. This is how our normally distributed curve looks like when it contains 10.8 million patients, of which no more than 170,000 are ill at the same time:
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Dampening the infection rate of COVID-19 to a level that is compatible with our medical system means that we would have to spread the epidemic over more than a decade!
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confident that we will have found effective treatments until the
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reducing the infectivity of the new corona virus to a manageable level is simply not going to be possible by mitigation, it will require containment.
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My back-of-the-envelope calculation is not a proper simulation, or a good model of what’s going on either. Don’t cite it as such!
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Of the 180 million, 80% will be regarded as “mild” cases.
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Containment works
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China has demonstrated to us that containment works
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lockdown of Wuhan did not lead to starvation or riots
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made it possible to focus more medical resources on the region that needed it most
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implemented effective containment measures as soon as the first cases emerged.
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South Korea was tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation.
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For some reason, Western countries refused to learn the lesson.
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The US, UK and Germany are not yet at this point: they try to “flatten the curve” by implementing ineffective or half hearted measures that are only meant to slow down the spread of the disease
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instead of containing it.
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some countries will stomp out the virus and others will no
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few months from now
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almost all travel from red zones into green zones will come to a hal
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world will turn into red zones and green zones
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Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment and stop the curve.
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"Flattening the curve is not an option for the United States, for the UK or Germany. Don't tell your friends to flatten the curve. Let's start containment and stop the curve." Strong article with data visualizations from a Phd working out of MIT/Harvard.
