5 ms·

Flatten the Coronavirus Curve

84 points by slowhand09 7y ago

gringoDan 7y ago
Here is the original animation linked in the post: https://twitter.com/alxrdk/status/1237021885239635969 https://twitter.com/alxrdk/status/1237021885239635969 And the gif to maximize sharing: https://giphy.com/gifs/delay-covid19-containment-dWCcpgCRiOHk5B8znA https://giphy.com/gifs/delay-covid19-containment-dWCcpgCRiOH...
NPMaxwell 7y ago
Nice demonstration that the entire point and argument can be presented in one (animated) graphic -- like code that needs no comments.
_jal 7y ago
Thank you! I've been arguing this point, mostly without success, against some "just get it over with" folks. Maybe a picture will help. (Yes, I should know better, but in this case it can be hard to distinguish ignorance from sociopathy.)
- HarryHirsch 7y ago
  In the US, there's the religious angle as well. People really consider the Apocalypse prophecy in the sense of foretelling the future, not forthtelling the will of God. The faithful, so the widespread belief goes, will be raptured in time, such as not to live under the Satanic authorities. Twenty years ago, everyone thought that "Left Behind" was blasphemous, but reality has overtaken fiction. We are living in a branch of reality not intended for production use.
jacknews 7y ago
To me, the animation does not help, and especially the meaningless x-axis 'early containment measures/time' doesn't make any sense. I understand the point, but I think a few static graphs, or a 3d rendition, could convey it much more clearly.
- OJFord 7y ago
  > especially the meaningless x-axis 'early containment measures/time' doesn't make any sense. The horizontal axis is labelled only 'Time', in the same font and relative location as the vertical axis label. 'Early containment measures' is labelling the animation (or specifically the black arrow that points in the direction it's animated) of the area under the 'sick curve', indicating what it is that causes that change.
sgt101 7y ago
Ok, get that, but it looks like hand washing isn't enough, and step 2 (lock everything up) is a bit drastic, so how?
- kradeelav 7y ago
  - work from home voluntarily if you can - don't go to unnecessary crowded events if you can - start meal prep for medium term food storage (~1 month) if possible - wear face masks if you have them
  - sgt101 7y ago
    Interesting about the meal storage - what are the arrangements that places like Italy are making for food distribution?
- mixedbit 7y ago
  The goal is to slow down the spread not to stop it completely, so everything that reduces probability of a person catching a virus helps. For example if a person goes to one meeting instead of two, the probability is reduced.
- ajross 7y ago
  Everything is about defense in depth. "Locking everything up" as Italy is doing now is a last resort. But every bit helps: * We wash our hands because it reduces the chances for infection from something we recently touched (also reduces the chance we'll spread a still-incubating infection by touching things!) * We don't touch our face because mucus membranes are where the virus enters (and leaves!) the body, reducing the chance of infection. * We wear masks because a common vector is water droplets from coughs entering (or leaving!) the lungs and this reduces the chance of such a droplet leaving an infected person's lungs and entering a healthy body. * We avoid large crowds because the fewer people we are near, the lower the chance someone healthy will be near someone who is infected. * We avoid travel to reduce the chance of an infection being introduced into a region where it doesn't exist yet. * We test pervasively because when people know they are infected, or that people near them are infected, they are much (!) more likely to follow the rules above. (And also because it allows for better public planning and resource allocation, e.g. moving health care resources around to places we know are emerging as hotspots.) Etc... It all adds up. And if we're lucky the simple/cheap versions of this strategy will be enough to contain it. It seems to have been true in Korea. In the US? I'm not hopeful, honestly.
lubujackson 7y ago
This is great and all, but misses the problem when containment doesn't happen soon enough. I feel like people look at China and South Korea and say "oh it peters out" but miss the need for extreme interventions to make that happen. We still don't know how this turns out if everyone puts their head in the sand like the U.S. is intent on doing with minimal testing and uneven regional containment. Seems to me like a typical measuring problem of having one hard metric so everyone argues about it's implication rather than focusing on where the number comes from.
- koheripbal 7y ago
  Testing is ramping up pretty quickly now. I think we're going to see a major shift in the next couple weeks with an explosion of newly-detected cases.
  - AbrahamParangi 7y ago
    Seattle will likely be Italy within 2 weeks.
  - HarryHirsch 7y ago
