It’s working! How social isolation is flattening the COVID-19 curve

Social isolation is starting to flatten the COVID-19 curve in the United States.  Learn why social isolation is essential, and what’s next for us all.

With most of the United States under some form of a “stay at home” order, it’s fair to address a few basic questions about social isolation. 

Here’s what I’d like to answer today:

  1. What is social isolation?
  2. Why is it necessary for everyone, instead of just the infected?
  3. Why do we need to “flatten the curve”?
  4. Is social isolation working?

What’s social isolation?

During a pandemic, social isolation is a more extreme version of social distancing.  Instead of just keeping people away from each other in public, social isolation means people are compelled to remain at home unless absolutely necessary.  

Non-essential human contact is kept to a minimum.  No first dates over candle light. No grabbing beers with friends at happy hour.  And for the parents out there, no playdates and no school!  

These drastic measures allow people with mild symptoms of the virus to recover at home without infecting others.  While home, these people may infect their family, but hopefully the virus will run its course without leading to the exponential spread I showed in my first COVID-19 post.  

Why is it necessary for everyone?

When it comes to COVID-19, everyone must socially isolate for the pandemic to be controlled.  Why? Because of asymptomatic spread.  

In an ideal world, anyone that is infected with a particular virus would have a visible sign that pops up on their forehead. 

Wouldn’t this be convenient? These people can then be isolated safely while the rest of the world goes about their business.  

Sadly, this isn’t the case.  After infection, all viruses have an incubation period, during which the virus is silently replicating and reaching a critical mass before its host will actually show any symptoms.  For COVID-19, the average incubation period seems to be about 5-6 days.

But worrisome research suggests that COVID-19 patients can infect others up to 2 days before showing any symptoms of illness

Even more concerning, evolving data suggests that a lot of people never get any symptoms at all from their COVID-19 infection, yet still might be able to transmit the virus. 

The CDC estimated that 25% of COVID-19 infections might be asymptomatic. But in early April 2020, better data from Iceland showed that about 43% of Icelandic COVID-19 cases had no symptoms of infection despite a positive test!  

So to recap, COVID-19 patients may be able to infect people before they show signs of the virus.  And up to 50% of those infected might not ever know they have the virus.

This explains why it’s important for everyone to socially isolate, not just those who are actively showing signs of infection.  

Why do we need to “flatten the curve?”

I’ve heard some people ask why we must take such drastic measures to slow the spread of COVID-19.  “We’re all going to get it anyway!” they say. I’ve even heard some people say that they want to just get the virus now so they can “get it over with.”  

I can empathize with these people.  They are probably right that eventual infection rates may be quite high.  Germany estimates that up to 70% of its population might eventually get infected with the virus.  

But here’s the thing.  You don’t want it to happen all at once.  If too many people get infected all at once, the critical cases will rapidly overwhelm the medical system.  In practical terms, this means that a large surge of patients in respiratory failure will deplete all available ventilators, physicians, and nurses.  Once capacity is reached in this nightmare scenario, many people will die who might otherwise have been saved. 

Incredibly, this has already happened in some parts of the world.  In northern Italy, with hospitals overrun with COVID-19 patients, doctors had to make agonizing choices about who was to live or die.  As reported in the New England Journal of Medicine, “it has been impossible to meet the needs of so many critically ill patients simultaneously.”

Stories from the front lines in New York show that even our system is teetering on the knife edge of being able to meet the demand.

The evening before I’m due to return to the hospital, a colleague messages our group to say that a 49-year-old Covid patient of hers, who was waiting in the E.R. for an inpatient bed, was found blue and dead in a chair.

NY Times Magazine: I’m an ER doctor in NY. None of us will ever be the same.

So “flattening the curve” isn’t really about preventing people from getting infected, ever.  It’s about slowing the rate of infection now so the healthcare system can handle the demand.  I don’t want to be the patient dying in an ER waiting room because there aren’t enough hospital beds or ventilators.  Do you?

Is social isolation working?

The Johns Hopkins Dashboard confirms that the USA has by far the most confirmed COVID-19 cases in the world (> 600,000), and also the highest number of deaths (> 27,000) as of mid April 2020.  To put this in perspective, 2996 people died in the 9/11 World Trade Center bombings.

(Number updated daily)

But there are glimmers of hope.  Now with most of the country under some form of a lockdown, our rate of infection is slowing.  

US COVID-19 cases through mid April 2020

Conclusion

So it’s working.  Staying at home with social isolation is flattening the curve and lowering the rate of COVID-19 infections.  This will save lives in the near future.  

Instead of the first curve in this image, below, hopefully we’ll end up with the second curve:

I can’t emphasize enough that social isolation is absolutely necessary to ensure that hospitals can handle the COVID-19 patients already flooding into the ERs. 

On the bright side, social isolation is starting to work, as is also reflected in more optimistic US death projections.  These projections have fallen to around 60,000 deaths, as opposed to the hundreds of thousands previously estimated to die.

But it’s also important to realize that social isolation can’t go on forever.  Unemployment rates have skyrocketed. Society has ground to a halt. Businesses that can’t go virtual have been shuttered and may never recover.  The fate of my real estate empire is in flux.

So what’s next?  As social isolation continues to drive down new infections, there will be a gradual loosening of restrictions.  Expect it to be slow, and expect there to be recurrent lockdowns as cases spike up again.  

I anticipate life will continue in this manner until there is widespread testing and also a COVID-19 vaccine.  

We are living through a historic, tragic event in world history.  Stay safe, stay at home, and stay optimistic.  

— TDD

The COVID-19 pandemic is a fast and fluid situation. My research and statistics are up to date as of the publication date of this post. Please share, comment, and subscribe for more content.

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