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Coronavirus: How Do We Flatten the Curve?

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 You might’ve heard the term “flatten the curve” when it comes to containing the coronavirus. The term “flatten the curve” in epidemiology is the curve that refers to the projected number of new cases over time. The objective of flattening the curve is to stagger the number of new patients over a longer duration of time. Therefore, healthcare can be accessible to all diagnosed patients without overwhelming the healthcare system, as shown in the chart below.

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In recent weeks, the number of cases has increased across America. WHO has characterized the virus as a pandemic, and now is the time to act. The most imperative thing we can do is try to flatten the curve at the rate that the virus is spreading. Some necessary actions we can take to try to limit the spread of the disease include:

Social Distancing
One way to decrease the number of patients is to practice social distancing. The act of social distancing applies to specific measures taken by Public Health officials to stop or reduce the spread of a highly contagious disease. These actions are aimed to reduce the amount of the virus spreading, and protect those most vulnerable such as people with weakened immune systems and the elderly. Experts recommend that it’s vital to stay at least 6 feet away from others since researchers discovered the virus is transmitted through droplets. When an infected individual speaks, exhales, coughs, or sneezes, the droplets from their mouth and nose travels approximately 3 to 6 feet before gravity pulls them to the ground. Applying social distancing to our daily lives can ultimately reduce the number of people infected.

Containment 
To effectively contain the virus, you must ensure all cases are identified, controlled, and isolated. These steps were carried out by Taiwan, Singapore, Japan, and Hong Kong. All provinces intervened quickly by wearing protective gear while locating infected individuals and placing them in isolation. China also conducted prompt tactics resulting in 1,800 teams of 5 people that tracked every infected person, who they were in close contact with, and then placed them in isolation. Performing these actions allowed China to contain the virus without spreading any further across the population.

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The chart above depicts the effects of the travel ban enforced by Wuhan that helped in delaying the epidemic. The bubble sizes indicate the number of daily cases. The top line illustrates the number of cases if nothing is done. The two other lines display the impact if 40%, and 90% of travel is eradicated. This is a model created by epidemiologists since we cannot determine certainty. 

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In the chart above, the top block is similar to the one you’ve seen before. The other two blocks show the number of transmission rates decreasing. If the transmission rate reduces by 25% through social distancing, it flattens the curve and suspends the peak by a total of 14 weeks. If you lower the transition rate by 50%, then you cannot see the epidemic emerge within a quarter.

The European travel ban authorized by the United States spared a few days, perhaps even hours, but not enough time to stop the virus. Once there are hundreds or thousands of patients infected within a population, preventing, tracking existing cases, and isolating their contacts becomes an insufficient solution. The next step to eliminate the spread of the disease is to move on to the mitigation phase.

Mitigation
The mitigation phase consists of an escalated form of social distancing. These measures include shutting down all kinds of social gatherings such as concerts, businesses, and public places. The severity of transmission from the virus can result in more closures. Just recently, the stay-at-home order was issued by California Governor Gavin Newsom due to the number of cases climbing in the state. Observing the progress in Wuhan by closing down businesses ordering people to stay at home, this is something that can slow the progression of the infection. 

Take Action
The time to act is now by following safety measures set in place from the federal and state governments in the U.S. that can result in recovery, as China has. California has taken steps to contain the virus by Gov. Newsom, issuing the stay-at-home order. If we work together and follow the proper procedures recommended by the CDC, do you think our economy and health could improve sooner than expected? Let us know in the comments! 

Sources: 

  1. https://www.cnbc.com/2020/03/19/coronavirus-what-does-flattening-the-curve-mean-and-why-it-matters.html
  2. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
  3. https://www.pbs.org/newshour/health/how-social-distancing-works-and-what-it-means-for-you
  4. https://science.sciencemag.org/content/early/2020/03/05/science.aba9757
  5. https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
  6. https://science.sciencemag.org/content/early/2020/03/05/science.aba9757
  7. https://wordofhealth.com/2020/03/20/could-chinas-new-progress-indicate-hope-for-the-future-of-coronavirus/
  8. https://wordofhealth.com/2020/03/21/coronavirus-update-california-issued-statewide-stay-at-home-order/
  9. https://www.nbcnews.com/news/us-news/california-issues-statewide-stay-home-order-coronavirus-fight-n1164471
  10. https://www.usa.gov/coronavirus
  11. https://www.usa.gov/state-health
  12. https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

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Do I Need a Face Mask?

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Since the initial outbreak of COVID-19, two questions have dawned on Americans, “Do I need a face mask?” and secondly, “Where can I find one?” There has been a significant increase in purchases consisting of hand sanitizers, disinfectant wipes, and face masks to protect individuals from the infectious disease. Previously the Centers for Disease Control stated that healthy individuals did not need to wear a mask limiting it to only healthcare professionals and those who are actively sick to limit transmission. 

Newfound studies caused the CDC to rethink recommendations regarding face masks, including where and when individuals should wear them. The study indicated that a large portion of COVID-19 patients was “asymptomatic” and did not show any symptoms. Those who gradually developed symptoms were considered to be “pre-symptomatic” and could transmit the virus to others before demonstrating any symptoms. This evidence means it is possible to infect others through social interaction such as talking, coughing, sneezing, before showing any symptoms.

