A COVID Critic’s Guide: An Ending and Word on What’s Next
By: Joshua Liao
Tags: Covid 19, Healthcare, Coronavirus, Co Vid, Health

For information about caveats and disclaimers, click here.

Whether one thinks the major driving force has been the virus, the human response to the virus, or both, it’s undeniable that COVID has produced a once-in-a-century global crisis.

With anything of this magnitude, there will inevitably multiple stages of understanding, action, and reaction. This “Critic’s Guide” series was designed to be a time-limited sprint to navigate the first stage (recognition and preparedness) using a critic’s perspective to acknowledge and address skepticism, rather than dismissing it, and to help us all approach what’s next with thoughtfulness and perspective. Things that didn’t reinforce this goal — even if newsworthy or “trending” — were intentionally excluded.

The content really boils down to a few key points:

The COVID pandemic matters to most all of us, directly or not (link)

Early data must be interpreted and acted upon carefully (link)

Ongoing efforts to fight the pandemic fall under the heading of “flattening the curve,” an important effort that unfortunately may bring new challenges even as it address others (link 1, link 2)

The fight against COVID-19 is likely still in its early stages (link)

Additionally, I hope the series conveyed a recognition of the gaps in what we know (there are many). We still have much to learn about the virus and its clinical, public health, and economic effects.

So what’s next?

No one knows for sure, but I hope that the next stage will be marked by a few things:

Better data. Whatever one thinks about the data we have, I think it’s inarguable that we need more data, more quickly, to track viral transmission in a way that is more comprehensive than we currently have. Much more work to do, but we are on our way.

Willingness to “tame”, not necessarily “flatten” the wave. As a health care worker, I am concerned about health care system capacity. But I am also sympathetic to the trade-off that flattening the curve creates on our economy, social interactions, and lives in general.

As mentioned in the prior installment, two conclusions from simulations by the Imperial College COVID-19 Response Team in the UK were that (a) milder mitigation measures were unlikely to prevent health systems from becoming overwhelmed, but (b) harsher suppression measures could address this issue if extended for a prolonged period of time.

With negatives on both ends, the UK team raised the possibility of a third, more middle-of-the-road option: “We show that intermittent social distancing — triggered by trends in disease surveillance — may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound.”

This is what I’ll call “taming the wave” — intensive upfront efforts followed by close tracking and reinstatement of measures serially as needed over time. Given the trade-off between mitigation and suppression, I don’t know a better alternative for balancing the effects on the health care system and our lives (discussed here). Here’s what it looks like in my framework:

My Framework

Kindness. Its in all of us to fear the unknown, and much remains unknown about COVID-19. But this is also an occasion for us to show the best parts of ourselves, whether in hospitals caring for those infected; working in communities to try to mitigate the negative effects of shut-downs and social distancing; advocating, educating, and otherwise supporting efforts to fight the pandemic. If current projections are anywhere near accurate, patience, understanding, and grace will certainly be needed in the coming weeks and months.