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If U.S. doesn’t ‘flatten the curve,’ severe cases of COVID-19 will overrun health system

Amid the novel coronavirus pandemic, epidemiologists warn that without sufficient protective measures, the number of severe virus cases will spike sharply, which would overwhelm the health system. The practice of social distancing is intended to slow the rise of cases to a manageable rate -- or to "flatten the curve." Dr. Asaf Bitton of Brigham and Women’s Hospital joins Judy Woodruff to discuss.

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  • Judy Woodruff:

    One term you're likely hearing a lot about to help deal with the coronavirus is what's known as flattening the curve.

    Epidemiologists say, if not enough protective measures are taken, there'll be a sharply rising number of cases, as shown in this pale blue spike, a huge jump over a very short period of time. That would strain the capacity of our health system.

    But flattening the curve, reflected by the lower gray swell, is achieved by taking strong measures, like physical and social distancing, to make sure the number of cases increases more gradually.

    Dr. Asaf Bitton has been talking about this very issue. He's with Brigham and Women's Hospital in Boston. And he joins us now.

    Dr. Bitton, between Washington and the states, are the American people now being given enough guidance to induce them to do the right thing?

  • Asaf Bitton:

    I think that we're starting to be given that guidance, but we really need to urgently increase the pace of coordination and of stringency in the response.

    As you mentioned, the curve that you're talking about, the trajectories that we're seeing, are not sustainable for our health system to manage. We do not have enough beds or ventilators to manage a moderate or severe outbreak like this.

    So we have to stretch out the number of cases and prevent the number of cases from flooding the hospitals now.

  • Judy Woodruff:

    So, just to clarify, we're not saying that people aren't going to get this virus. A lot of people will get it.

    The goal is not to have them — so many of them get it at the same time, which would overwhelm the capacity of our health care system. Is that right?

  • Asaf Bitton:


    The issue really is about the speed in growth of cases of people that get it, and the severity of cases that would overwhelm our — particularly our acute hospital and ICU systems' response capacity.

  • Judy Woodruff:

    I'm asking, because I think some people think, maybe I can avoid this altogether. I mean, the fact is, many Americans will get the coronavirus. Is that correct?

  • Asaf Bitton:

    Unfortunately, it appears to be so.

    This is an incredibly transmissible infection. It has a high reproduction rate. It has a high infection rate. A lot of those cases might be mild, but a lot will be severe, especially for folks in high risk.

  • Judy Woodruff:

    And so Americans should be — as we have been saying, they should be distancing themselves. They should be staying at home.

    What do you say, though, to those people who say, I really need to, for example, continue whatever work I can continue, I need to get out, because my family is depending on me?

  • Asaf Bitton:

    These are going to be some of the really difficult choices that we all face moving ahead.

    On the one hand, right now, these seem, for some people, a voluntary choice. We are seeing that some people are working from home. Some companies are trying to have their workers work from home.

    But, increasingly, as we just saw today in San Francisco and we will see in other states, there will be involuntary measures that will really start to close down and distance people from each other physically.

    So while people who work perhaps in nonessential services may want to continue that work, and I'm very sympathetic to it, unfortunately, the speed of the rise of this epidemic may make necessary more involuntary closures or restrictions.

  • Judy Woodruff:

    Dr. Bitton, a lot of people are asking, I think, a question that's probably impossible to answer probably, but how long is this going to last?

    How do you answer that?

  • Asaf Bitton:

    It's a hard question, but it's one we need to start grappling with.

    And what I would say is, this looks to be many weeks to months. It's hard to imagine that there's evidence from other countries that we can control this within just a week or two.

    So I think we need to prepare for this to be an extended time where we are socially distant. It's really hard to predict the dynamics of any particular epidemic, but this one is almost unprecedented. And I think it's really important that we all have a new social compact around coming together by staying apart.

  • Judy Woodruff:

    And just quickly, finally, to those who are concerned about whether there are enough hospital beds, enough ventilators for those who are most seriously — the most seriously ill, what do you say?

  • Asaf Bitton:

    Well, we have — according to the American Hospital Association a couple of years ago, we have a little over 900,000 beds. We have about 50,000 medical ICU beds that are staffed and another 50,000 other type of ICU beds that are staffed, and, in total, about 160,000 vents.

    What that means is, even in a moderate scenario, like predicted by the John Hopkins Center for Health Security, if it came at once, we wouldn't really have the capacity. That would overwhelm that existing capacity.

    So what is needed now is for people to take the community mitigation and social distancing strategies to flatten the curve, to spread that out, so that, if those cases emerge — and it's hard to predict, but it's possible at this point — it at least can emerge over an increased amount of time.

    Otherwise, this is going to be very difficult on our health system and our health care workers.

  • Judy Woodruff:

    Dr. Asaf Bitton, thank you very much. We appreciate it.

  • Asaf Bitton:

    Thank you.

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