5 ms·

“Flattening the Curve” is a deadly delusion

28 points by yasp 7y ago

ColinWright 7y ago
This article goes horribly wrong very quickly: > They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy. No, they don't. They mean to tell you that we need to slow the spread of the infection as much as possible, by whatever means we can sustain. That includes the potential of lockdowns. We individuals can only do so much. What we must do is wash our hands, practise social distancing, wash our hands, interact with as few people as possible, wash our hands, and only go out if essential. This graphic is telling people why they have to do this, it's not saying that to do so is enough to avoid lockdowns. Much of the rest of the article is right, but that part is seriously wrong. It concludes with: > Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment. That's just bizarre. Containment is part of flattening the curve, and the other measures that we personally can implement is also part of flattening the curve. Everything we do to slow and hinder the spread will help. Total containment is not possible, all we can do is slow the spread, and that is flattening the curve! So wash your hands, go out as little as possible, interact with as few people as possible, and do your bit to help flatten the curve.
- etrabroline 7y ago
  https://miro.medium.com/max/2400/1*FoIElQyKudIShpnBHckC5A.png https://miro.medium.com/max/2400/1*FoIElQyKudIShpnBHckC5A.pn... Would you like to refute or respond to this plot? > Containment is part of flattening the curve But "flattening the curve" means allowing exponential growth and waiting for most people to become infected. That would be a catastrophe, so no, containment is not a part of flattening the curve, and FTC is a wholly inadequate goal.
  - ColinWright 7y ago
    > Would you like to refute or respond to this plot? "Flattening the Curve" is not and cannot be the entire story. It's a process to reduce the stress on the health services, but what seems clear from all the numbers is that the health services will be overwhelmed, we're just trying to reduce the number of concomitant deaths. > But "flattening the curve" means allowing exponential growth ... The cumulative number of cases will, barring exceptional intervention, be a logistic function, and the number of cases "in progress" will more-or-less be the derivative. And for a logistic function the first part is more-or-less an exponential. So whether you "Flatten the Curve" or not, the first phase is always effectively exponential, and since containment is now effectively impossible, it's inevitable that most people (they're suggesting 80%) of people will eventually have been infected. The way to reduce the catastrophe is to make the rate of infection as low as possible, thus stretching the logistic function and thereby reducing the maximum of the derivative. That's my understanding.
    - etrabroline 7y ago
      The health services will be overwhelmed if all we do is tell people to wash their hands. You are content with ~1,000,000 dead Americans, I am not.
      - ColinWright 7y ago
        There's something here you're really not understanding, and I don't know if it's because you're not reading carefully enough, or I'm not being clear enough. I'm not saying that all we do is tell people to wash their hands. Flattening the Curve is not just telling people to wash their hands. It's also saying self-isolate, where possible don't travel, where possible don't go out at all, when it's necessary to go out, stay a minimum of 2 metres away from people whenever you can. Flattening the Curve is not about "Just wash your hands and we'll be fine", it's about making as many contributions in as many ways as possible to slowing the rate of infection. I'm genuinely astonished if you think "Flatten the Curve" just means "Wash your hands". And when I run the numbers, it looks to me like the US health services are going to be overwhelmed regardless, the point is to do every little thing possible to reduce the amount. That's what Flattening the Curve means.
  - rumanator 7y ago
    > But "flattening the curve" means allowing exponential growth and waiting for most people to become infected. I really have no idea where and how you've created that definition, because it has absolutely no relation to the real meaning of flattening the curve and even completely ignores the problem. Just to be clear, flattening the curve refers to limit the spread of the epidemic so that the amount of new cases are not an exponential spike but a smooth curve throughout time. Thus, the curve is flattened. That's it. How do you do that? Well, by containing how the disease spreads by enforcing containment and self-isolate and avoid contact with everyone. Washing your hands is great and makes up for a good scapegoat, but the reason why people are being sent to work from home, stock up on supplies, and not sey foot outside unless they really need to, is to contain how the disease spreads.
aawalton 7y ago
I understood this to mean flattening the curve is important, but not enough. Containment is the most critical intervention, but also the one that requires effective government intervention (South Korea).
- rumanator 7y ago
  > I understood this to mean flattening the curve is important, but not enough. Containment is the most critical intervention Containment is enforced to flatten the curve. That's the whole point. It's not an either/or thing. And the whole point of flattening the curve is to avoid saturating healthcare services with an exponential increase in demand concentrated in a span of a couple of weeks. The article is crap.
babulus 7y ago
Strawman arguments. JFC.
- babulus 7y ago
  Like seriously some people think they fucking know everything b/c they know a lot about one thing
  - tallyhotallyho 7y ago
    Writing like you are an alcoholic Chandler Bing is annoying. Please stop.
dangus 7y ago
The author lists his own credentials, which do not include any medical field, and certainly not not epidemiology. Author: you are part of the problem. We don’t need more articles written by non-experts.
etrabroline 7y ago
The point he makes is valid and critically important. If it were titled "heard immunity is a dangerous delusion" then the "well actually" crowd here wouldn't be up in arms.
- gus_massa 7y ago
  The title should have been "Flattening the Curve is not enough!!!".
cashsterling 7y ago
Agree with other commenters... this article is criminally stupid. Author... Stop writing articles in an effort to appease your ego. You are contributing to the problem. I have a PhD in chemical engineering and worked in biotechnology off and on for several years: aseptic filling, clean room design, microbiology contamination mitigation, bio-processing design) and I come from a family with a lot of medical doctors. Even though I have a fairly good grasp of our situation, you won't see me writing any articles about the pandemic because I'm not an expert. Among many errors in the article, you can't blindly apply statistics from China or other parts of the world. It is a question of "data sample size" relative to the "actual population"; as a statistician, the Author should know that. The sample size, relative to population, is very small and highly skewed (mostly testing people who are sick). The question is: how many people came in contact with the virus vs. how many people got sick vs. how many people got really sick? This we don't know... China would have needed to randomly test a large percentage of the otherwise healthy population in Wuhan to figure this out BUT both PCR and immune antibody tests would need to be used (to my knowledge, these didn't exist in bulk a month ago)... and then there is difficult to know uncertainties in the percentage of false positives and false negatives. As an extreme example, what if 3-5 million people in Wuhan had contacted the virus but only a small portion (~100-300k) became ill enough to seek medical care and get tested and about 3-4k died? That would complete change the statistics around the severity of the virus. Given the contagious nature of the virus and delay between community transmission starting and 'the recognition that there was a problem", the virus was almost certainly more widespread in Wuhan than a mere 100-300k people.... the question is 'how widespread'. We don't know the answer. But the more widespread it was, the less severe the severity/mortality rate would look. Also, any comparison of statistical sample sets between countries should take into consideration other factors not included in the sample set: population density, severity of air pollution, percentage of people who smoke and how much, and other factors which negatively contribute to respiratory and immune system health (e.g. low-level heavy metal poisoning?, vitamin deficiencies?, etc.)

