It is unsustainable (effort grows with epidemic size). We need measures that while painful for all will slow social contact - cancelling public gatherings, paid sick leave, working from home, and the like. Social distancing is the general name for these interventions.
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And we need to stop feeling sheepish about it and just realize that some places (Italy, Iran) are in crisis, and some are very likely in the days before crisis, a crisis that will be less bad if we slow down the virus.
#flattenthecurve to reduce peak demand on health care18 replies 371 retweets 1,378 likesShow this thread -
The 1918 analogies have been discussed a lot and are correect. Flattening the curve reduces health care load, delays risk for everyone, and reduces total epidemic size. Here are some data from a paper we submitted to
@medrxivpreprint and is awaiting clearance. Led by@ruoranepi12 replies 269 retweets 906 likesShow this thread -
with
@megan_b_murray@cmyeaton Eric Toner, Qi Tan. The link to full document will be on last tweet as I want to replace it with a more permanent one.1 reply 51 retweets 267 likesShow this thread -
We looked at the epidemics in Wuhan and Guangzho and their ICU and hospital bed use vs US capacity. Summary: Wuhan's peak critical case load per capita was equal to the total number of ICU beds per capita in the US -- a similar experience to Wuhan would fill our ICU with COVID
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Here's the graph. Gray lines show US capacities for ICU and hospital bedspic.twitter.com/z8HBPXk6DT
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Guangzho intervened much earlier in their epidemic, and had a MUCH smaller peak demand. Note different scalepic.twitter.com/51vtTDbQNr
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My takeaways: 1) early intervention spares the health system from intense stress -- like Philly vs. St. Louis. 2) Early intervention means before it feels bad. Guangzho intervened when they had 7 confirmed cases & 0 deaths. Wuhan's came when they had 495 confirmed cases, 23 dead
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3) We will not intervene as intensely as China, making speed even nore important. 4) Slowing transmission did not immediately relieve health care burden. People take a long time (weeks) to get really sick, so the peak burden trailed peak transmission by weeks esp in Wuhan
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Replying to @mlipsitch
Why start with self-defeating assumption that USA cannot, even in principle, intervene as competently as China (or Taiwan or Singapore or South Korea)? Not resisting because one assumes one will be defeated, endures one will be defeated.
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The US was being made artificially stupid. We have had a big wake up now.
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