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Sat Mar 14, 2020, 12:49 PM

Flattening the curve

Something I wonder about the "flattening the curve" plot that everyone is spreading.

If they succeed in flattening the curve, it appears they suggest that the epidemic will last 2 to 3 times as long judging from the comparative length on the abscissa. Presuming a 3 month period for the sharp peak, that would suggest upwards of 9 months for the flattened curve. And it is hard to tell, but it would appear that the total area of the flattened curve is larger than the sharp peak curve. This would suggest that flattening the curve will result in more people being infected. Is this a trade off that isn't being communicated? Do they really intend for more people to get infected so that we don't overwhelm the system?

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Arrow 20 replies Author Time Post
Reply Flattening the curve (Original post)
zipplewrath Mar 14 OP
Fresh_Start Mar 14 #1
zipplewrath Mar 14 #3
jpak Mar 14 #9
Terry_M Mar 14 #12
morillon Mar 14 #2
zipplewrath Mar 14 #7
morillon Mar 14 #17
lunasun Mar 14 #4
JustABozoOnThisBus Mar 14 #5
DrToast Mar 14 #10
DrToast Mar 14 #6
uponit7771 Mar 14 #8
bpj62 Mar 14 #11
MH1 Mar 14 #13
WhiskeyGrinder Mar 14 #14
zipplewrath Mar 14 #15
The_jackalope Mar 14 #18
lunasun Mar 14 #20
The_jackalope Mar 14 #16
LAS14 Mar 14 #19

Response to zipplewrath (Original post)

Sat Mar 14, 2020, 12:52 PM

1. fewer people die. medical system does not collapse

I'm not sure the number of infected is larger or smaller...because I think it will become endemic. I don't think the curve is to scale because no one knows accurate numbers. It is purely illustrative of a principle.

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Response to Fresh_Start (Reply #1)

Sat Mar 14, 2020, 12:58 PM

3. I get that

But it does appear to "illustrate" that they expect to lengthen the period significantly.

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Response to Fresh_Start (Reply #1)

Sat Mar 14, 2020, 01:04 PM

9. Both curves assume the same number of infected

NT

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Response to Fresh_Start (Reply #1)

Sat Mar 14, 2020, 01:06 PM

12. This

The numbers I've read is that total hospital capacity is around 1 million beds in our country of 300 million, with about 30% free at any time (so 300k beds might be free right now).

If 1% of the population catches the virus today (3 million people) - 10-20% of them will have a severe reaction that needs hospitalization a week from now. That right there is already 300k+ beds needed. If this is all evenly spread out, (nice and even distribution of the sick based on capacity in their area) this doesn't sound so bad I guess.

If 2% of the population catches the virus today, that's 600k+ beds needed. Now we're running out of beds - people are getting turned away, hospitals are over-stuffed, doctors are nurses are overworked and basically... the end result... is that mortality for this and other conditions (because patients with other conditions may now be getting less attention/getting turned away) is higher.

If 5% of the population catches the virus, many of that 1.5 million who get severe symptoms will never get any professional medical attention. Mortality will be even higher (not that low end 1%, but because the system can't handle it, it will be way higher).

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 12:57 PM

2. Fewer people die as a result of medical system collapse

The overall number of people affected by the virus may or may not be the same, but what we DO know is that people dying just from being turned away is lower when we flatten the curve. People needing treatment for things other than coronavirus don't get turned away and face life-threatening delays, either. All of that has been happening in Italy. People who ordinarily could've pulled through ended up dying due to scarce equipment and personnel. This is apparently taking quite a toll on medical personnel, since they're having to let some people die when under other circumstances they could have at least tried to save them.

Flatten the curve.

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Response to morillon (Reply #2)

Sat Mar 14, 2020, 01:02 PM

7. And the economic impact will be lengthened.

Shutting down the economy for 9 months to a year could be devastating. And I suspect unsustainable.

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Response to zipplewrath (Reply #7)

Sat Mar 14, 2020, 01:21 PM

17. There'd be worse knock-on effects with a spike

Italy's had a situation where people died at home, and their families struggled to find mortuaries to take them. One family waited something like 36 hours. There've been worse reports out of Wuhan. Hospitals AND mortuaries are overwhelmed, and it freaking wrecks your society to go through things like that.

Weathering an economic crisis for 6-9 months is bad, no doubt. But if we let a spike happen, we're in uncharted territory -- culturally, psychologically, and many other -lys -- and I don't think anyone knows what economic effects that'd have.

