Sunday, March 15, 2020

Exponential growth, limited scalability

Saying that the spread of covid-19 is "exponential" is vague; what matters is the size of the exponent. Without testing, without "social distancing", its spread is unabated and the exponent is large. Measures to slow its spread will lower the value of the exponent; in other words, "flattening the curve".

The curve here is steeper than with other viruses because it is thought to be transmissible before people get sick. Usually when people get sick they stay home to recover and so are far less likely to pass it on to others; with covid-19, when someone gets sick they may will have passed it on to tens of other who in turn have passed it on to hundreds and so on.  That's what makes this contagion so problematic.

The goal of eliminating the virus is, in all likelihood, no longer attainable. Too many people have been infected to make containment an option. It is therefore important to understand what mitigation means. The most critical issue is the capacity to treat those who are in the high risk category, generally thought to be those with preexisting respiratory ailments.

Since there is no known cure most will require elaborate medical care, often in an Intensive Care Unit (ICU). ICUs are not something that can be created in short order, they are not easily salable because they require not only equipment that can't be manufactured fast enough but, more importantly, trained staff to operate them who can't be trained or recruited in time.

If the rate of new infractions among the vulnerable leads to a situation (as it did in Italy) where the number needing access to an ICU at a point in time exceeds their availability, people will die unnecessarily.  That has to be prevented.

Since ICUs can't be created fast enough, the only option is to slow the rate of arrival of new cases so that at its the peak, the number of simultaneously sick people who need access to an ICU is less than the number of ICU beds available. In other words, socially responsible actions that help flatten the curve will end up saving other people's lives.

No comments:

Post a Comment