“The US did succeed at flattening the curve — at least at first. Businesses closed and most states issued stay-at-home orders; later research concluded those lockdown measures helped prevent tens of millions of Covid-19 cases.
But America failed to take advantage of that window to ramp up its virus testing and tracing capabilities, and states quickly faced intense pressure to relax their policies to alleviate the economic costs of the shutdowns. Reopening began earlier than public health experts believed it should. The political will to impose new lockdowns had evaporated by the time cases spiked again.
At the end of 2020, with more than 20 million Covid-19 cases and nearly 350,000 deaths in the US, it is evident that trying to flatten the curve was not sufficient to end the pandemic. That doesn’t mean it failed entirely. Slowing the spread of Covid-19 was meant to buy time to figure out what came next. But the US never did.”
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“Multiple studies have found that mitigation measures suppressed the virus’s spread and likely prevented millions of cases — and with them many deaths. A study published in Health Affairs in May found that social distancing policies, particularly stay-at-home orders and closing bars and restaurants, had staved off as many as 35 million cases in the US by the end of April. More recent research published in Science concluded that closing schools and businesses, as well as limiting the size of private gatherings, reduced spread considerably.
“NYC flattened the curve. Other places delayed it,” William Hanage, an epidemiologist at Harvard University, told me. “But that ought to provide an opportunity to ramp up testing and health care and prepare people for the long haul. You know that did not happen.”
Experts came up with roadmaps for how to proceed once the initial curve was flattened. A proposal from the American Enterprise Institute set specific thresholds for case numbers, hospital capacity, and testing that were designed to allow states to safely begin relaxing their lockdown measures once the virus had been sufficiently suppressed and the health system’s capacity had been expanded.
But the Trump administration never embraced those plans. Instead, the president often said that the cure (lockdowns) could not be worse than the disease (Covid-19). The White House eventually settled on a message that the US would need to learn to live with the virus.”
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“many US states that had avoided the worst of Covid-19 in the spring saw the lack of an outbreak as a sign that they could push ahead with reopening. Once the curve was flat, the political will to keep it that way began to crumble.
America wasn’t the only place to struggle with figuring out how to move forward from its spring lockdown; many European countries saw their own second waves over the summer. But the missed opportunity still set the course for the rest of the pandemic.”
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“In some ways, flattening the curve did work as intended.
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“Hospitals have not — yet — been overwhelmed, as they were in the dire situation in Lombardo, Italy, in the spring. But today, with cases and hospitalizations still rising, US hospitals warn they are again nearing a breaking point.
Slowing the spread of the disease in the spring also gave scientists a chance to learn more and more about the virus.
Among other things, they learned that people were the most infectious before they showed symptoms. They figured out the virus primarily spread through respiratory droplets, not through touch or surfaces. The elevated fatality risk to the elderly became more apparent. Researchers quickly began to figure out which treatments worked (putting patients in a prone position, administering remdesivir and dexamethasone) and which ones didn’t (the Trump-favored hydroxychloroquine).
With this information, the US could have used the time it bought by flattening the curve to figure out whether more targeted interventions would work better than lockdowns, as the Science study suggested, and whether individual cities or counties could best manage their own outbreaks.”
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“in other ways, flattening the curve still failed to accomplish its goal of preserving health care access. While hospitals have not yet been completely overwhelmed, some people aren’t getting the care they need. ProPublica reported that over the summer in Houston, medical examiners saw a spike in the number of people found dead in their homes. Some of those deaths were from Covid-19; some were from heart attacks, strokes, and other conditions. Either way, the news of the virus’s rapid spread in the area may have kept people from seeking medical assistance, with deadly consequences.”
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“330 million Americans were left to make their own risk assessments — or not.
Given the research that shows a small percentage of infected people account for a very large share of the transmission, that was a recipe for disaster. And rather than take proactive measures as infection rates first ticked up, which public health experts say are most important given the pre-symptomatic spread of Covid-19 and its slow gestation, governors seemed to be paralyzed and waited to act until the crisis was already upon them.
“Every American’s personal definition of Covid-caution is completely unique, with some holed up at home for weeks at a time and others traveling the country to visit friends,” Kumi Smith, an epidemiologist at the University of Minnesota, told me over email. “While the institutional level measures may seem extreme, if they had been more uniformly implemented around the country for longer, we might have been able to achieve low enough community transmission to the point that a careful reopening coupled with other measures like contact tracing and widespread testing and isolation would have been possible.””
https://www.vox.com/22180261/covid-19-coronavirus-social-distancing-lockdowns-flatten-the-curve