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:02 PM

4. Yes you want to prolong it . Not overwhelm critical wards all at once . That's how to prevent death

Thatís what is the problem in pkaces like Italy A hospital could have 50 respirators 100 need it now all at once
Some will not get it.
China same it came all at once and did not have the facilities
Prolong it out for months the turnover will allow treatment for many more

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:02 PM

5. Another hope: at some point along the curve, a "cure" and a vaccine might be developed.

And, with some risk analysis, the testing window might be shortened. That could end the curve and save lives.

I'm sure we have top people working on it. Top. People.

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Response to JustABozoOnThisBus (Reply #5)

Sat Mar 14, 2020, 01:04 PM

10. This too. Treatments and vaccines are currently under trials

In that regard, flattening the curve can reduce cases if we get effective treatments or a vaccine.

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:02 PM

6. No, it doesn't materially change the number of cases

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:03 PM

8. We wont know for more than a month what the curve is seeing there's no unfettered testing

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:04 PM

11. The system is not overwelmed

If the medical system crashes we have no care givers or facilities to treat the sick. By flattening the curve you lengthen the time frame of the epidemic but you allow the healthcare system to survive which allows for people to continue to get care. The virus is going to run a course before it burns out, we are extending that season.

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:08 PM

13. Unless vaccine or highly effective treatment arrives VERY quickly

(relative to expectations)

No, you will not see "more people infected". Because:

First, disclaimer: I am not a medical person, epidemiologist, or any other credentialed person. I *am* a computer scientist who has a reputation for catching on to new concepts quickly.

My take:
EVERYONE will be exposed. (with possibly small exceptions in very unusual circumstances, like maybe a small commune in the wilds of Montana.)

All of those susceptible will be "infected". According to reports, a high percentage of people "infected", do not develop significant symptoms. (I'll leave it to medicos to debate whether those actually can be called "infected". If the virus gets into one's system and plays around a bit before it goes away, that to me is "infection", even if you don't notice it much.)

The only thing that will stop infections from happening is a vaccine. That is a year and a half away at best, according to story I heard on NPR.

The only thing short of a vaccine that will reduce death:

1) more effective rapid treatment. Yeah that could happen but it's a wish and a prayer at the moment.

2) flattening the curve. Giving the medical system a chance to "catch up" so services and people are not overwhelmed.

That's it. But no, I do not believe you will reduce infections by "getting it over with quickly". There is no "getting over it quickly".

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:09 PM

14. Whatever graph you're looking at isn't to scale or even a reflection of reality; it's an

illustration to help you grasp the concept.


It's entirely possible that flattening the curve drops the line to close to zero very early on, because the system has the capacity to develop an effective vaccine.

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Response to WhiskeyGrinder (Reply #14)

Sat Mar 14, 2020, 01:19 PM

15. That'll take a year

That means shutting down the economy for the better part of a year. I don't think that is sustainable.

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Response to zipplewrath (Reply #15)

Sat Mar 14, 2020, 01:23 PM

18. Talking about economies

It's entirely possible that this event will cause a major inflection in the global economy. Whether it recovers afterward is an open question, IMO.

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Response to zipplewrath (Reply #15)

Sat Mar 14, 2020, 03:41 PM

20. Think life during wartime we will survive maybe not pretty maybe ok if we can immediately contain

See China * according to officials dramatically slowed there
Of course we to understand they perhaps are not reporting correctly
But 7 of their latest cases have been imported from Europe

*But also see freedomUSA I donít think a true quarantine like theirs is sustainable here also
I think masks became mandatory there again I donít see it happening here

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Response to WhiskeyGrinder (Reply #14)

Sat Mar 14, 2020, 01:20 PM

16. What you said. nt

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Response to zipplewrath (Original post)

Sat Mar 14, 2020, 01:24 PM

19. So for really long term preparedness, what about this?

1 - Stock pile enough beds and ventilators to handle an un-mitigated rhespiratory pandemic.

2 - Require minimal training in managing ventilators of every MD. Or every hospital MD. Or... or... you get the idea.

3 - Tell people over 70 and people with underlying conditions to do everything they can to be one of the 30% to 40% who never get sick.

4 - Everyone else goes about their normal lives. Analagous to when some of us were young and were sent to friends houses to get the measles or mumps so we didn't get them when we were older and they were more dangerous.

What do you think?

tia
las

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