Flattening the Curve vs. Area under the Curve

1,994 Views | 8 Replies | Last: 5 yr ago by John Francis Donaghy
Squadron7
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10:03a, 4/12/20
AG
Anyone seen any estimates on how many...if any...lives are actually saved by flattening the curve with lockdowns vs having no lockdowns? It is important because we cannot lock down indefinitely. The hungry unemployed will become more of a risk to the citizenry than the virus itself.

Sans vaccine, it looks like it will necessarily be an individual decision on how best to protect ourselves to put off our perhaps inevitable dance with COVID.
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Patentmike
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In reply to Squadron7 • 10:40a, 4/12/20
AG
Squadron7 said:
Anyone seen any estimates on how many...if any...lives are actually saved by flattening the curve with lockdowns vs having no lockdowns? It is important because we cannot lock down indefinitely. The hungry unemployed will become more of a risk to the citizenry than the virus itself.

Sans vaccine, it looks like it will necessarily be an individual decision on how best to protect ourselves to put off our perhaps inevitable dance with COVID.
You have to consider 3 curves....

  • Infections
  • Infections with long term morbidity (damage that lasts beyond the infection)
  • Deaths

The area under the curve for infections won't be vastly different. 85% of infections cause mild symptoms, so that's not a problem.

The area under the curve for deaths will be less because of (i) treatment lessons learned during the first wave and (ii) time to ramp up supplies for those treatments.

I don't think we know enough about long term morbidity to make good guesses on that curve.
PatentMike, J.D.
BS Biochem
MS Molecular Virology


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dcbowers
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10:55a, 4/12/20
AG
The other variables to consider are hospital, ICU, and ventilator capacity. If the peak curve exceeds capacity (as happened in northern Italy), the doctors will be forced to ration available resources to save lives.

Resources (PPE and testing, mostly) are being rationed, but I am not aware of this resulting in additional lives being lost in the United States.
dcbowers
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Sq 17
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10:58a, 4/12/20
hopefully beneficial therapies are developed so fewer people die, eventually everybody will catch it flattening the curves lowers mortality rates by protecting the health care system and buying time while therapies are developed , tested, and ramped up to meet the demand.
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plain_o_llama
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In reply to Squadron7 • 11:08a, 4/12/20
Treatment protocols may improve over time. That itself might change the case severity rates in the future. I would prefer to not be in the "learning" wave of cases if I get a choice.

The virologists suggest that, on average, virus mutations tend to reduce severity rather than increase it. Small chance that could be helpful.
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FratboyLegend
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11:17a, 4/12/20
The whole premise of flattening the curve was to prevent marginal loss of life owing to lack of hospital capacity.

We have massively added capacity at great expense.

So let's call it good and steepen the now shifted curve to take advantage of this capacity and get this whole thing over with quicker. Staring at empty hospital beds while our economy crashes is pretty foolish.
#CertifiedSIP
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DadHammer
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In reply to FratboyLegend • 11:40a, 4/12/20
AG
I agree Fratboy.
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Patentmike
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In reply to plain_o_llama • 11:50a, 4/12/20
AG
plain_o_llama said:
Treatment protocols may improve over time. That itself might change the case severity rates in the future. I would prefer to not be in the "learning" wave of cases if I get a choice.

The virologists suggest that, on average, virus mutations tend to reduce severity rather than increase it. Small chance that could be helpful.
Beneficial mutations are less likely for this virus because so many patients are infectious with mild or no symptoms. Infected patients who are shedding the virus are not self-quarantined to the same extent we saw with SARS because they simply don't feel sick.
PatentMike, J.D.
BS Biochem
MS Molecular Virology


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plain_o_llama
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In reply to Patentmike • 12:02p, 4/12/20
I was thinking of something like this.

https://www.virology.ws/2020/04/10/a-382-nucleotide-deletion-in-the-genome-of-sars-cov-2/

I assumed asymptomatic spread would result in wider spread and more diverse strains. Hopefully any less severe mutant strains will be as robust or more so than the severe versions.
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John Francis Donaghy
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12:23p, 4/12/20
Slowing the spread also buys time for doctors to figure out how to treat the severe cases. Once we have an effective treatment protocol for severe cases, this whole thing becomes much less of an issue.

Letting the virus run its course to high peak before doctors have an effective treatment is just plain foolish.
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