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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 ma

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.
- ansible 6y ago
  It would have been possible in the USA, but we've seen a failure in leadership to prevent the spread of the virus. If we had taken decisive action in January or February, we would have had enough resources for contact tracing, and really limit the spread. Instead we'll see at least 200K deaths from this before it is over. Looking at the new case counts for the USA vs. the EU makes me sad and angry.
  - usaar333 6y ago
    California has plenty of contact tracers and testing. Rt is still above 1.
    - bsder 6y ago
      Because we have a whole bucketload of idiots who can't be bothered to wear a damn mask and stay the hell home. When 2 Mother's Day gatherings account for 50% of the cases in Santa Cruz county, what can you do short of saying "You're a moron." It probably also doesn't help that a lot of Arizonans travel to California at this time of year to escape the heat.
- nradov 6y ago
  At this point the pandemic is so widespread that testing and contact tracing would be unlikely to achieve containment. We would have to first impose a very strict lockdown for several weeks, which would be politically difficult.
  - OminousWeapons 6y ago
    You're never going to achieve containment with just contact tracing, testing, and politely requesting that people stay at home. People won't comply. Containment requires mandating compliance: * Forcibly testing people regularly * Forcibly quarantining people who test positive * Mandating contact tracing regardless of personal preference * Imposing travel restrictions on hot spots with actual blockades * Restricting any gatherings that aren't essential, with "essential" actually meaning essential (grocery stores, pharmacies, hospitals, etc) rather than politically necessary. * Mandating correct wearing of masks * Closing borders or requiring quarantine upon entry In effect, we need to do what China did. We absolutely lack the political will to do that in the US for a variety of reasons, and so we will not be able to approach containment until we get a vaccine.
closeparen 6y ago
“Flatten the curve” is a different strategy from “minimize until medical advances come through.” It’s the difference between finding a version of life that keeps hospitals just under saturation vs. maintaining full lockdown as long as it takes.

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.

ansible 6y ago
It would have been possible in the USA, but we've seen a failure in leadership to prevent the spread of the virus. If we had taken decisive action in January or February, we would have had enough resources for contact tracing, and really limit the spread. Instead we'll see at least 200K deaths from this before it is over. Looking at the new case counts for the USA vs. the EU makes me sad and angry.
- usaar333 6y ago
  California has plenty of contact tracers and testing. Rt is still above 1.
  - bsder 6y ago
    Because we have a whole bucketload of idiots who can't be bothered to wear a damn mask and stay the hell home. When 2 Mother's Day gatherings account for 50% of the cases in Santa Cruz county, what can you do short of saying "You're a moron." It probably also doesn't help that a lot of Arizonans travel to California at this time of year to escape the heat.
nradov 6y ago
At this point the pandemic is so widespread that testing and contact tracing would be unlikely to achieve containment. We would have to first impose a very strict lockdown for several weeks, which would be politically difficult.
- OminousWeapons 6y ago
  You're never going to achieve containment with just contact tracing, testing, and politely requesting that people stay at home. People won't comply. Containment requires mandating compliance: * Forcibly testing people regularly * Forcibly quarantining people who test positive * Mandating contact tracing regardless of personal preference * Imposing travel restrictions on hot spots with actual blockades * Restricting any gatherings that aren't essential, with "essential" actually meaning essential (grocery stores, pharmacies, hospitals, etc) rather than politically necessary. * Mandating correct wearing of masks * Closing borders or requiring quarantine upon entry In effect, we need to do what China did. We absolutely lack the political will to do that in the US for a variety of reasons, and so we will not be able to approach containment until we get a vaccine.

closeparen 6y ago

“Flatten the curve” is a different strategy from “minimize until medical advances come through.” It’s the difference between finding a version of life that keeps hospitals just under saturation vs. maintaining full lockdown as long as it takes.