Flattening the Curve: Controlling the COVID-19 pandemic

In the time of COVID-19, a week feels more like an eternity. I find myself checking the news hourly just to keep up-to-date. This week, the World Health Organization officially named the COVID-19 outbreak as a pandemic. U.S. President Donald Trump has banned incoming flights from 26 European countries. The wife of Canadian Prime Minister Justin Trudeau, Sophie Gregoire-Trudeau, confirmed that she tested positive for COVID-19 today. Both individuals are in isolation.

With these developments and certainly more to come, there is a heightened focus on what we can be doing as a society to protect ourselves and each other.

Flattening the curve

It is a concept that has become increasingly talked about, especially in recent days. Flattening the curve is a method that can be used to ease pressures on the health care system during pandemics. Have a look at this graph:

The x axis (or horizontal axis) represents time. The y axis (or vertical axis) represents number of cases. In the case of COVID-19, if no public health interventions are put in place, we would expect the results of the yellow curve. There would be an exponential number of new COVID-19 cases over a shorter period of time. In health systems already pressured and operating at their maximum capacity (which is true of many health care systems in our world), a pandemic would create extra strain. It may lead to a scenario were there are not enough resources to treat everyone.

The blue curve represents what would happen if appropriate public health measures are followed. This includes policies like implementing social distancing and increasing public education. We are already seeing many measures such as this take place across Canada. The government of British Columbia requires the cancellation of all gatherings of 250 people or more. All publicly funded schools in Ontario will close for two extra weeks after March break.

Numerous professional sports leagues have suspended their seasons, including the NBA, NFL and MLB. Many governments are discouraging travel, or in some cases, prohibiting it. There is extensive public messaging around hand hygiene and cough hygiene. Alternatives to handshakes are being promoted.

The COVID-19 pandemic is overwhelming systems, even in countries that are well-resourced. Dr. Giacomo Grasselli is a senior Italian government health official coordinating the network of Intensive Care Units in Lombardi, Italy. In an interview with Channel 4 News, he described the severity of the pandemic in his region, which is the worst affected area in Italy.

“It’s worse than a bomb because a bomb is one event limited in time and space. This is an event that…keeps increasing and it’s contagious.”

Dr. Graselli added that he never thought he would be in a situation where he would have had to create 500 new ICU beds over a two-week period.

“If you are not very careful in controlling the spread of the disease, this disease will overwhelm your system, not matter how efficient, good, modern it is.”

Panic is never a helpful emotion, no matter what the situation. It will certainly not help in addressing the pandemic. For example, if an asymptomatic person goes to a testing centre or emergency department against government recommendations, they are unnecessarily putting themselves at risk. They are also contributing to strain on the system, preventing others from getting the care they need.

That being said, rational thinking and preparedness are essential. I think this pandemic presents another natural experimental question: Will society listen to scientists and follow governmental recommendations? I hope that the answer is yes.

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