We Need To Crush The Curve Now—Or COVID-19 Will Come Back To Haunt Us

Coronavirus precautions in New Zealand

WELLINGTON, NEW ZEALAND – APRIL 3: A woman is seen empty Lambton Quay, main shopping precinct, during the lockdown due to coronavirus (COVID-19) pandemic in Wellington, New Zealand on April 3, 2020. (Photo by Mike Clare/Anadolu Agency via Getty Images)


In a bid to slow the spread of COVID-19, communities across the United States have taken action to “flatten the curve.” The curve in question represents the number of people predicted to contract the novel coronavirus over time, while attempts to flatten it have so far included various forms of social distancing, self-isolating, and frequent handwashing.

As critical as these actions are, they’re still not enough—not nearly. Flattening the curve may lessen the burden of care for hospitals and healthcare workers, but it won’t necessarily decrease the number of people who fall ill. If we don’t act now to crush the curve completely, subsequent waves of reinfection will continue to haunt us long after the current pandemic has cleared out—each smaller in scope, maybe, but not without significant aftershocks to our health, our economy, and our psyches. 

To put a definitive end to this pandemic, the United States must follow the lead of countries like New Zealand and pivot from a containment strategy to an elimination strategy; to not just flatten the curve, but crush it. Deployed swiftly, aggressively, and in conjunction, the following three countermeasures may give us the momentum we need to reduce the total number of cases, shorten the length of the pandemic, and allow economic activity to resume.

First, use widespread testing to identify everyone who has been infected. More funds and resources must be invested in the procurement and production of available COVID-19 tests, whether genomic or serological, as well as necessary implements like nasopharyngeal swabs. Clinical and community test sites must be established where low-cost, rapid diagnostic tests can be administered to all.

In South Korea, one of the few countries to successfully bring down their COVID-19 caseload, an early effort to test half a million people—including those experiencing either mild symptoms or none at all—allowed public health officials to predict the trajectory of the disease with greater accuracy and precision. Taiwan, another country where proactive testing led to greater prevention, went so far as to retest those whose results came back negative.

Second, use contact tracing to identify everyone who has been exposed. Detecting where the virus is already present cannot sufficiently anticipate where it will go next. Federal health agencies tracking the pandemic from above must cooperate with local health authorities reacting to it on the ground to trace the links between those infected and those they interact with.

Tools like privacy-protecting contact tracing apps can help expedite this search—a technique that proved especially fruitful in Singapore. In addition to organizing teams of contact tracers who interview coronavirus patients and track down the names, phone numbers, and addresses of those exposed, the Ministry of Health launched a TraceTogether app that uses Bluetooth wireless technology to monitor close contacts.

Lastly, mandate quarantines for everyone who has been infected or exposed. While this component of the elimination strategy may be the hardest to stomach, a two-week period of mandatory quarantine and self-isolation for all exposed, regardless of test status, is needed to stop infection from spreading. For those entering the country from overseas, this is best done in hotel rooms where any development of symptoms can be closely observed.

Like contact tracing, the efficacy of quarantine can be increased through technological means. When Wuhan, ground zero of the pandemic, was still under lockdown, China used mobile QR codes to monitor quarantined individuals. If scanned, green indicated clearance and the absence of infection; yellow, instructions to stay inside and self-isolate; and red, forcible quarantine. Today, the system is still in effect, though the QR codes now help regulate access to public transport.

So far, the elimination strategy has yielded promising results in New Zealand, where mandatory quarantine has been in effect since March 25. As of Tuesday, New Zealand has reported more recoveries than new cases and only one death.

Once implemented, these countermeasures cannot be relaxed until there is absolute certainty that the virus no longer among us.


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Originally published on Forbes (April 15, 2020)

© William A. Haseltine, PhD. All Rights Reserved.