A simple arithmetic rationale for crushing the epidemic curve of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) instead of flattening it

Abstract

Countries with ambitious strategies to crush the curve of their epidemic trajectories, to promptly eliminate SARS-CoV-2 transmission at national level, include China, Korea, Japan, Taiwan, New Zealand and Australia. In stark contrast, many of the European countries hit hardest over the last two months, including Italy, Spain, France, Ireland and the United Kingdom, currently appear content to merely flatten the curve of their epidemic trajectories so that transmission persists at rates their critical care services can cope with. Here is presented a simple set of arithmetic modelling analyses that explain why preferable crush the curve strategies, to eliminate transmission within months, would require only a modest amount of additional containment effort when compared to flatten the curve strategies that allow epidemics to persist at a steady, supposedly manageable level for years, decades or even indefinitely.

Containment strategies for the 2019 Novel Coronavirus: flatten the curve or crush it?

“…Unfortunately, and consistent with the way their work was represented in one of our national newspapers, the authors only emphasize one side of their own results in the abstract of their paper. There are two issues the authors fail to mention in their own summary: (1) at the end of the 18 month period they presented (Figure 1), epidemics suppressed sufficiently for ICUs to consistently cope with are still going strong, requiring just as much effort to keep contained and continuing to cause illness, death and socioeconomic disruption, (2) when they simulated crush the curve [3] approaches to eliminating the virus with sustained and uninterrupted restrictions, their timelines to that exit point are about 3 months ( Figure 2), very similar to our own predictions [2,4].…”

“…So why not just put our foot on the accelerator to terminate the epidemic in time for the coming winter [2][3][4]? The second set of graphs in figure 2 of Chowdhury et al [1] almost exactly matches our own [2,4] and confirms that elimination timelines of 2-4 months are feasible. In the authors' own words: "…in 3 months, most of the countries would not have any new cases to report".…”

“…Taking Ireland as an example, our current rate of epidemic contraction closely matches those predicted by the authors to approach a definitive exit from lockdown within 3 months, an opportunity we may be foolhardy to decline. Faster progress towards elimination would obviously be better and these timelines could be shortened if we were to push ahead with even more stringent and effective restrictions [4]. However, such a bold choice would require a dramatic rethink of our national strategy, broad support from the public at large, and cooperation with our trading partners across Europe and the rest of the world [2].…”

Awareness On The Mode Of Transmission Of Virus Causing COVID 19 Among General PublicA Questionnaire Survey

“…The benefits of social distancing were most effective as the number of cases decreased. It reduced the median number of cases by more than 92% in China and hence seemed to be very effective [24]. According to WHO, people are requested to maintain a minimum of 1-3m of distance from a person having symptoms of the COVID [25].…”