28 points by yasp 7y ago

This article goes horribly wrong very quickly: > They mean to tell you that we can get away without severe lockdowns as we are currently observing them in China and Italy. No, they don't. They mean to tell you that we need to slow the spread of the infection as much as possible, by whatever means we can sustain. That includes the potential of lockdowns. We individuals can only do so much. What we must do is wash our hands, practise social distancing, wash our hands, interact with as few people as possible, wash our hands, and only go out if essential. This graphic is telling people why they have to do this, it's not saying that to do so is enough to avoid lockdowns. Much of the rest of the article is right, but that part is seriously wrong. It concludes with: > Flattening the curve is not an option for the United States, for the UK or Germany. Don’t tell your friends to flatten the curve. Let’s start containment. That's just bizarre. Containment is part of flattening the curve, and the other measures that we personally can implement is also part of flattening the curve. Everything we do to slow and hinder the spread will help. Total containment is not possible, all we can do is slow the spread, and that is flattening the curve! So wash your hands, go out as little as possible, interact with as few people as possible, and do your bit to help flatten the curve.

etrabroline 7y ago
https://miro.medium.com/max/2400/1*FoIElQyKudIShpnBHckC5A.png https://miro.medium.com/max/2400/1*FoIElQyKudIShpnBHckC5A.pn... Would you like to refute or respond to this plot? > Containment is part of flattening the curve But "flattening the curve" means allowing exponential growth and waiting for most people to become infected. That would be a catastrophe, so no, containment is not a part of flattening the curve, and FTC is a wholly inadequate goal.
- ColinWright 7y ago
  > Would you like to refute or respond to this plot? "Flattening the Curve" is not and cannot be the entire story. It's a process to reduce the stress on the health services, but what seems clear from all the numbers is that the health services will be overwhelmed, we're just trying to reduce the number of concomitant deaths. > But "flattening the curve" means allowing exponential growth ... The cumulative number of cases will, barring exceptional intervention, be a logistic function, and the number of cases "in progress" will more-or-less be the derivative. And for a logistic function the first part is more-or-less an exponential. So whether you "Flatten the Curve" or not, the first phase is always effectively exponential, and since containment is now effectively impossible, it's inevitable that most people (they're suggesting 80%) of people will eventually have been infected. The way to reduce the catastrophe is to make the rate of infection as low as possible, thus stretching the logistic function and thereby reducing the maximum of the derivative. That's my understanding.
  - etrabroline 7y ago
    The health services will be overwhelmed if all we do is tell people to wash their hands. You are content with ~1,000,000 dead Americans, I am not.
    - ColinWright 7y ago
      There's something here you're really not understanding, and I don't know if it's because you're not reading carefully enough, or I'm not being clear enough. I'm not saying that all we do is tell people to wash their hands. Flattening the Curve is not just telling people to wash their hands. It's also saying self-isolate, where possible don't travel, where possible don't go out at all, when it's necessary to go out, stay a minimum of 2 metres away from people whenever you can. Flattening the Curve is not about "Just wash your hands and we'll be fine", it's about making as many contributions in as many ways as possible to slowing the rate of infection. I'm genuinely astonished if you think "Flatten the Curve" just means "Wash your hands". And when I run the numbers, it looks to me like the US health services are going to be overwhelmed regardless, the point is to do every little thing possible to reduce the amount. That's what Flattening the Curve means.
- rumanator 7y ago
