What Flattening The Curve Means


Dear Editor

“Flattening the curve” was frequently promoted early in the COVID-19 epidemic. Many reporters and policy makers promote continuing, some essentially indefinitely, restrictive policies to continue “flattening.” But, what does flattening the curve mean?

Simply put, flattening the curve is a tradeoff between peak infection and length of epidemic. In its purest statistical/mathematical form, flattening the curve does not prevent infections. The area under the curve, the number of patients, remains the same in both high peak and flattened statistical models. Reducing the peak only prevents medical resources from being overwhelmed today.

COVID-19 is a coronavirus. Coronaviruses are extremely infectious. They are one of the causes of the common cold. Luckily, they have low severity as long as the immune system works well. The problem is this coronavirus is so new that the body doesn’t recognize it. Every disease can cause reinfection. However, the body is able to more efficiently mount defenses during reinfection. Sometimes the body is so effective we won’t notice reinfection. High-risk individuals, today’s elderly and today’s reduced immunity patients, haven’t been able to benefit from prior infection.

Close to 100 percent of the population has had a cold in their life. With or without flattening policies, it is likely that close to 100 percent of the population will eventually contract COVID-19. They will develop natural immunity reducing future severity/high level medical care requirements during reinfection. Tomorrow’s elderly and tomorrow’s immune compromised will benefit from natural immunity developed today.  Tomorrow’s health system will not require curve flattening.

Flattening the curve doesn’t reduce infection. Flattening only preserves medical resources to manage a high volume of at-risk patients. It only reduces case fatality. It only does this today. Tomorrow we will not need this.

So, why are politicians planning to maintain current level of restrictions, or increase restrictions, until a COVID-19 vaccine is developed? Since vaccines were first successful, we have tried to creat a vaccine against the causes of the common cold. After decades of trying, we still do not have a vaccine against the common cold/other coronaviruses. The current optimistic projection is 12 to 18 months. However, three months ago the prediction was 12 months from then. Realistically, a vaccine against COVID-19 will take 12 months to never. If we continue to maintain restrictions until a vaccine is developed, we may never be free.

Alan Burke