Spring is in the air, and “stay home” and “shelter in place” orders are popping up all over the U.S. as unstoppable as dandelions. Other places like South Korea are taking different approaches. There’s no doubt all of these orders bring hardship: economic, social, even educational. Moreover, there’s always the question of “Will it work?”
We here at 3BY can’t see the future, and we’re less interested in pretending we can than some others you can find on the internet. (Spoiler alert: They can’t either.) What we can do is offer a couple of examples, and related outcomes. You can decide for yourselves what measures you think are warranted.
Why does it matter what any individual thinks, when the governments are passing the edicts?
Do we all drive no faster than 55 mph just because that’s the limit? Or do we decide how closely to adhere to some government edicts based on our own judgments? Part of our community outcomes depend on decisions each of us make.
More directly, even if other households in your area are behaving like idiots, you have a lot of control over your own outcomes. All you have to do for that is convince those in your household to hang with you.
South Korea: The Best Example of A Nation That Flattened Its Epidemic Curve
The goal of all these “keep away from other people” orders is, as we’ve all heard a few times by now, to “flatten the curve”. The curve in question is the one that plots new cases of disease over time. If no attention is paid to stopping a communicable disease, it will tend to increase exponentially until a large proportion of the population has gotten it, then flatten out.
The problem is by then, given the characteristics of COVID-19, we’d have a Whole Lot of dead people. The fatality rate for the disease overall is between 1 and 2%. More than bad enough if most people get it. But the real kicker is that if the rate of new cases needing high level care exceeds the hospital capacity, the fatality rate skyrockets.
To “flatten the curve” means to slow down the development of new cases much sooner than it would naturally slow. The goal is to not exceed the hospital capacity and keep the death toll as low as is practicable.
Of the nations that got hit early with this virus, the star of the show when it comes to “flattening its curve” has undoubtedly been South Korea.
See the pink line that started out the steepest of all then dropped nearly flat? That’s South Korea.*
If you look at the curve above, you’ll see South Korea started off with a really steep exponential curve … but it fell off that mathematical trend almost immediately. By two weeks after the first diagnosis, South Korea had a nearly flat curve.
What did South Korea do?
They did several things differently; the most important of which was chasing down every contact possible from the early infected people and quarantining all contacts. It was a lot of effort and inconvenience. But it worked.
They’ve been maintaining their low rate very well, despite infected people newly entering the country. Here’s an example of what they’re doing. It is a report from a student of mine. She just returned to South Korea when my school shifted to distance learning for the rest of the semester.
Arriving from the U.S., the government had separate buses for those from ‘high virus’ origins. Everybody from those places got an immediate COVID test.
As hers was negative, she is obliged to fulfill two weeks home quarantine before rejoining normal society. It’s a serious home quarantine: Must have separate rooms from rest of family, take temp and report physical condition twice a day online, random calls by government worker to see how she’s doing (and that she’s home). All people in quarantine were provided food, masks, and sanitizing equipment.
An American Story: Shelter In Place Fail
In our area, at the same time but with many more cases around, we were being urged to “shelter in place“. That mostly meant not gathering in groups larger than ten (where they got that magic number I’m not sure), and keeping six feet of personal space.
How’s that going? One of our friends, a young mother forced to work from home, shared the following (slightly edited to remove references to names and locations to protect her identity), shared this on her social media. We use it (with her permission) as it typifies what we’re seeing and hearing in many places in the U.S. It also expresses the feelings of a major subset of the population.
Should we be more like South Korea?
I’m not going to tell you what to think. There are costs and benefits to both approaches. The point I wanted to make is factual, not opinion: South Korea went with strict, enforced quarantines of every potentially infected person they could find. Their economy is not currently shut down and they’re not having many cases.
The U.S. did not go that route. There were suggestions, the rules were much more lax, and we’ve made no serious attempt to chase down all potential contacts. We’re seeing a steeper curve despite a major economic disruption.
Isn’t this horse out of the barn?
The COVID-19 first wave horse is indeed out of the barn in many places in the U.S. The tracking of contacts approach is no longer feasible.
Nevertheless, we can learn from this. Quarantine can work from either direction — keeping the potentially ill away from you and yours, or keeping you and yours away from the potentially ill. So long as no one in your household is currently infected, the South Korea example is one you could still choose to follow.
Also, it must be said, this is not the only horse in the barn. This kind of viral mutation was known to be highly likely, and another is likely to happen.
There’s also the back side of COVID-19. As I write, more serious lockdowns are being put in place — some with actual enforcement at the individual level planned. And the infection curves do appear to be dropping off of the exponential pattern in places with these lockdowns. We are starting to flatten the curve.
Eventually, we will need to get back to work. And as isolation is relaxed, more cases will pop up. With those smaller case numbers, we Will be able to choose how to respond.
* Image thanks to TedjevanEs / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)
The magic number of no more than ten in a group actually came from Philadelphia during the 1918 Spanish Flu.It was on posters stuck up around the city. I don’t know if those posters stayed up through the whole ordeal or not.
Kinda like the “eight glasses of water a day” thing. Everybody says it because everybody’s been saying it. Risk is proportional to number of people encountered (as modified by their exposures); there’s no “less than 10 dispensation”.