6 ms·

> I always thought, based on what I've read/heard, that one of the big reasons, maybe the biggest reason we're doing all this is to flatten the curb so hospital

by kop316 6y ago

> I always thought, based on what I've read/heard, that one of the big reasons, maybe the biggest reason we're doing all this is to flatten the curb so hospitals don't get overwhelmed. This was my understanding as well, and it is what is shown in Wikipedia: https://en.wikipedia.org/wiki/Flatten_the_curve https://en.wikipedia.org/wiki/Flatten_the_curve The bigger thing that I have chatted about with several other is that the area under the curve is the same, i.e. the same amount of inidividuals will still get sick.

snug 6y ago
Exactly this, in fact we did such a good job, that people who were sick for other reasons didn't seek medical help and health care professionals have been laid off https://calmatters.org/health/coronavirus/2020/05/health-care-workers-layoffs-california-coronavirus-nurses-furloughs-pay-cuts-hospitals/ https://calmatters.org/health/coronavirus/2020/05/health-car...
zzleeper 6y ago
afaik not true; google for "epidemic overshoot"
- arcticfox 6y ago
  that's in the case that we even have to arrive at herd immunity through infections. By far the bigger factor here are the dozens of vaccines and treatments (eg monoclonal antibodies) in development, if any of them work in time, the "area under the curve is the same" idea is blown out of the water to the tune of millions of preventable deaths.
  - noobaccount 6y ago
    Millions of preventable deaths? Do you have a source handy? I’m wondering how that aligns with the latest data.
    - lllr_finger 6y ago
      (number of uninfected that need to be infected to achieve herd immunity) * (case fatality rate) = future deaths With the assumption that every vaccinated person counts towards herd immunity and isn't likely to die, you can plug in your own numbers to the equation above. Even with really conservative estimates, it's easy* to get into the millions when you consider the entire planet. *Barring some highly effective treatments that may or may not surface.
      - dragonwriter 6y ago
        > (number of uninfected that need to be infected to achieve herd immunity) * (case fatality rate) = future deaths You need the lower IFR, not the CFR, here.
      - nradov 6y ago
        Every vaccinated person will not count towards herd immunity. Vaccines can be tremendously helpful in controlling infectious diseases, but not every person who is vaccinated will produce neutralizing antibodies. This is why it's important to vaccinate as many people as possible in order to surpass the herd immunity threshold. At this time we don't know how effective any of the vaccine candidates will be.
        glofish 6y ago
        in addition it is also not clear if the vaccine will have a lower incidence of side effects than the virus itself kids and young adults have less than 1/100,000 chance of dying of COVID. The vaccine needs to be better than that. There is an ethical issue at hand of vaccinating people that are not at risk to save those that are at risk. For reference after administering 3.1 billion vaccines the US paid damages in about 3,000 cases thus across all vaccines the rate of serious side effects is about 1 in a hundred thousand (considering about 10 vaccines per individual).
        greedo 6y ago
        There is an ethical issue at hand when people are unwilling to protect 30-40% of the population because they fear a miniscule risk of vaccination.
- kop316 6y ago
  I just did, and the first 6 answers do not really clear it up. Do you have a specific source that can explain it?
  - makomk 6y ago
