Coronavirus- Flatten the Curve

In my previous blog, I talked about Cornonviruses and COVID19 in general. I touched three major diseases- SARS2002, MERS-2012, COVID19, and how Covid19 is unique.

For this blog, I will talk about what does it mean to “flatten the curve”. To understand this, first, I will explain the symptoms and spread of this virus.

This virus affects the respiratory tract of humans. Most people who get infected show flu-like symptoms- cough, fever, tiredness, headache, etc. in many cases, diarrhea is also reported. Another symptom that has been reported by patients across globe is the loss of smell and taste. This last symptom is very interesting though we don’t have much understanding about it right now. Globally scientists (including me as well) in the field of taste and smell are working on understanding what is the correlation between virus and these two senses. Most people (about 80%) have very mild symptoms and only 1 in 5 people get a serious illness. The chunk of population who are immunocompromised, or have a pre-existing medical condition like diabetes, hypertension, asthma, etc. are at high risk of becoming severely ill due to this virus.

The disease spread via respiratory droplets when an infected person coughs or sneezes releasing virus particles in the air. Once the virus comes in the air, it can spread easily. If it lands on a surface, it can be sticking there for a few hours to a couple of days, and if someone touches that, they might catch the virus via contact with the infected surface. Sometimes, a person might be having coronavirus infection and does not show any symptoms (asymptomatic patient), thus making it very difficult to track the virus spread.

To summarize, virus spread via two ways: via coming in contact with someone infected with virus or contact with surfaces where virus might be sticking. To stop the spread, the best way is to isolate (Quarantine) infected, avoiding social interactions and disinfect surfaces.

No of cases over time worldwide

Now let’s come to the CURVE and what does it mean to FLATTEN THE CURVE ? The Curve here refers to the graph of number of patients over a period of time. If we see today’s worldometer graph, the number of patients is increasing over time and within 3-4 months, more than 4.3 million people worldwide are infected. Looking at these number come the question, can our health care system take care of so many patients? To quantify the potential of health care system, we use the metric of number of hospital beds available. Let us understand with an example, every country like India has only limited number of hospital beds which is generally way less than the population of country and these health care facilities are also not uniformly distributed across country. for instance rural areas have less facilities as compared to cities. India has already crossed the patient mark of 70 thousand since March and the count is increasing, with ramped-up testing in progress. Everyday about three thousand individuals are tested positive in India and this is at a stage when country is under lockdown for 50+ days and strict social/physical distancing protocols are implemented. Really soon India will reach the mark that it will not have have enough ICU beds for patients. This is exactly what happened in Italy, the number of Covid 19 patients rose sharply that there was not enough spaces or beds in hospital to treat patients.

daily-cases-india - CopyTill now I have been only talking about Covid19 patients, now let’s think about other diseases and emergencies. Healthcare system has to cater to other patients and emergencies as well. There are patients who come with chronic illness and emergencies to hospital and require medical care, like diabetes, strokes, heart problems, accidents etc. If all our health care is focused on Covid19, a lot of these patients will be neglected. India on an annual basis sees about 5 million patients requiring ICU services, this number is from before Covid19 pandemic. We have to make sure that our health system is not overloaded and we are able to provide care to patients in need. We can not assume that in a short period we will have enough hospital beds, doctors, nurses and health care professionals to treat people, that is impractical, so the only way we can make sure that patients are treated is that we keep their number on any single day low. If all of a sudden number of patients increases on a given day, that particular day health care services will not be able to provide them support and people will start dying.

Flatten the curve
This graph shows two scenarios 1. Blue color: when number of cases are above the capacity of health care system 2. Orange color: When number of cases on any given day is less then threshold capacity of health care system

We as society have to make sure that number of patients in any single day does not cross the threshold capacity of our health care system. By reducing the spread of virus, we are reducing the number of cases per day, thus helping our medical system in taking care of fewer patients each day. If we are able to reduce spread, a smaller number of patients will be added every day and the graphs shape will change to a flat plateau, thus making the popular phrase “FLATTEN THE CURVE”.

By following the measures of social distancing, we can reduce this number and flatten the curve. By flattening this curve, we are keeping disease under control and our scientific teams can work on finding therapeutics, drugs and vaccines against this Virus. These researchers need time to work on vaccines, drugs and testing which makes it even more crucial that we keep the disease spread under control and get some more time to work on these research areas.

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