Flattening the curve is flattening the complexity of covid-19

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作者
Marcel Boumans
机构
[1] Utrecht University,
关键词
Compartmental model; Epidemic control; Reproduction number; Shape of an epidemic curve; Social distancing;
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摘要
Since the February 2020 publication of the article ‘Flattening the curve’ in The Economist, political leaders worldwide have used this expression to legitimize the introduction of social distancing measures in fighting Covid-19. In fact, this expression represents a complex combination of three components: the shape of the epidemic curve, the social distancing measures and the reproduction number R0\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \mathscr{R}_{0}$$\end{document}. Each component has its own history, each with a different history of control. Presenting the control of the epidemic as flattening the curve is in fact flattening the underlying natural-social complexity. The curve that needs to be flattened is presented as a bell-shaped curve, implicitly suggesting that the pathogen’s spread is subject only to natural laws. The R\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \mathscr{R}$$\end{document} value, however, is, fundamentally, a metric of how a pathogen behaves within a social context, namely its numerical value is affected by sociopolitical influences. The jagged and erratic empirical curve of Covid-19 illustrates this. Although the virus has most likely infected only a small portion of the total susceptible population, it is clear its shape has changed drastically. This changing shape is largely due to sociopolitical factors. These include shifting formal laws and policies, shifting individual behaviors as well as shifting various other social norms and practices. This makes the course of Covid-19 curve both erratic and unpredictable.
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