It wouldn’t have occurred to anyone to see the Louvre and the Colosseum deserted in broad daylight. But strict quarantine regulations in France and Italy have locked down famous landmarks and entire cities in an effort to stop the spread of COVID-19. With global cases breaching the 700,000 mark, countries have launched varying social distancing measures.
In the Philippines, the Palace put the entire Luzon under Enhanced Community Quarantine (ECQ) in mid-March.
Response to the quarantine, unfortunately, varied as well. Some heeded the orders and stayed indoors, but some (who have neither a frontline job nor a necessary errand) flout quarantine regulations and party the night away. Case in point: crowds in Bondi Beach.
Their justification? Their immune systems — young and uncompromised — will be able to crush the virus, anyway. However, by joining non-essential gatherings, the young and uncompromised only steepen the curve, which the quarantine seeks to flatten.
But what is the curve? And how does staying at home help flatten it out?
What “Flatten the Curve” Means
The curve refers to a bell-curve graph that predicts how many people will be infected during a pandemic.
Outbreaks, more or less, follow the bell-curve pattern. The first half of a curve — the rising slope — depicts the rise in the number of new cases every day. It eventually reaches a peak (that day with the highest number of new cases), then cases will dwindle. The second half — the declining slope — depicts the fall in the number of cases daily.
Now, there are two ways a pandemic could go, depending on community response: the steep, navy blue curve shows what will happen if we do not do anything. The flat, baby blue curve shows what will happen if we launch quarantine measures.
The steep curve happens fast — cases rise rapidly but fall just as fast. On the other hand, the flat curve, even though it may infect the same number of people, happens across a prolonged period.
So why do we want a flat curve?
Because we have a limited healthcare system — our hospitals can only cater to so many patients. And this is represented by the horizontal line.
In the event of a steep curve, our healthcare system will be overwhelmed.
Medical supplies and workforce are depleted. Some hospitals will have to turn away infected patients. They won’t be able to take care of everyone above the line, and they will have to make the horrible choice of who gets to live and who gets to die.
Surreal as it is, these horrible choices, according to reports, are currently happening in saturated hospitals in Spain and Italy.
On the other hand, a flat curve ensures that the number of cases at any given time can be managed by the healthcare system. Hospitals are less likely to turn away patients; if the curve remains below the line, every infected patient gets the care he or she needs. Hopefully, this results in fewer deaths.
It’s like a school cafeteria.
A cafeteria doesn’t have enough chairs for the entire student body at once. If different grade levels have different lunch hours, however, everybody would have the chance to sit down.
Can Social Distancing Flatten the Curve?
The short answer is yes.
The coronavirus is contagious; it is transmitted from one person to another through small droplets from the nose or mouth of an infected person. If another individual inhales or swallows the droplets or touch contaminated objects then touch their eyes, nose, or mouth afterwards, they can acquire the infection.
It’s important to note that in every outbreak, the natural (no protective measures; steep) curve depends on how contagious the disease is and how many people are vulnerable to it.
- Contagion. Citing initial data, the NPR reports that the coronavirus might be more contagious than the flu. The average flu patient spreads the flu virus to about 1.3 other people, while a COVID-19 patient spreads the infection to 2 to 2.5 additional people.If infected individuals encounter fewer people, there are fewer opportunities for transmission. If everyone stayed at home, there is a much lower chance of meeting a patient and acquiring the infection.
- Vulnerability. Though COVID-19 seems just like the flu, people have built immunity against the flu virus, but not against coronavirus. This means more people are vulnerable to COVID-19. Plus, according to initial data, the coronavirus can cause more severe diseases.
If people remain socially distant, there is a much lower chance of acquiring the infection and passing it to a vulnerable individual.
Social distancing also could also prevent the rise of super-spreaders, or infected people who transmit the virus to more people than other patients do. Take South Korea’s Patient 31 for example. Unaware that she was carrying the virus, she attended several social gatherings, like church services and a buffet lunch. Thousands of cases have been confirmed in the church group, which in turn spread the virus even further through other social gatherings
A Tale of Two Cities — and Two Curves
You only have to look at the fate of two cities during the 1918 pandemic to affirm that social distancing works. Dr. Drew Harris, a population health researcher at Thomas Jefferson University, compares the containment efforts of Philadelphia and St. Louis.
Philadelphia city officials ignored the warnings of infectious diseases experts that the flu was circulating in their community. Instead of postponing a huge parade for World War I, they moved forward, gathering hundreds of thousands of people in one place. Within 72 hours, thousands of people in and around the city died. Within half a year, the death toll reached 16,000.
On the other hand, St. Louis officials implemented strict quarantine measures — they closed down schools, isolated the sick, and encouraged social distancing. The city’s death toll was only 1/8 of Philadelphia’s.
A 2007 analysis of historical data published in the Proceedings of the National Academy of Sciences, stressed that, had St. Louis waited another week or two, they might have faced the same fate as Philadelphia.
The biggest lesson to take from the 1918 pandemic, according to the papers, is that it’s critical to not only intervene but to intervene early.
Parties and Drinking Sessions aren’t Worth It
Stakes are high for the COVID-19 pandemic. There’s a high possibility that it’s more contagious and severe than the flu.
So while it may be thrilling to hold illicit get-togethers far from the reach of peace and order officers, the fun isn’t worth it.
These non-essential gatherings serve as a hotspot for virus transmission, which can reach your friend’s arthritic grandmother or asthmatic little brother. With our hospitals stretched thin and forced to deny COVID-19 admissions, it’s our duty to set aside personal conveniences in the name of public health.
We don’t want our doctors and nurses to make more horrible choices.