Flattening the Curve Too Much

There's been a lot of talk, during the 2020 virus pandemic, of the need to flatten the curve. The reasoning, which is valid up to a point, is that hospitals don't have enough equipment (e.g., ventilators; Galion hospital for instance has two of them) to treat as many people at once, as would need to be treated if the virus ran its natural course. This is true up to a point, as you can see in places like Italy, which didn't flatten the curve nearly enough and have consequently seen a disturbingly high mortality rate. The American medical care system would be more difficult to overwhelm than that of most other countries. American culture is obsessed with medical care; on an average day, something like 10% of the population receives medical care of some kind, and that's if you don't count prescription drugs as medical care; if you do, it's more than 50%; so our medical care industry is pretty substantial. It's expensive (and Americans spend a disturbingly large amount of money on medical care), but it's substantial. Nonetheless, we don't want to be in the boat Italy is in. We want to flatten the curve —up to a point.

But there is such a thing as flattening the curve too much.

I live in Crawford County. It's difficult to get an exact population figure, because population changes over time, but the 2018 estimate is around 41 and a half thousand. (This is down from almost 44 thousand in 2010. The population is on a long-term decline since the mid twentieth century, because most of the graduating students who go away to college, never come back. There are very few jobs suitable for college graduates here, and an employer would be mad to locate here if they need that kind of workforce, which creates a vicious cycle. What, if anything, we could be or should be doing about that, is an interesting question, which I will not attempt to address today.) It's now 2020 and we're due for a new census, but meanwhile I will be conservative and estimate that we have at least 40 thousand people in Crawford county.

We've had, according to the latest figures, which are about a day old at the time of this writing, 37 known cases of the virus. Being generous and assuming that only one case in twenty is confirmed and known (bearing in mind that some people never show symptoms), we could guess that perhaps as many as 750 people in the county have been exposed to the virus and are no longer in danger of catching it, either because they already have it, or because they are immune. (The difference between already having it and being immune may be of great personal importance, but for the calculation we are about to do, it actually doesn't change the figures, so it's something we don't need to distinguish in our estimates.) The true figure is probably markedly less than 750, but I'm being conservative here.

We started canceling stuff back on March 6th, and at that time we had 0 cases in Crawford county. (Some people were already being tested; but those early tests ended up coming back negative.) Our number-of-cases figure is from April 20th, a difference of more than six weeks. If the curve were linear, this would mean we'd need to stay home for about six more years. The curve is, as the word "curve" suggests, not linear. Technically, it's still an exponential growth curve. But we've flattened it so much, that the difference from linear is not nearly as dramatic as you'd normally expect. For the last month, the only time the statewide increase in reported cases has been noticeably different from linear, was in the last few days, when comprehensive testing in the prison system confirmed a large number of already-suspected cases. Prisons are a particularly problematic environment, for a variety of reasons (nursing homes aren't much better), so you expect a higher curve there. For most of the state, and especially for smaller communities, the curve is effectively so close to linear as makes no practical difference. Maybe we won't have to stay home for six years, but if something major doesn't change, it's going to be months and months and months. Which is really not ok.

We have flattened the curve too much.

We cannot, realistically, all remain cooped up at home for even one year. Inevitably, at some point, we are going to have to start going out again. And then the curve will be less flat, possibly a lot less flat. The natural shape of this curve, when people aren't all staying home, is very steep. I propose that we would have been better of with a curve somewhere in between these two extremes. Flattened, but not so completely flattened.