    That's nice, but how about treatment costs? You can get tested for COVID, but if you present at the ER with respiratory symptoms, physicians will want to rule our influenza and staph, and that will still cost you, nevermind treatment when you are admitted and uninsured. It has been drilled into people that physicians will cheat and overbill you, and that you should not "overconsume medical resources", and now the economic damage of that mindset becomes apparent.
    - murph-almighty 7y ago
      Mark my words, the stories of "Corona patient hit with $100k" bill _will_ lead to a push for M4A.
      - HammockTester 7y ago
        Maybe in another 4 years after Biden loses this election.
JaDogg 7y ago
From what I understand (correct me if I'm wrong) - Some people who can survive the virus might need to use a nebuliser.. but what if medical care is overburdened at that time? Then even they will die from difficulty in breathing. This is why slowing the spread is important.
- learc83 7y ago
  I can't respond to whether people need to use a nebulizer or not, but nebulizers can be used at home with basically zero training. Or they can be administered by minimally trained workers in tent hospitals.
asimilator 7y ago
It's endlessly frustrating to me that animated graphs are published as GIFs/videos (see r/dataisbeautiful on reddit for lots of examples). In this particular one, I can't read the annotations before they disappear, and the whole graph resets before I've figured out what anything means. These graphs would really benefit from proper content aware controls (i.e. not just play/pause and a timeline, something aware of the key timeline points of the content). GIF/video is obviously used because it's so easily embeddable, but IMO the format makes most of these graphs essentially incomprehensible.
- jupp0r 7y ago
  On the other hand, a GIF is easy to share and can be viewed on very low end devices.
- dkarl 7y ago
  I'm frustrated, too, but it's not necessarily the worst solution. My first reaction was that a video with a pause button and a slider would have been significantly better for little extra effort, but a lot of people disable autoplay and would have missed the point. An interactive animated data visualization would have been the best experience for people visiting this page, but it would have been a lot more work to make sure it worked across browsers and form factors and would have been harder for others to share and spread. The disappearing caption was really irritating, though, and it wasn't obvious why it couldn't have been fixed in the gif.
deleted 7y ago
[deleted]
kaiabwpdjqn 7y ago
There’s an important bit in this that depends on age. If you’re young and healthy, in addition to being less likely to die from the disease, you’re also less likely to acquire the disease (exposure level being held equal). If you’re older, you’re more likely to acquire the disease. This implies the disease will spread much faster in areas with more old people, because more people are vulnerable to it and they are more likely to become infectious themselves. A similar statement could be made for how well integrated the older generations are in a given society. I don’t live there and have no particular horse in this race, but I would predict the Bay Area will not look like Italy right now for this reason. Edit: do be careful though. The takeaway is not that young people can ignore this.
lubujackson 7y ago
Aaaand I completely missed the point of this post, sorry. Was just arguing against someone about this now I'm jumping at shadows.
deleted 7y ago
[deleted]
krick 7y ago
I don't understand how to read this. Why is it animated? What's the 3rd dimension?
- deleted 7y ago
  [deleted]
- slg 7y ago
  The third dimension is us slowing down the spread of the virus. It doesn't necessarily prevent people from ultimately getting sick, but spreading it out ensures that the medical infrastructure is not overwhelmed. If we do nothing to stop the spread, we won't have the infrastructure to handle it and many patients with potentially recoverable ailments (not just corona related issues) will end up receiving subpar care and dying.
- mythrwy 7y ago
  I don't understand the first sentence of text. "The coronavirus can possibly infect a lot more people than there are those who can provide medical care." Well yes, obviously! (I assume they meant the virus can infect more people then can be provided medical care during infection).
nebulous1 7y ago
I think this animated version is terrible and offers mostly confusion. The version here is much easier to understand: https://twitter.com/_rospearce/status/1235603201648402432 https://twitter.com/_rospearce/status/1235603201648402432
- krick 7y ago
  Yeah, this is how it usually is with animation. That's much better. Regardless, "measures" is too abstract to provide any meaningful information. At this point of reduction what the plot offers is basically self-evident. Well, maybe the only thing that might surprise someone is that the better the thing is handled, the longer it will last.
