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Ten Reasons Why We Should Flatten the Curve

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Empty hospital beds

The United States is still in the throes of the coronavirus pandemic. Across the nation, we are bombarded by signs asking us to keep our distance and to wear masks. The reason behind social distancing and mask policies is to keep the infection numbers from “overwhelming” hospitals and to control the very contagious Covid-19 virus. Instead of having a spike in infections, our nation has decided instead to spread the infections out over a longer period of time. This idea is called “flattening the curve.” Here are ten reasons why America should make a concerted effort to flatten the curve.  

1) To have hospital beds if we get sick

If we flatten the curve in the U.S. it will allow for more available beds at hospitals. Hospitals have a limited number of beds. In 2018, the United States had 924,000 beds with an average of a 65.9% occupancy rate. In some particularly bad influenza years, like the 2017-18 season, the number of hospitalizations exceeded the number of staffed beds. 

Covid-19 is a highly virulent virus, and a high number of those infected require hospitalization. Each Covid patient occupies a bed that the hospital had not planned for. Thus, an inundation of Covid patients can “overwhelm” our hospitals, which would mean that some patients would not have beds. Intensive care units (ICUs) have another type of bed that has equipment setup to monitor vital signs, negative-pressure rooms for Covid patients (which help keep virus particles from escaping), and round-the-clock care. A hospital may have available normal beds but no available ICU beds, which is particularly dangerous for the sickest patients. 

New York City hospitals at the peak of the pandemic were almost overwhelmed. In July, some Houston hospitals were close to their capacity.

2) To have enough medicine for the hospitals

If we flatten the curve we will have enough medicine for sick patients. While Covid-19 patients with mild cases often can get better at home, patients who are critically ill require in-hospital treatment. Different drugs have shown promise in helping in the recovery. Dexamethasone, an immunosuppressant, has shown evidence of reducing the death rate of critically ill patients who are on ventilators. Anticoagulants like heparin are given to patients with severe cases because Covid-19 patients run the risk of developing dangerous blood clots. Remdesivir, an antiviral, has been found to reduce recovery times. If Covid patients need ventilators, paralytics and analgesics are needed to keep their lungs from fighting the ventilators. The United States has a critical shortage of many of these drugs. Read more on how the drug shortages are threatening Covid-19 treatments.

We need to flatten the curve and keep it flattened so that the U.S. does not run out of these key drugs. Without them, the treatment for Covid-19 patients would not be as effective. Additionally, non-Covid-19 patients who also rely on the same drugs will be put into difficult situations. As an example, dexamethasone is also used with patients who have auto-immune diseases.

3) To have enough ventilators at hospitals for the critically-ill patients

We need to flatten the curve so that we can have enough ventilators to take care of critically-ill patients. Covid-19 patients often develop viral pneumonia, which can reduce the oxygen intake of the lungs. When the oxygen levels of the body are so low that enriched oxygen air is not enough, hospitals will put patients on mechanical respirators as a last resort. Initial studies of the mortality rates of Covid-19 patients on ventilators were grim. Recent reports have shown that the majority of patients who are put on ventilators benefit from the treatment and survive. They are the last stand against the virus.

It is important that hospitals have enough ventilators for the critically ill. Overwhelmed hospitals can run out of ventilators. When Italy was in the peak of the pandemic, Italian hospitals ran out of ventilators. Doctors had to make tough ethical decisions about who to ventilate and who to not. Hospitals in the U.S. hope to never have to force our healthcare workers to make those tough decisions.

4) To prevent healthcare workers from getting sick

Doctor in scrubs slumped with fatigue

By flattening the curve, fewer healthcare workers will get sick. The Covid-19 virus is much more contagious than the influenza virus. Without any safeguards, one person infected with Covid-19 will infect three to four others. Influenza pales in comparison at a reproductive number of 1.4 to 1.7.

Every time a healthcare worker is around a Covid-19 patient there is the possibility of infection. Healthcare workers attempt to minimize the risk by wearing personal protective equipment such as N95 masks, double gloves, and face shields. Sometimes their equipment fails and sometimes they don’t have enough. At the beginning of the pandemic crisis in the U.S., like many other states, New York experienced a shortage of personal protective equipment, which put healthcare workers at risk. It is estimated that by the end of May, 60,000 healthcare workers had been infected with Covid-19 and 300 had died.

Healthcare workers are essential not only for the care of Covid-19 patients but also for the care of non-Covid-19 patients. While healthcare professionals are out sick, valuable care cannot be given. U.S. patients would suffer. Additionally, if healthcare workers are sick but are not aware of the sickness, they have the potential to infect vulnerable patients with the virus unintentionally. 

5) To give sick Covid-19 patients a place for care

We need to flatten the curve to give sick Covid-19 patients a place to recover. From mid-March to early April, the Emergency Medical Services of New York City were inundated with cardiac calls with three to five times the number of people dying as who died during the same months in 2019. Covid-19 patients were waiting too long before calling for help. However, the problem was due to the healthcare system. 

