#Don'tFlattenTheCurve
The optimal strategy to defeat the disease is currently the subject of much debate. Several strategies have emerged, and a popular meme right now is #flattenthecurve. The idea of flattening the curve is that if we increase the duration of the pandemic, the number of people infected at any one time will be lower and our ability to treat people properly will be increased. People put a lot of time into creating convincing memes and diagrams showing how this works:
Unfortunately people didn't put much effort into getting the numbers right. Every single one of these diagrams is a steaming pile of nonsense because the line for "Healthcare System Capacity" is about 20-50 times too high, which was first pointed out by Joshua Bach. That tiny red line right next to the x-axis is our health system capacity:
(taken from The Imperial College COVID-19 Response Team's latest report ).
The UK government's "herd immunity" strategy was another possible way forward, but the government reversed course on this when they realized it would involve at least a few hundred thousand deaths.
Contain and Eradicate
In my opinion, the correct strategy to beat covid-19 whilst minimizing losses from this point forward is a contain-and-eradicate strategy. The New England Complex Systems Institute's writeup on this, written by Nassim Nicholas Taleb of Black Swan fame outlines the strategy:
- Close borders and limit internal travel, lockdown and hygiene to drive R0 below 1
- Ban large events to cut off the long tail of the R0 distribution
- Use aggressive testing and contact tracing to clean up any remaining holdouts, and eradicate the virus on a region-by-region and country-by-country level.
- "Green" regions can return to mostly normal life, albeit without large events and travel. That means that people can go back to work and we can reverse the economic damage.
Contain-and-eradicate probably results in both less loss of life and less economic damage than any other strategy, and we can see this as a consequence of taking an exponential process and fighting it in the low orders of magnitude rather than the high ones. Flatten-The-Curve is bad because a flat curve that lasts for a long time is still, in log-terms, almost at the maximum power of the virus and therefore it can do huge amounts of damage. Herd-Immunity and Deliberate-Infection are bad for the same reason. The only other sensible plan I have seen is the idea of rushing a vaccine as quickly as possible, but that is beyond my expertise.
The optimal strategy to defeat the disease is currently the subject of much debate. Several strategies have emerged, and a popular meme right now is #flattenthecurve. The idea of flattening the curve is that if we increase the duration of the pandemic, the number of people infected at any one time will be lower and our ability to treat people properly will be increased. People put a lot of time into creating convincing memes and diagrams showing how this works:
Unfortunately people didn't put much effort into getting the numbers right. Every single one of these diagrams is a steaming pile of nonsense because the line for "Healthcare System Capacity" is about 20-50 times too high, which was first pointed out by Joshua Bach. That tiny red line right next to the x-axis is our health system capacity:
(taken from The Imperial College COVID-19 Response Team's latest report ).
The UK government's "herd immunity" strategy was another possible way forward, but the government reversed course on this when they realized it would involve at least a few hundred thousand deaths.
Contain and Eradicate
In my opinion, the correct strategy to beat covid-19 whilst minimizing losses from this point forward is a contain-and-eradicate strategy. The New England Complex Systems Institute's writeup on this, written by Nassim Nicholas Taleb of Black Swan fame outlines the strategy:
Since lockdowns result in exponentially decreasing numbers of cases, a comparatively short amount of time can be sufficient to achieve pathogen extinction, after which relaxing restrictions can be done without resurgence. ...
Finally, the use of geographic boundaries and travel restrictions allows for effective and comparatively low cost imposition and relaxation of interventions. Such a multi-scale approach accelerates response efforts, reduces social impacts, allows for relaxing restrictions in areas earlier that are less affected, enables uninfected areas to assist in response in the ares that are infected, and is a much more practical and effective way to stop otherwise devastating outbreaks. ...
A few other issues are of importance: They ignore the possibility of superspreader events in gatherings by not including the fat tail distribution of contagion in their model. This leads them to deny the importance of banning them, which has been shown to be incorrect, including in South Korea. Cutting the fat tail of the infection distribution is critical to reducing R0.Basically:
- Close borders and limit internal travel, lockdown and hygiene to drive R0 below 1
- Ban large events to cut off the long tail of the R0 distribution
- Use aggressive testing and contact tracing to clean up any remaining holdouts, and eradicate the virus on a region-by-region and country-by-country level.
- "Green" regions can return to mostly normal life, albeit without large events and travel. That means that people can go back to work and we can reverse the economic damage.
Contain-and-eradicate probably results in both less loss of life and less economic damage than any other strategy, and we can see this as a consequence of taking an exponential process and fighting it in the low orders of magnitude rather than the high ones. Flatten-The-Curve is bad because a flat curve that lasts for a long time is still, in log-terms, almost at the maximum power of the virus and therefore it can do huge amounts of damage. Herd-Immunity and Deliberate-Infection are bad for the same reason. The only other sensible plan I have seen is the idea of rushing a vaccine as quickly as possible, but that is beyond my expertise.
by Roko, Less Wrong | Read more:
Images: CDC/The Economist; The Imperial College COVID-19 Response Team report