baron_harkonnen 7y ago
I wasn't too worried about covid19 until I realized the radical disconnect between the understanding of the real risk of this I see here and on twitter vs in the real world. At least in the US people won't take this seriously until we see very high numbers of cases. Which means when people do take it seriously, we'll be in trouble. It's not simply a case of not understanding exponential growth, Americans actively do not want to understand what's happening. I was in a meeting yesterday and someone, with no hint of reservation, said they felt very optimistic about the business in the next quarter. This bizarre denial means that things will inevitably get much worse in the US then they will in Italy (and we don't have the political will to solve this like China has even in the most extreme cases).
- blowski 7y ago
  If nobody is diagnosed as having COVID19, then Trump was right that COVID19 wasn't a problem. So how do you keep diagnoses low - by not testing anybody! It's like turning off your phone so you can argue "I didn't get any phone calls".
  - dkarl 7y ago
    He already hedged his bets by saying it was a huge problem. Hoax, real, no problem, big problem, he's doing a good job of covering the important possibilities.
- nonbirithm 7y ago
  I don't think there has been an outbreak that could be this deadly in the age of prolific social media use. Or maybe it's been too long since the swine flu for people to remember, or the swine flu wasn't as deadly. People saw it as a thing that comes and goes. Just news that will tide over, and people can remain optimistic as they always have that life can go on exactly as it always has. This has only ever happened in movies. It can't happen to them. Actual virus outbreaks are incompatible with this mindset. The markets vastly underestimated the impact it would have. People can exercise their liberty and individualism and right to an opinion to go off and unknowingly infect other people. A week ago I stated I was concerned over the virus and that I was taking shelter to a coworker and got back "there's no need to panic, the media makes it out to be worse than it is" and "this is no worse than the flu." By now there isn't a soul that's not working from home, including them. It's like speed limits only being imposed on residential neighborhoods after someone's kid gets run over and killed. For these kinds of things some people will only learn when it's too late to take action and the consequences become apparent. They would have to learn to switch off their optimism when it's appropriate next time, if there's a next time. Or maybe they won't learn, and the actions of a majority we don't control will have irreversible consequences for us as a species. In that case I can't see how it wouldn't be fated. It's a matter of getting everyone on Earth who is well-meaning or not to cooperate in just the right manner when some of them simply won't. Antibiotic resistance is a thing because we trust the general public to take them properly, and they don't. When the next outbreak is even more deadly or contagious, who knows what will become of us.
jrd259 7y ago
I get that flattening is good, but the animation is actually harder to read than the original static graph (Pearce). I can't stop it to read it. I can't read which outcomes are fatalities, and which are not. I can't read the total number of infections or total deaths. In addition, like Pearce, neither axis has a scale so this is purely qualitative. It's made to look like it's quantitative but it's not. A rational decision maker (if only we had them) would trade the cost of aggressive quarantines (economic and political) or aggressive testing vs the cost of infection (economic and human). Flattening the curve saves lives, but how many? Can I save 1000 lives in my country by an absolute ban on all gatherings of 100 people? and so on.
dkarl 7y ago
Are we doing anything to increase capacity in the United States besides making testing kits? I know we will learn more about treating patients with COVID-19 over time, but that doesn't add more beds and nurses. As healthcare workers themselves get sick, and supply disruptions compound, I would expect capacity to go down. It doesn't undermine the author's point, but I have no idea where the positive slope on the capacity curve is coming from in liberal democracies where the government can't commandeer labor and order factories to be built overnight. (Theoretically, the solution in liberal democracies would be to pay health care companies to maintain the potential to expand capacity, like we pay farmers not to grow crops. I'm sure we could have a huge off-topic conversation about whether that would actually work, so let's just leave it at "theoretically.")
greywolf 7y ago
districts in Cali, for example, have not closed their schools yet. what are we waiting for? this is a major misstep. kids will probably not suffer much, but they will spread the virus