In the early days of the pandemic crisis, many very sick people were sent home from hospitals to recover. Only the sickest got hospital beds, and if someone had already been refused care, the probability of them not calling for an ambulance even if they were dangerously ill increased. NBC reported about one healthcare worker, Kaila Corrothers, who was denied a test four times and sent home from the hospital because she was not sick enough. She later passed away due to Covid-19. Her story is one of many.

By flattening the curve, Covid-19 patients will have more care available to them. The number of patients asked to recover by themselves with no real treatment will decrease. Covid-19 has been associated with walking pneumonia, which means that patients can feel okay until their oxygen levels plummet. If help does not arrive quick enough, death could result. More careful monitoring by healthcare professionals will improve patients’ outcomes. Dangerous blood clots are also common side effects of the immune response to Covid-19. Blood clots can cause heart attacks, strokes, and kidney disease. Being at a hospital will help prevent these.

6) To not get our seniors sick

Holding hands with elderly

We need to work on flattening the curve to prevent our seniors from getting sick. Covid-19 discriminates. Although most children and young adults will probably only get mild symptoms, its severity increases greatly with age. Eight out of ten Covid-19 deaths have been amongst seniors 65 years of age or higher. 

Flattening the curve will reduce the number of infected in the population, which will then keep our seniors safer. The virus is highly contagious. If the curve is not flattened, all seniors will have to isolate themselves, which will require not seeing their grandchildren. By flattening the curve, grandmothers and grandfathers around our country will not have to worry about loving hugs by small children.

7) To not get the vulnerable sick

The United States should flatten the curve so our vulnerable communities will not get sick. Among many comorbidities, it has been found that hypertension, diabetes, respiratory problems, and cancer put people more at risk of critical illness or death when infected by Covid-19. But vulnerable people still have jobs and still care for others. There are 34 million Americans with diabetes and more than 100 million Americans who have high blood pressure. Those vulnerable to severe effects from Covid-19 are everywhere.

By flattening the curve, we will be taking our vulnerable population out of risk. They will be able to work at their jobs and care for their children and parents without the fears of getting sick. It is not possible to look at someone and know if they are vulnerable or not. Anybody around us could have a risk factor of having a bad outcome with Covid-19.

8) To reduce the infection fatality rate for Covid-19

America needs to flatten the curve so less people die from Covid-19. A recent article in Nature discussed the infection fatality rate for Covid-19. When the asymptomatic patients are added in, the fatality rate appears to be between 0.5% to 1% with treatment. Although more research needs to be done, it does appear that for the vast majority of infections patients will survive, which is positive news. The caveat, though, is that treatment is necessary. Without treatment, the infection fatality rate certainly would be much higher.

Hospitals and healthcare workers provide valuable services to society. If they are overwhelmed, Covid-19 patients may find themselves without proper treatment, which will undoubtedly increase the mortality rate. We are flattening the curve to prevent this from happening.

9) To allow for non-Covid-19 related medical procedures to occur

Empty operating room

We need to flatten the curve in the U.S. so that patients have a place to go to have medical procedures done. For much of the initial lockdown period, many states had stopped nonessential medical care. As the number of Covid-19 infections increased, state governments hoped to reduce the risk of non-Covid-19 related patients getting infected as well as to free up some beds. A further example of this happened at the end of June when four counties in Texas experienced a surge of Covid-19 cases. Texas governor Greg Abbot stopped elective surgeries

What is essential or what is nonessential medical care is determined by the hospital, though. During the first months of the pandemic in the U.S., many people reported that their surgeries for cancer and treatment such as chemotherapy were delayed. The benefits of the treatments were weighed against the risks of contracting the virus, but for the patients, the outcome of their cancer was certainly worsened. Likewise, many people with other ailments were also not being treated.

With a surge of Covid-19 patients, non-Covid-19 patients also feared the hospital itself. This fear can be dangerous as there are times when the sick should seek medical help, but they aren’t. The CDC reported that emergency room visits decreased by 42% between March and May 2020. 

A surge of Covid-19 patients not only increases deaths in those who have the virus but it also increases deaths in those who do not have the virus. Medical treatment is skipped either due to rescheduling or fear. Flattening the curve will also save lives for non-Covid-19 patients.

10) To ensure fewer people experience long-term damage due to Covid-19

By flattening the curve, fewer people will have long-term health problems due to Covid-19. Most people who contract Covid-19 have mild cases and will recover. The mortality rate is not the only issue. The virus has not been around long enough to make precise conclusions about the long-term effects of having an infection. However, Covid-19 causes pneumonia. Additionally, pulmonary fibrosis, which is a common symptom of Covid-19, has been associated with a decrease in lung functioning. How temporary this decrease is has yet to be ascertained. 

There are other severe symptoms. 10% of hospitalized patients appear to have dangerous blood clots. When clots block arteries they can cause organ damage. The Covid-19 virus has also been known to cause heart problems, kidney disease, gastrointestinal problems, and it may even affect the brain. Cases of long term neurological effects are increasing. 

Living with chronic deleterious health effects causes extended suffering. By flattening the curve, we can reduce the number of people who will suffer chronic health problems due to Covid-19.

Read more about the medical impacts of the pandemic with how Covid-19 is pushing the next generation of healthcare into telehealth or how drug shortages threaten Covid-19 treatment.