Observing this new information, the CDC has now issued recommendations to the public to wear face coverings for preventative measures. CDC advises that face coverings can be made from household items or made at home from simple and cost-effective materials. 

The CDC reiterated surgical masks, and N-95 respirator masks should be exclusive to healthcare professionals. 

Sources: 

  1. https://www.pppmag.com/article/1336
  2. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html#studies

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Coronavirus Update: 1 Million Cases Worldwide

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The devastating hit from the coronavirus continues to take a toll not just in the U.S. but also internationally, crippling economies and healthcare systems. The virus hit 1 million worldwide, with more than 50,000 deaths as recorded by the John Hopkins University in New York

The number of true cases and deaths are presumed to be much higher due to limited testing available, differences in counting practices, suspicions of a cover-up in some countries, and mild cases that have gone unreported. In the U.S., the unemployment rate has accelerated past 10 million and predicted by officials could be the highest collapse since the Depression. 

Unemployment has also soared in Europe, approximately a million or higher on the content lost their jobs over the same period, according to European Worker Unions. Spain alone acquired more than 300,000 to its unemployment rolls in March.

Spain announced a record 950 one-day number of deaths accounting for a total of 10,935. Italy, the worst among any country infected, reported 766 additional deaths bringing in a total of 14,681 deceased. Over 10,000 medical professionals in Italy have been infected, and 69 doctors have died, as reported by authorities. In France, the death toll reached 5,387 in hospitals, with 471 in the last day.

As of today, there are 264,159 infected patients in the U.S. and 6,714 recorded deaths. New York continues to lead as the worst hot spot in the country, with 102,863 total number of cases and 2,935 deaths reported. In Louisiana, deaths soared to 370, and confirmed infections rose to 10,297 due to backlogged test results finally returning from laboratories.

Preparations have begun as the Federal Emergency Management Agency requested 100,000 body bags from the Pentagon for the possibility that funeral homes will be overwhelmed, as stated by the military. President Trump announced the federal stockpile is significantly low of essential protective equipment needed by doctors and nurses. 

What do you think about the spike in cases? Will we see this number increase to 1.5 million? Please let us know in the comments.

Sources: 

  1. https://www.latimes.com/world-nation/story/2020-04-02/coronavirus-one-million-cases
  2. https://www.worldometers.info/coronavirus/#countries

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Is Social Distancing helping Californians?

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In California and Washington, the accelerated spread of the coronavirus led both states to issue social distancing measures before other states followed. According to the LA Times, experts are now observing the effects of social distancing, indicating that it can be effective. Since the virus is still relatively new, it is difficult to predict what the future will look like in the hands of the latest viral infection. 

The early actions adopted by the SF Bay area just may have saved the city from resulting in high cases, as seen in New York. The only way to determine the actual number of cases is from the number of hospitalizations and deaths. This information provides much more accuracy than the cases identified through testing, according to Dr. Robert Kim-Farley, an epidemiologist at UCLA.

The fact remains that cases are still actively increasing across California. On Monday, Gavin Newsom announced the number of patients under hospitalization due to COVID-19 doubled in four days, and patients in ICU’s tripled.  

There are still mishaps that could occur in California, for example, through the lack of testing. Unable to identify the number of true cases and those who may be carriers increasing exposure to other individuals. The exact number of cases will determine just how many hospital resources will be needed to meet the demand in healthcare facilities. 

On March 16, Bay Area health officials ordered six counties to shelter in place to help slow the spread of the virus. Soon after the measures taken by the Bay Area,  California issued a statewide stay-at-home order set in place by Newsom to increase social distancing. Unlike New York state that took a later initiative and  issued the stay-at-home order on March 20 and made it effective on March 22

A model designed by the University of Washington’s Institute of Health Metrics and Evaluation implies when California and New York will face its most challenging days. New York will see its most challenging day of the epidemic in early April. The early stay-at-home order indicates that New York will be significantly worse than California’s hardest day. 

Other than the later stay-at-home order for New York, different elements play a role in the state’s surge in cases. Including the high population and overcrowded mass transit systems, stated by Dr. Chris Murray, professor, and director of the Institute for Health Metrics and Evaluation.

According to the report projects, California will experience a peak in hospitalizations and deaths in late April. The models created to project the duration of the pandemic can only be as reliable as the data collected which can make the projections questionable. The lack of testing is the disadvantage California has, according to Barbara Ferrer, Los Angeles County’s public health director

California continues to prepare for an influx of patients by issuing a statewide order to keep social distancing in place to help slow the spread of the virus, implemented by Newsom. Recently Newsom reached out to medical students and healthcare professionals to join the California Health Corps to acquire expanded treatment for COVID-19 patients.

Sources:

  1. https://www.latimes.com/california/story/2020-03-31/coronavirus-social-distancing-west-coast-california-new-york-covid
  2. https://wordofhealth.com/2020/03/21/coronavirus-update-california-issued-statewide-stay-at-home-order/
  3. https://covid19.healthdata.org/projections
  4. https://wordofhealth.com/2020/04/01/attention-medical-students-california-needs-you/
  5. https://covid19.ca.gov/healthcorps/

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