84 points by slowhand09 7y ago

Here is the original animation linked in the post: https://twitter.com/alxrdk/status/1237021885239635969 https://twitter.com/alxrdk/status/1237021885239635969 And the gif to maximize sharing: https://giphy.com/gifs/delay-covid19-containment-dWCcpgCRiOHk5B8znA https://giphy.com/gifs/delay-covid19-containment-dWCcpgCRiOH...

NPMaxwell 7y ago

Nice demonstration that the entire point and argument can be presented in one (animated) graphic -- like code that needs no comments.

_jal 7y ago

Thank you! I've been arguing this point, mostly without success, against some "just get it over with" folks. Maybe a picture will help. (Yes, I should know better, but in this case it can be hard to distinguish ignorance from sociopathy.)

HarryHirsch 7y ago
In the US, there's the religious angle as well. People really consider the Apocalypse prophecy in the sense of foretelling the future, not forthtelling the will of God. The faithful, so the widespread belief goes, will be raptured in time, such as not to live under the Satanic authorities. Twenty years ago, everyone thought that "Left Behind" was blasphemous, but reality has overtaken fiction. We are living in a branch of reality not intended for production use.

jacknews 7y ago

To me, the animation does not help, and especially the meaningless x-axis 'early containment measures/time' doesn't make any sense. I understand the point, but I think a few static graphs, or a 3d rendition, could convey it much more clearly.

OJFord 7y ago
> especially the meaningless x-axis 'early containment measures/time' doesn't make any sense. The horizontal axis is labelled only 'Time', in the same font and relative location as the vertical axis label. 'Early containment measures' is labelling the animation (or specifically the black arrow that points in the direction it's animated) of the area under the 'sick curve', indicating what it is that causes that change.

sgt101 7y ago

Ok, get that, but it looks like hand washing isn't enough, and step 2 (lock everything up) is a bit drastic, so how?

kradeelav 7y ago
- work from home voluntarily if you can - don't go to unnecessary crowded events if you can - start meal prep for medium term food storage (~1 month) if possible - wear face masks if you have them
- sgt101 7y ago
  Interesting about the meal storage - what are the arrangements that places like Italy are making for food distribution?
mixedbit 7y ago
The goal is to slow down the spread not to stop it completely, so everything that reduces probability of a person catching a virus helps. For example if a person goes to one meeting instead of two, the probability is reduced.
ajross 7y ago
Everything is about defense in depth. "Locking everything up" as Italy is doing now is a last resort. But every bit helps: * We wash our hands because it reduces the chances for infection from something we recently touched (also reduces the chance we'll spread a still-incubating infection by touching things!) * We don't touch our face because mucus membranes are where the virus enters (and leaves!) the body, reducing the chance of infection. * We wear masks because a common vector is water droplets from coughs entering (or leaving!) the lungs and this reduces the chance of such a droplet leaving an infected person's lungs and entering a healthy body. * We avoid large crowds because the fewer people we are near, the lower the chance someone healthy will be near someone who is infected. * We avoid travel to reduce the chance of an infection being introduced into a region where it doesn't exist yet. * We test pervasively because when people know they are infected, or that people near them are infected, they are much (!) more likely to follow the rules above. (And also because it allows for better public planning and resource allocation, e.g. moving health care resources around to places we know are emerging as hotspots.) Etc... It all adds up. And if we're lucky the simple/cheap versions of this strategy will be enough to contain it. It seems to have been true in Korea. In the US? I'm not hopeful, honestly.

lubujackson 7y ago

This is great and all, but misses the problem when containment doesn't happen soon enough. I feel like people look at China and South Korea and say "oh it peters out" but miss the need for extreme interventions to make that happen. We still don't know how this turns out if everyone puts their head in the sand like the U.S. is intent on doing with minimal testing and uneven regional containment. Seems to me like a typical measuring problem of having one hard metric so everyone argues about it's implication rather than focusing on where the number comes from.

