How did "flatten the curve" become "flatten the economy?" A perspective from the United States of America

Abstract

The coronavirus SARS-CoV-2 (COVID-19) pandemic offers many medical, economic, societal, and cultural challenges. The response by individual states in the United States of America varies, but with the common initial impetus for all being to "flatten the curve," which was intended to delay infections and spread the burden and impact on hospitals and medical systems. Starting with that intention, the responses by states has included many major steps not taken in prior pandemics. Those steps have significantly adversely affected hospitals rather than support them, and the overall impact has been to "flatten the economy" rather than just to "flatten the curve." Many state governors have stated that their decisions are "science-led" and "data driven" but the reality is that there is not relevant experimental data. The progression of decisions during the early pandemic decisions is traced, and the basis of decisions based in science or herd mentality is discussed. Experiences are not experiments, and experiences are not founded in the scientific process. Medical and government leaders must be vigilant to recognize the limitations of available data in responding to unique circumstances.

Keywords: COVID-19; Coronavirus SARS-CoV-2; Decision-making; Flatten the curve; Pandemic response.

Fig. 1

The goals of “flatten the curve” to reduce in epidemic incidence peak. From the Centers for Disease Control and Prevention, 2007 (Centers for Disease Control and Prevention, 2007).

Fig. 2

Total COVID-29 cases per million residents (European Centre for Disease Prevention and Control) (Wall Street Journal, 2020).

Fig. 3

Coronavirus deaths in selected countries shown as weekly rolling average of fatalities since the fifth death. (Denmark and Norway initiated lockdowns before reaching five deaths) (European Centre for Disease Prevention and Control, 2020).