    The mainstream media coverage of overshoot in publications like the New York Times is intentionally misleading in order to push the (false) narrative that herd immunity requires infecting and killing far more people than you'd naively think. (Their numbers are only accurate if you assume no social distancing at all, which probably isn't even possible at this point.) Basically, the number of infections peaks at the point where - due to some combination of immunity and measures like social distancing - each person infects at most one other person on average. However, there are still a whole bunch of infected and susceptible people spreading the disease, meaning that quite a lot more people then become infected than is actually necessary to end the outbreak. If you assume no attempt to flatten the curve, then a lot more people become infected than the herd immunity threshold, and that's what the NYT and co have focused on. However, one consequence is that flattening the curve without fully surpressing the outbreak reduces overall infections and deaths - the peak is lower and happens after fewer total infections, making it possible to build a whole bunch of herd immunity without all the extra infections and deaths from massively overshooting it.
    - kop316 6y ago
      Thank you for your explanation. That makes a lot of sense, and was a lot better than anythign i could find.
marvin 6y ago
If everyone gets vaccinated a year from now, the total area under the curve will be lower if it's spread out over a long time than if everyone got sick before the vaccine became available.
- tonyedgecombe 6y ago
  More so as treatments improve and if the virus weakens (which they usually do).
bluGill 6y ago
The area under the curve need not be the same though. There are many things that can change the area under the curve. A vaccine is an obvious one, once one hits the area doesn't change, so the less there is the better. (ecconmics can debate how much we should have reopened after that) the virus could also mutate and affect everyone again thus increasing the area. I have never been able flattening the curve. If people would just stay home for a month and take precautions this would be over as it wouldn't spread and those who have it get over it. The details of living like that are tricky but too many people didn't try.
tunesmith 6y ago
I am amazed at how many people repeat the point about the area under the curve being the same. It's just completely irrelevant unless we believe that we will make no medical advancements. You flatten the curve to buy time for medical advancements, which will reduce the total area under the curve. It can be any or all of: 1) flattening the curve enough to make contact tracing viable, which can eradicate breakouts before they take hold 2) finding a decent anti-viral treatment so that number of deaths or "permanent damage" cases decrease, even if # of cases does not 3) developing a vaccine This thing about "area under the curve remaining the same" is only true for calculus, it has no bearing on real life because we are making medical advances.
- credit_guy 6y ago
  4) find out that dexamethasone can reduce mortality for ICU patients by a lot. Aside from medical advancements, if the health care personnel is not overworked, overstressed, overtired, patients have a better chance to survive. Flattening the curve means lives saved.
  - makomk 6y ago
    The way that we discovered dexamethasone can reduce mortality in ICU patients was through enough people being infected and dying to run studies testing a whole bunch of potential treatments on them. There's very limited potential to decrease the number of deaths by buying time for this to be discovered, at least from a global perspective.
  - m4rtink 6y ago
    This is something that people often forgot - even if hospitals do not reach their full "paper" capacity, you can easily burn out or even kill your irreplaceable (in the pandemic timescale) medical personnel, if they have to deal with constant influx of infected patients over long periods. Not to mention hospitals usually shutting down elective procedures once the amount of infected patients in their care crosses a certain threshold.
- amanaplanacanal 6y ago
  The other possible outcome is to get enough testing and contact tracing in place so that we don't have to all get sick. Other countries have successfully done this, but it seems impossible in the US.
Leherenn 6y ago
I don't know, look at Europe, quite a few places have managed to do quite a bit more than flattening the curve. At the current rate, reaching even 50% of the population would take decades, hopefully there will be a vaccine well before them.

