Covid-19

Flattening the curve

1. What is the curve

The "curve" researchers are talking about refers to the projected number of people who will contract COVID-19 over a period of time. (To be clear, this is not a hard prediction of how many people will definitely be infected, but a theoretical number that's used to model the virus' spread.) Here's what one looks like:

The curve takes on different shapes, depending on the virus's infection rate. It could be a steep curve, in which the virus spreads exponentially (that is, case counts keep doubling at a consistent rate), and the total number of cases skyrockets to its peak within a few weeks. Infection curves with a steep rise also have a steep fall; after the virus infects pretty much everyone who can be infected, case numbers begin to drop exponentially too.

The faster the infection curve rises, the quicker the local health care system gets overloaded beyond its capacity to treat people. As we're seeing in Italy, more and more new patients may be forced to go without ICU beds, and more and more hospitals may run out of the basic supplies they need to respond to the outbreak.

 A flatter curve, on the other hand, assumes the same number of people ultimately get infected, but over a longer period of time. A slower infection rate means a less stressed health care system, fewer hospital visits on any given day and fewer sick people being turned away.

• How do we flatten the curve

As there is currently no vaccine or specific medication to treat COVID-19, and because testing is so limited in the U.S., the only way to flatten the curve is through collective action. The U.S. Centres for Disease Control and Prevention (CDC) has recommended that all Americans wash their hands frequently, self-isolate when they're sick or suspect they might be, and start "social distancing" (essentially, avoiding other people whenever possible) right away.

 To comply, many states in the USA and even Singapore have temporarily closed public schools, and many businesses have advised employees to work from home if possible. On March 15, the CDC advised that all events of 50 people or more should be cancelled or postponed for the next eight weeks.

• Singapore  flattening the curve

Singapore’s ability to flatten the curve – public health expert speak for slowing the rate of infections to ensure hospitals are not overwhelmed – has been attributed to its aggressive tracing and containment methods and top-notch health care system.

Singapore was also one of the first countries to ban all travellers except its citizens and residents from Hubei province when the outbreak peaked there and just days after it included the whole of China in the travel restriction. This then expanded to South Korea, Italy and Iran as the infection moved out of China, and was later adjusted to include Germany, Spain and France as the disease spread across Europe.

Every time a case is confirmed, authorities will leap into tracing close contacts, asking infected patients questions such as “Who did you meet? What did you do? Did you share food?”

Officers from the police’s criminal investigation department have been roped in to conduct investigations into contacts, with CCTV footage and data visualisations used as well.

The government on Friday also launched an app called TraceTogether that uses Bluetooth technology to note down the close contacts of citizens – people whom they have come within 2 metres of and spent at least 30 minutes with.

Quarantine also helps flatten the curve. All infected patients have been hospitalised, those deemed at high risk of contracting the illness are quarantined, while others who are potentially exposed are ordered to stay home for 14 days. Flouting either order can result in a fine of up to S$10,000 (US$6,900) and/or six months in jail.

The city state freed up government chalets and school hostels to be used as quarantine sites, and postponed elective surgeries at public hospitals so the focus could be on Covid-19 patients.

When foreigners in the region started going to the Lion City to be treated for the coronavirus, the country reversed its policy of waiving treatment fees for foreigners to curtail the strain on its health care system.

This allowed Singapore to be commended by WHO in mid-Feb to be a role model to other countries for our “all-government approach”, especially Prime Minister Lee Hsien Loong’s regular videos which explains risks and assures Singaporeans, in containing COVID-19.

Adapted from:

https://www.scmp.com/week-asia/health-environment/article/3076268/aggressive-tracing-lessons-sars-how-singapore

https://www.livescience.com/coronavirus-flatten-the-curve.html