"Flatten the curve" has become a rallying cry for people to take on aggressive measures in order to slow the spread of COVID-19 with the goal of avoiding an overwhelming spike in confirmed cases. The phrase has even earned itself a hashtag on Twitter. WGBH News' Morning Edition host Joe Mathieu spoke with STAT infectious diseases and global health reporter Helen Branswell about efforts to "flatten the curve," and what we can likely expect from the coronavirus in the coming days, weeks and months. The transcript below has been edited for clarity.
Joe Mathieu: I wonder, are you preparing for a major increase in cases?
Helen Branswell: Oh, yes, of course. Everybody needs to be expecting that. There's been very, very little testing done in the United States in the last couple of months, as all of your listeners would know. And as more testing comes online, the numbers are going to jump really dramatically. Some of that will be about discovering cases that have already been sick for a little while and some of it, of course, will be tracking the new infections.
Mathieu: As we consider the concept of "flattening the curve," the big question that's emerging, Helen, is how much damage may have been done by not having enough tests available immediately?
Branswell: Well, effectively, the country has been flying blind. You know, it doesn't really know how much of the coronavirus is in the country and where exactly. I mean, obviously, everyone knows that Seattle's having a major outbreak right now and New York City is having problems. Boston, as well; there's been a pretty sharp uptick of cases here as they have started to test. But whether or not there are other places that are sort of percolating, it's really not clear. The problem with this infection is that for most people, it's a very mild illness. And that's great, but because of that it takes a while for a whole bunch of those cases to sort of infect one another before you start to see the severe cases. And the unfortunate part of this is that with COVID-19, about 20 percent of people who get infected become seriously, severely or even critically ill.
Mathieu: So a couple of questions tied to that then. Because of the actions that are being taken now — closing bars and restaurants, limiting large groups here in Massachusetts to 25 people — is that disrupting the natural flow of infection? Are we, in fact, going to "flatten the curve"?
Branswell: Well, certainly other locations that have had outbreaks earlier than North America — I'm thinking about East Asian countries like Singapore, South Korea and, of course, China — took a variety of measures like this, some of them more draconian. And they did effectively really lower the amount of transmission. The whole goal is to limit the number of close interactions you have with other people in the hopes that it will just make it that much harder for the virus to spread from one person to another, slow down the spread and make the inevitable surge in cases something that is more manageable for the health care system as opposed to a tsunami of cases that would effectively cripple hospitals.
Mathieu: If we succeed in flattening the curve, Helen, that does not suggest there will be fewer cases, does it? We're simply spreading them out. Do I understand that right?
Branswell: Yeah, that is right. I was talking to somebody last night in Hong Kong about what they've been doing and he said the problem with flattening the curve is that it it prolongs the pain. It means that the virus will be with us for longer, but that there will be fewer total infections at any one given time. That said there's work afoot to really try to rapidly develop a vaccine. That won't happen within weeks or months, but at some point there hopefully will be vaccine available that will help to mitigate the problem.
Mathieu: You mentioned other countries. When we look at Italy, for instance, maybe South Korea, if we're 10 to 14 days behind them, where will we be? What will this look like in two weeks?
Branswell: It depends on what you're talking about in terms of when you say "we." For the United States, it's not going to be one picture. It's going to be some hot spots and some places that have very little transmission or some places that are percolating to become a hot spot. In terms of the places where things are going to get bad, we're probably going to see what's happening in Seattle where they're slammed, where health systems are struggling to cope and where hospitals are really sort of buckling under the demand for help. This is a disease in which the people who get it and who develop serious illness have trouble breathing and that's a really urgent problem. If somebody has trouble breathing and goes into an emergency room, they are always prioritized. But at a time when you have a lot of those, it becomes really, really difficult to deliver high quality care.
