Dispatch from Seattle v6: What bending the curve looks like

With Seattle on the front end of America’s COVID outbreak, the region was also on the front end of canceling schools, limiting gathering and promoting social distancing.

So, it’s useful to explore whether those strategies are having some impact so that other states can learn from the Seattle experience.

In a piece published online on Sunday, the NY Times’s Mike Baker said that it’s possible the unique culture of the Puget Sound region may have helped slow the virus’s spread in Puget Sound.

Perhaps the city’s social norms helped, too, as local residents have long had a reputation for keeping to themselves or within circles of longtime friends — a phenomenon often explained to newcomers as the Seattle Freeze.

I’m not sure how this particular “insight” made it into this story, but other than this sort of odd inclusion, the article is worth a quick read.

 

Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.

 

Most notably, Baker reports:

While each infected person was spreading the virus to an average of 2.7 other people earlier in March, that number appears to have dropped, with one projection suggesting that it was now down to 1.4.

This new reproductive rate is important. 1.4 is a great number, meaning the Puget Sound region has markedly slowed the spread of the disease.

Holding at this rate means that one contagious person will generally infect only one other person. While that still allows for a doubling of the infection rate, it will occur over a period of 9-10 days instead of 5-6.

If you think of a COVID+ person, the average person will show symptoms in about 5 days. So, that means many new infections may now start occuring while individuals are symptomatic.

Once someone is symptomatic, they are much more likely to be self-quarantining, thus staying away from folks and further limiting the spread.

So, it’s clear that the infection rate is on a downward trajectory – but it’s entirely possible that we’ve hit an inflection point where that trajectory will increase it’s downward slope significantly.

Here’s what this trend looks like from the Washington State Dept. of Health.

If we can move the reproductive factor from 1.4 to less than 1, that would suggest that some number of infected patients will be infecting zero additional folks.

This will likely continue to reduce community spread, and increasingly localize remaining outbreaks. Health care facilities will be one of those places where outbreaks are likely to continue. Long term care facilities likely will as well. But, these are relatively discreet spaces where further outbreaks of community spread will be limited.

In other words, we’re close to a point where the additional spread will not come from a more general “community spread,” but rather through more specific hot zones, in families, institutions, or organizations.

So, the good news is that things appear to be “flattening” in the Puget Sound area.

As they sometimes say in medicine, “The patient is getting better, but it is still not well.”

According to a new analysis by the Institute for Health Metrics and Evaluation, the Puget Sound region is slowing the spread of the virus, but it is still only on the front end of the curve.

 

 

According to IHME, the bell curve that lies ahead of Washington State suggests that the number of deaths Washington State had from COVID on March 29th (8) won’t again be seen until June 1. In other words, the number of deaths is projected to be higher every day between now and then.

 

So, it appears there is some progress on controlling the spread of the disease in Washington State. But, it’s also clear things are going to get much worse before they get better.

This means if you’re in a lagging community behind Washington State, it’s better to move early than wait for this disease to knock on your door.