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When does the curve end? - Printable Version

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When does the curve end? - magnus - 03-17-2020

I've got a bunch of questions about this curve that we're trying to flatten and wonder what other people's thoughts were.  With all this talk about flattening the curve...which is important just to avoid overwhelming our hospitals (and all the fallout from that), what about the length and tail end of the curve.  How do we know when we've gotten there?  Any predictions on what that would look like and how long it will take to get there?  Will we be under strict socializing rules until the curve is done?

It seems that the end of the curve is when the virus basically dies out right?  By dies out, I just mean, it at worst has a very very low infection rate.

One way for it to die out is if we develop a vaccine.  But that will take at least a year.  That's a long curve.
Another way is if we develop herd immunity.  But that means that all the elderly we're trying to save...will still be hit...unless we try to pull off the UK's initial plan of quarantining the elderly until herd immunity is reached.  
Alternately, maybe hitting summer will help (though that seems less and less likely with all the current warm nations being affected)

Seems like we're going to be in a delicate balance for a while.   Let's say we are able to get the infection rate under control through the social restrictions...can we afford to relax those restrictions?  All it would take would be for another few large gathering to once again have an infected person and another explosion of infections would follow.  Would that mean that barring a vaccine or warm weather effect, most of us should expect to get it over the coming months?

Yuck.  Hopefully someone can poke holes in my ponderings.  Thanks

RE: When does the curve end? - OutsiderFan - 03-17-2020

I hate not having all the information in one thread. Forcing threads out of their natural orbit is confusing and takes way too long to track, with more steps involved - never a good thing when designing user experiences!

Anyway, here is a mind blowing curve chart.  It's impossible for me to understand how if everyone stays inside for two months that it still gets so bad, but I'm not questioning scientists either.

[tweet]https://twitter.com/Laurie_Garrett/status/1239772655852675072[/tweet]

RE: When does the curve end? - burger - 03-17-2020

(03-17-2020, 02:16 AM)magnus Wrote:  I've got a bunch of questions about this curve that we're trying to flatten and wonder what other people's thoughts were.  With all this talk about flattening the curve...which is important just to avoid overwhelming our hospitals (and all the fallout from that), what about the length and tail end of the curve.  How do we know when we've gotten there?  Any predictions on what that would look like and how long it will take to get there?  Will we be under strict socializing rules until the curve is done?

It seems that the end of the curve is when the virus basically dies out right?  By dies out, I just mean, it at worst has a very very low infection rate.

One way for it to die out is if we develop a vaccine.  But that will take at least a year.  That's a long curve.
Another way is if we develop herd immunity.  But that means that all the elderly we're trying to save...will still be hit...unless we try to pull off the UK's initial plan of quarantining the elderly until herd immunity is reached.  
Alternately, maybe hitting summer will help (though that seems less and less likely with all the current warm nations being affected)

Seems like we're going to be in a delicate balance for a while.   Let's say we are able to get the infection rate under control through the social restrictions...can we afford to relax those restrictions?  All it would take would be for another few large gathering to once again have an infected person and another explosion of infections would follow.  Would that mean that barring a vaccine or warm weather effect, most of us should expect to get it over the coming months?

Yuck.  Hopefully someone can poke holes in my ponderings.  Thanks

I don't think anyone knows how long it will take for this to peter out.  The models give estimates, but I would be leery of any model predictions, as the model will be less and less accurate the farther you go into the future. 

As for relaxing restrictions, I've seen (can't recall where) models showing that relaxing restrictions leads to a second big spike in infections.  If there are a few infectious people and we relax social distancing, then it just starts over again.

The good news is that there is an alternative strategy: do a ton of testing and hunt down the infected.  South Korea has done this to great effect.  Unfortunately, the federal government initially fucked up the testing so badly that this was impossible in the US.  But, say a few months from now, when testing capacity is much greater, we could conceivably use the testing strategy and use more moderate social distancing.

RE: When does the curve end? - BostonCard - 03-17-2020

Yes, a lot of uncertainty here, but both China and South Korea have been able to bring their new infection rates to fewer than 100 a day (from a peak of ~800/day).  When the number of infections is at that level, old fashioned epidemiology can be used: surveilence, contact tracing, close observation and quarantine.

BC

RE: When does the curve end? - magnus - 03-17-2020

Well apparently a new UK study has predicted that even with successful mitigation, our hospitals will overflow and we'll still lose 1+ million lives in the US.

To avoid that, the suppression strategy would be used...until a vaccine could be developed.  Suppression being very restrictive socializing in order to reduce the infection rate down to small numbers.

https://www.cnn.com/2020/03/17/health/coronavirus-uk-model-study/index.html

Impossible to fully imagine all the repercussions from either of these strategies.

RE: When does the curve end? - M T - 03-17-2020

[I had been keeping this up to date in the old thread.  This new thread seemed the right place to keep it.]

SCC new cases, from Feb 28:  1, 1, 3, 2, 2, 3, 6, 4, 8, 5, 6, 2, 3, 18, 13, 12, 23, 24, 17, 20, 14, 7 (Mar 19)
Total number:  3, 4, 7, 9, 11, 14, 20, 24, 32, 37, 43, 45, 48, 66, 79, 91, 114, 138, 155, 175, 189, 196
Total deaths: 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 1 (3/9), 1, 1, 1, 2(3/13), 2, 4(3/15), 4, 6 7(3/17), 7, 8 (3/19)

Mar 20: I'm going to quit updating this. Instead, see https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_California#Daily_case_data_for_Santa_Clara_County

RE: When does the curve end? - magnus - 03-17-2020

What's testing capacity like in SCC?

RE: When does the curve end? - CardinalSagehen - 03-17-2020

Daily new cases in Italy seem to have reached a plateau over the last 4 days at ~3,500/day. This means the doubling time is slowing down. One might doubt the country's capacity to test, but sadly, the count of the deceased is indisputable.  And that number has also reached a plateau at ~350/day for three days running. 

https://www.worldometers.info/coronavirus/country/italy/ (scroll to bottom for today's stats, not included in the charts)

You could discount the Italian experience, as it's not yet a trend.  But it looks like the beginning of a trend toward the experience of other countries that have corralled the virus, like S. Korea and China.  This suggests to me that 4-5 weeks of draconian countermeasures, plus testing, might be enough to turn the tide.  If only we had better testing...  

RE: When does the curve end? - 2006alum - 03-17-2020

This thread is absolutely terrifying and is the strongest argument I've seen yet against the (cull the) herd immunity approach:

[tweet]https://twitter.com/jeremycyoung/status/1239975682643357696?s=20[/tweet]