koheripbal 7y ago
Testing is ramping up pretty quickly now. I think we're going to see a major shift in the next couple weeks with an explosion of newly-detected cases.
- AbrahamParangi 7y ago
  Seattle will likely be Italy within 2 weeks.
- HarryHirsch 7y ago
  That's nice, but how about treatment costs? You can get tested for COVID, but if you present at the ER with respiratory symptoms, physicians will want to rule our influenza and staph, and that will still cost you, nevermind treatment when you are admitted and uninsured. It has been drilled into people that physicians will cheat and overbill you, and that you should not "overconsume medical resources", and now the economic damage of that mindset becomes apparent.
  - murph-almighty 7y ago
    Mark my words, the stories of "Corona patient hit with $100k" bill _will_ lead to a push for M4A.
    - HammockTester 7y ago
      Maybe in another 4 years after Biden loses this election.

JaDogg 7y ago

From what I understand (correct me if I'm wrong) - Some people who can survive the virus might need to use a nebuliser.. but what if medical care is overburdened at that time? Then even they will die from difficulty in breathing. This is why slowing the spread is important.

learc83 7y ago
I can't respond to whether people need to use a nebulizer or not, but nebulizers can be used at home with basically zero training. Or they can be administered by minimally trained workers in tent hospitals.

asimilator 7y ago

It's endlessly frustrating to me that animated graphs are published as GIFs/videos (see r/dataisbeautiful on reddit for lots of examples). In this particular one, I can't read the annotations before they disappear, and the whole graph resets before I've figured out what anything means. These graphs would really benefit from proper content aware controls (i.e. not just play/pause and a timeline, something aware of the key timeline points of the content). GIF/video is obviously used because it's so easily embeddable, but IMO the format makes most of these graphs essentially incomprehensible.

jupp0r 7y ago
On the other hand, a GIF is easy to share and can be viewed on very low end devices.
dkarl 7y ago
I'm frustrated, too, but it's not necessarily the worst solution. My first reaction was that a video with a pause button and a slider would have been significantly better for little extra effort, but a lot of people disable autoplay and would have missed the point. An interactive animated data visualization would have been the best experience for people visiting this page, but it would have been a lot more work to make sure it worked across browsers and form factors and would have been harder for others to share and spread. The disappearing caption was really irritating, though, and it wasn't obvious why it couldn't have been fixed in the gif.

deleted 7y ago

[deleted]

kaiabwpdjqn 7y ago

There’s an important bit in this that depends on age. If you’re young and healthy, in addition to being less likely to die from the disease, you’re also less likely to acquire the disease (exposure level being held equal). If you’re older, you’re more likely to acquire the disease. This implies the disease will spread much faster in areas with more old people, because more people are vulnerable to it and they are more likely to become infectious themselves. A similar statement could be made for how well integrated the older generations are in a given society. I don’t live there and have no particular horse in this race, but I would predict the Bay Area will not look like Italy right now for this reason. Edit: do be careful though. The takeaway is not that young people can ignore this.

lubujackson 7y ago

Aaaand I completely missed the point of this post, sorry. Was just arguing against someone about this now I'm jumping at shadows.

deleted 7y ago

[deleted]

krick 7y ago

I don't understand how to read this. Why is it animated? What's the 3rd dimension?

deleted 7y ago
[deleted]
slg 7y ago
The third dimension is us slowing down the spread of the virus. It doesn't necessarily prevent people from ultimately getting sick, but spreading it out ensures that the medical infrastructure is not overwhelmed. If we do nothing to stop the spread, we won't have the infrastructure to handle it and many patients with potentially recoverable ailments (not just corona related issues) will end up receiving subpar care and dying.
mythrwy 7y ago
I don't understand the first sentence of text. "The coronavirus can possibly infect a lot more people than there are those who can provide medical care." Well yes, obviously! (I assume they meant the virus can infect more people then can be provided medical care during infection).

nebulous1 7y ago

I think this animated version is terrible and offers mostly confusion. The version here is much easier to understand: https://twitter.com/_rospearce/status/1235603201648402432 https://twitter.com/_rospearce/status/1235603201648402432

krick 7y ago
Yeah, this is how it usually is with animation. That's much better. Regardless, "measures" is too abstract to provide any meaningful information. At this point of reduction what the plot offers is basically self-evident. Well, maybe the only thing that might surprise someone is that the better the thing is handled, the longer it will last.

