Thursday, March 19, 2020

Flattening the curve

If you have been following the evolving COVID-19 story at all, you have come across the term “bending (or flattening) the curve.” What does that mean and why should you care?

Students of health economics have long heard that phrase used to mean that while we could not hope to cut the cost of U.S. health care, we could hope to slow the rate at which costs were rising by doing X or Y. Well, now it describes a much more important phenomenon, one which literally is a matter of life and death.

Let’s do a simple math exercise. Assume each person infected with the coronavirus spreads the disease to three others. While this number is not proven, it is a reasonable guess based on what we now know; the virus is very contagious and easily spread. Each of these people will infect three others and so on for quite a while.
How does this look?

3, each infect 3 more, leading to
9, each infect 3 more leading to
27 ->

So, after 12 cycles, you have over half a million people infected from one initial case. Presume that 10% are sick enough to need hospital care, since we know that many are only mildly ill and others, while sick, will recover at home. That still means 53,000 people needing hospital care. However, at any given time in Massachusetts, there are about 3000 to 4000 beds available. If we assume that the time between each cycle is, say 3 days, that means that in a little over a month, we will have 15 times as many people needing hospital care as there are beds available. The healthcare system will be overwhelmed and people will die for lack of care. This is what we are seeing right now in Italy, a country with an advanced medical care system.

Let’s instead say that by doing things proven to slow down the spread, we can increase the time between one contagious person spreading the disease to others from 3 days to 10 days. You will still see the same number of people needing care, but they will accumulate over 4 months instead of one, allowing hospitals to treat and discharge people, ramp up staff and supplies and take care of many more of those needing care.

How can we do this? Apply the lessons you have already heard:

stay home if you are sick;
do not gather in large groups;
do not shake hands or hug;
wash your hands well with soap and water after any possible exposure such as opening a door or holding a handrail in a common area;
use hand sanitizer when soap and water are not available;
when in groups, keep at least 6 feet apart.

Doing these things may well cut the spread from 3:1 to 2:1, which would have a major impact, and even if it does not cut it below 2.5:1, it will “flatten the curve,” spreading out the numbers of infected people over a longer time, allowing more to live!

We are in this together. Let’s all do our part.

Prescription for Bankruptcy. Buy the book on Amazon

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