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Flattening the Curve Revisited

Is there truly wisdom in this concept of flattening the curve or is it just a buzz word?

By Rocky Jedick MD, MBA · · 5 min read

Flattening the curve discussion

Should all businesses reopen immediately if local healthcare facilities are not overwhelmed? Definitely. No way. Maybe? Hmm...I dunno.

On one hand (likely the right one), it makes sense that healthcare systems should be optimized to work near capacity during a pandemic. However, due to COVID concerns and stay-at-home orders, the number of patients engaging the healthcare industry are drastically down across the country. This is true in each of the 4 hospitals I work as an ER doctor at in Salt Lake City and Las Vegas.

1918 Mortality Curves by City

The doom and gloom prediction of overrun hospitals were largely never realized. Doesn't this mean we have successfully flattened the curve? This is proof we should immediately reopen our economy and ease social distancing...right?

But on the other hand, I am inclined to proceed with caution. I am drawn to the most useful example in recorded human history for possible insights. The second peaks of deaths experienced across many U.S. cities during the 1918 pandemic give me pause.

WHY DID WE FLATTEN THE CURVE ANYWAY?

Flattening the Curve

1. Preventing a scenario in which healthcare systems are overwhelmed

This will theoretically save many lives as the system will clearly perform optimally when not overwhelmed.

2. Allowing time for clinicians and researchers to learn how to treat & prevent disease

It has been fascinating for me as a physician treating COVID-19 to observe the rapid changes in our treatment strategy in such a short time. Outcomes are improving.

3. Aggressive social distancing and quarantines actually suppress and eradicate virus

In a perfectly closed system, the virus ceases to replicate, shed, and infect. Disease can be locally fully eradicated.

LIVES LOST NOW, LATER, OR NEVER?

Which 1918 city would you want to live in?

I am inclined to think that the policies we have implemented not only flatten the curve but also decrease the area under the curve. This would mean we are preventing COVID-19 deaths that will never occur.

"He that can have patience can have what he will." ~ Benjamin Franklin