by kop316 6y ago

snug 6y ago

Exactly this, in fact we did such a good job, that people who were sick for other reasons didn't seek medical help and health care professionals have been laid off https://calmatters.org/health/coronavirus/2020/05/health-care-workers-layoffs-california-coronavirus-nurses-furloughs-pay-cuts-hospitals/ https://calmatters.org/health/coronavirus/2020/05/health-car...

zzleeper 6y ago

afaik not true; google for "epidemic overshoot"

arcticfox 6y ago
that's in the case that we even have to arrive at herd immunity through infections. By far the bigger factor here are the dozens of vaccines and treatments (eg monoclonal antibodies) in development, if any of them work in time, the "area under the curve is the same" idea is blown out of the water to the tune of millions of preventable deaths.
- noobaccount 6y ago
  Millions of preventable deaths? Do you have a source handy? I’m wondering how that aligns with the latest data.
  - lllr_finger 6y ago
    (number of uninfected that need to be infected to achieve herd immunity) * (case fatality rate) = future deaths With the assumption that every vaccinated person counts towards herd immunity and isn't likely to die, you can plug in your own numbers to the equation above. Even with really conservative estimates, it's easy* to get into the millions when you consider the entire planet. *Barring some highly effective treatments that may or may not surface.
    - dragonwriter 6y ago
      > (number of uninfected that need to be infected to achieve herd immunity) * (case fatality rate) = future deaths You need the lower IFR, not the CFR, here.
    - nradov 6y ago
      Every vaccinated person will not count towards herd immunity. Vaccines can be tremendously helpful in controlling infectious diseases, but not every person who is vaccinated will produce neutralizing antibodies. This is why it's important to vaccinate as many people as possible in order to surpass the herd immunity threshold. At this time we don't know how effective any of the vaccine candidates will be.
      - glofish 6y ago
        in addition it is also not clear if the vaccine will have a lower incidence of side effects than the virus itself kids and young adults have less than 1/100,000 chance of dying of COVID. The vaccine needs to be better than that. There is an ethical issue at hand of vaccinating people that are not at risk to save those that are at risk. For reference after administering 3.1 billion vaccines the US paid damages in about 3,000 cases thus across all vaccines the rate of serious side effects is about 1 in a hundred thousand (considering about 10 vaccines per individual).
        greedo 6y ago
        There is an ethical issue at hand when people are unwilling to protect 30-40% of the population because they fear a miniscule risk of vaccination.
kop316 6y ago
I just did, and the first 6 answers do not really clear it up. Do you have a specific source that can explain it?
- makomk 6y ago
  The mainstream media coverage of overshoot in publications like the New York Times is intentionally misleading in order to push the (false) narrative that herd immunity requires infecting and killing far more people than you'd naively think. (Their numbers are only accurate if you assume no social distancing at all, which probably isn't even possible at this point.) Basically, the number of infections peaks at the point where - due to some combination of immunity and measures like social distancing - each person infects at most one other person on average. However, there are still a whole bunch of infected and susceptible people spreading the disease, meaning that quite a lot more people then become infected than is actually necessary to end the outbreak. If you assume no attempt to flatten the curve, then a lot more people become infected than the herd immunity threshold, and that's what the NYT and co have focused on. However, one consequence is that flattening the curve without fully surpressing the outbreak reduces overall infections and deaths - the peak is lower and happens after fewer total infections, making it possible to build a whole bunch of herd immunity without all the extra infections and deaths from massively overshooting it.
  - kop316 6y ago
    Thank you for your explanation. That makes a lot of sense, and was a lot better than anythign i could find.

marvin 6y ago

If everyone gets vaccinated a year from now, the total area under the curve will be lower if it's spread out over a long time than if everyone got sick before the vaccine became available.

tonyedgecombe 6y ago
More so as treatments improve and if the virus weakens (which they usually do).

bluGill 6y ago

The area under the curve need not be the same though. There are many things that can change the area under the curve. A vaccine is an obvious one, once one hits the area doesn't change, so the less there is the better. (ecconmics can debate how much we should have reopened after that) the virus could also mutate and affect everyone again thus increasing the area. I have never been able flattening the curve. If people would just stay home for a month and take precautions this would be over as it wouldn't spread and those who have it get over it. The details of living like that are tricky but too many people didn't try.

tunesmith 6y ago

I am amazed at how many people repeat the point about the area under the curve being the same. It's just completely irrelevant unless we believe that we will make no medical advancements. You flatten the curve to buy time for medical advancements, which will reduce the total area under the curve. It can be any or all of: 1) flattening the curve enough to make contact tracing viable, which can eradicate breakouts before they take hold 2) finding a decent anti-viral treatment so that number of deaths or "permanent damage" cases decrease, even if # of cases does not 3) developing a vaccine This thing about "area under the curve remaining the same" is only true for calculus, it has no bearing on real life because we are making medical advances.

credit_guy 6y ago
4) find out that dexamethasone can reduce mortality for ICU patients by a lot. Aside from medical advancements, if the health care personnel is not overworked, overstressed, overtired, patients have a better chance to survive. Flattening the curve means lives saved.
- makomk 6y ago
  The way that we discovered dexamethasone can reduce mortality in ICU patients was through enough people being infected and dying to run studies testing a whole bunch of potential treatments on them. There's very limited potential to decrease the number of deaths by buying time for this to be discovered, at least from a global perspective.
- m4rtink 6y ago
  This is something that people often forgot - even if hospitals do not reach their full "paper" capacity, you can easily burn out or even kill your irreplaceable (in the pandemic timescale) medical personnel, if they have to deal with constant influx of infected patients over long periods. Not to mention hospitals usually shutting down elective procedures once the amount of infected patients in their care crosses a certain threshold.
amanaplanacanal 6y ago
The other possible outcome is to get enough testing and contact tracing in place so that we don't have to all get sick. Other countries have successfully done this, but it seems impossible in the US.

Leherenn 6y ago

I don't know, look at Europe, quite a few places have managed to do quite a bit more than flattening the curve. At the current rate, reaching even 50% of the population would take decades, hopefully there will be a vaccine well before them.