Corona Strategy: Contain or Delay.
Matching hospital infrastructure capacity to peak demand. The fight for lives and fight for R0(reproduction)<1.0. The goal is to — not to get to a point where healthcare infrastructure is overwhelmed to prfioritize — who gets help and who dies..
Contain: Wuhan
Limiting the spread by lockdowns (social distancing); and build-up of hospital capacity. The actual cases may get under reported due to both — sheer amount of people & mild cases (treatment at home), however the death rates elimination is the focus. You cannot decrease the death rates if there is not enough capacity in the treatment system.
Delay: Flatten the Curve
This could be a combination of strategies:
South Korea: test as many as possible from the get go. You are executing few things at the same time:
- Increasing the public awareness by growing cases itself and people feel the urge to act (numbers talk).
- Finding the epicentres & spreaders fast — decreasing the spread (R0).
- Filling the hospital capacity as soon as possible (while there is capacity) — you’re pulling capacity bottlenecks from future weeks.
Other Countries: those that test slow at the beginning — let’s say they are past “Contain Strategy”, and the “Delay Strategy” is the remaining option. The reasons do not matter at this point. I see two overall strategies (three if you count a system breakdown):
Small guns strategy: partial lockdowns + get R0 under control.
- Immediate increase of testing to a) identify epicentres & people and b) limit the spread + increased awareness always helps.
- Any reasonable lockdown necessary — be it schools, work from home, closing clusters, even borders if necessary, travel limitations, etc.
- Prepare, increase and immediately utilise the healthcare system (pull demand from future, and increase future capacity).
- Pull the capacity peak forward by Flattening the Curve.
Big gun strategy: getting ready for several millions (millions of tests, millions of intensive care units patients, etc.)..
- You delayed the testing, ok. But there is no way you were delaying the backend infrastructure..
- Deployment of mass lockdowns.
- Deployment of millions of test kits.
- Deployment of work from home “for all that is possible”, learn from home “for all that’s possible”, etc.
- Doubling, tripling of healthcare infrastructure. You have to think hotels, stadiums, reserved staff (retirees, army, volunteers) etc.
- Pull the capacity peak forward as much as possible — this is your limit, your focus — by Flattening the Curve.
- And deployment of army, once legislators will start to die; army has clearer ranking rules for exchange of power, is the most trusted and capable institution (execution matters).
1918 Spanish Flu: Non healthcare Interventions matter.
Delayed Action Scenario
You do not want to get to a scenario where Intensive Care Unit is deciding who gets help and who does not. Who lives or who does not. Based on under capacity, based on age, based on probability of survival.
It can be you versus someone’s mom, it can be you versus someone’s son, it can be you versus someone’s grandma. If it’s not you, it may be someone else.
She is exponential..