  > But "flattening the curve" means allowing exponential growth and waiting for most people to become infected. I really have no idea where and how you've created that definition, because it has absolutely no relation to the real meaning of flattening the curve and even completely ignores the problem. Just to be clear, flattening the curve refers to limit the spread of the epidemic so that the amount of new cases are not an exponential spike but a smooth curve throughout time. Thus, the curve is flattened. That's it. How do you do that? Well, by containing how the disease spreads by enforcing containment and self-isolate and avoid contact with everyone. Washing your hands is great and makes up for a good scapegoat, but the reason why people are being sent to work from home, stock up on supplies, and not sey foot outside unless they really need to, is to contain how the disease spreads.

aawalton 7y ago

I understood this to mean flattening the curve is important, but not enough. Containment is the most critical intervention, but also the one that requires effective government intervention (South Korea).

rumanator 7y ago
> I understood this to mean flattening the curve is important, but not enough. Containment is the most critical intervention Containment is enforced to flatten the curve. That's the whole point. It's not an either/or thing. And the whole point of flattening the curve is to avoid saturating healthcare services with an exponential increase in demand concentrated in a span of a couple of weeks. The article is crap.

babulus 7y ago

Strawman arguments. JFC.

babulus 7y ago
Like seriously some people think they fucking know everything b/c they know a lot about one thing
- tallyhotallyho 7y ago
  Writing like you are an alcoholic Chandler Bing is annoying. Please stop.

dangus 7y ago

The author lists his own credentials, which do not include any medical field, and certainly not not epidemiology. Author: you are part of the problem. We don’t need more articles written by non-experts.

etrabroline 7y ago

The point he makes is valid and critically important. If it were titled "heard immunity is a dangerous delusion" then the "well actually" crowd here wouldn't be up in arms.

gus_massa 7y ago
The title should have been "Flattening the Curve is not enough!!!".

cashsterling 7y ago

Agree with other commenters... this article is criminally stupid. Author... Stop writing articles in an effort to appease your ego. You are contributing to the problem. I have a PhD in chemical engineering and worked in biotechnology off and on for several years: aseptic filling, clean room design, microbiology contamination mitigation, bio-processing design) and I come from a family with a lot of medical doctors. Even though I have a fairly good grasp of our situation, you won't see me writing any articles about the pandemic because I'm not an expert. Among many errors in the article, you can't blindly apply statistics from China or other parts of the world. It is a question of "data sample size" relative to the "actual population"; as a statistician, the Author should know that. The sample size, relative to population, is very small and highly skewed (mostly testing people who are sick). The question is: how many people came in contact with the virus vs. how many people got sick vs. how many people got really sick? This we don't know... China would have needed to randomly test a large percentage of the otherwise healthy population in Wuhan to figure this out BUT both PCR and immune antibody tests would need to be used (to my knowledge, these didn't exist in bulk a month ago)... and then there is difficult to know uncertainties in the percentage of false positives and false negatives. As an extreme example, what if 3-5 million people in Wuhan had contacted the virus but only a small portion (~100-300k) became ill enough to seek medical care and get tested and about 3-4k died? That would complete change the statistics around the severity of the virus. Given the contagious nature of the virus and delay between community transmission starting and 'the recognition that there was a problem", the virus was almost certainly more widespread in Wuhan than a mere 100-300k people.... the question is 'how widespread'. We don't know the answer. But the more widespread it was, the less severe the severity/mortality rate would look. Also, any comparison of statistical sample sets between countries should take into consideration other factors not included in the sample set: population density, severity of air pollution, percentage of people who smoke and how much, and other factors which negatively contribute to respiratory and immune system health (e.g. low-level heavy metal poisoning?, vitamin deficiencies?, etc.)