baron_harkonnen 7y ago

I wasn't too worried about covid19 until I realized the radical disconnect between the understanding of the real risk of this I see here and on twitter vs in the real world. At least in the US people won't take this seriously until we see very high numbers of cases. Which means when people do take it seriously, we'll be in trouble. It's not simply a case of not understanding exponential growth, Americans actively do not want to understand what's happening. I was in a meeting yesterday and someone, with no hint of reservation, said they felt very optimistic about the business in the next quarter. This bizarre denial means that things will inevitably get much worse in the US then they will in Italy (and we don't have the political will to solve this like China has even in the most extreme cases).

blowski 7y ago
If nobody is diagnosed as having COVID19, then Trump was right that COVID19 wasn't a problem. So how do you keep diagnoses low - by not testing anybody! It's like turning off your phone so you can argue "I didn't get any phone calls".
- dkarl 7y ago
  He already hedged his bets by saying it was a huge problem. Hoax, real, no problem, big problem, he's doing a good job of covering the important possibilities.
nonbirithm 7y ago
I don't think there has been an outbreak that could be this deadly in the age of prolific social media use. Or maybe it's been too long since the swine flu for people to remember, or the swine flu wasn't as deadly. People saw it as a thing that comes and goes. Just news that will tide over, and people can remain optimistic as they always have that life can go on exactly as it always has. This has only ever happened in movies. It can't happen to them. Actual virus outbreaks are incompatible with this mindset. The markets vastly underestimated the impact it would have. People can exercise their liberty and individualism and right to an opinion to go off and unknowingly infect other people. A week ago I stated I was concerned over the virus and that I was taking shelter to a coworker and got back "there's no need to panic, the media makes it out to be worse than it is" and "this is no worse than the flu." By now there isn't a soul that's not working from home, including them. It's like speed limits only being imposed on residential neighborhoods after someone's kid gets run over and killed. For these kinds of things some people will only learn when it's too late to take action and the consequences become apparent. They would have to learn to switch off their optimism when it's appropriate next time, if there's a next time. Or maybe they won't learn, and the actions of a majority we don't control will have irreversible consequences for us as a species. In that case I can't see how it wouldn't be fated. It's a matter of getting everyone on Earth who is well-meaning or not to cooperate in just the right manner when some of them simply won't. Antibiotic resistance is a thing because we trust the general public to take them properly, and they don't. When the next outbreak is even more deadly or contagious, who knows what will become of us.

jrd259 7y ago

I get that flattening is good, but the animation is actually harder to read than the original static graph (Pearce). I can't stop it to read it. I can't read which outcomes are fatalities, and which are not. I can't read the total number of infections or total deaths. In addition, like Pearce, neither axis has a scale so this is purely qualitative. It's made to look like it's quantitative but it's not. A rational decision maker (if only we had them) would trade the cost of aggressive quarantines (economic and political) or aggressive testing vs the cost of infection (economic and human). Flattening the curve saves lives, but how many? Can I save 1000 lives in my country by an absolute ban on all gatherings of 100 people? and so on.

dkarl 7y ago

Are we doing anything to increase capacity in the United States besides making testing kits? I know we will learn more about treating patients with COVID-19 over time, but that doesn't add more beds and nurses. As healthcare workers themselves get sick, and supply disruptions compound, I would expect capacity to go down. It doesn't undermine the author's point, but I have no idea where the positive slope on the capacity curve is coming from in liberal democracies where the government can't commandeer labor and order factories to be built overnight. (Theoretically, the solution in liberal democracies would be to pay health care companies to maintain the potential to expand capacity, like we pay farmers not to grow crops. I'm sure we could have a huge off-topic conversation about whether that would actually work, so let's just leave it at "theoretically.")

greywolf 7y ago

districts in Cali, for example, have not closed their schools yet. what are we waiting for? this is a major misstep. kids will probably not suffer much, but they will spread the virus