FLATTING THE CURVE VS SHIFTING THE CURVE

I always had an interest in Public health because it showed me the big picture. As, doctors, we always get consumed with what in front of us and the daily routine, but we do not stop and ask ourselves where all these diseases come from and what we can do about it.

During this pandemic, the public suddenly became aware of many new vocabularies. Terms such as ventilators, N95 masks, and flatting the curve became a meme. However, when it comes to curves, there are different types of dealing with them.

In this public health intervention, by asking the public to practice social distancing, we aim to spread the cases over a longer period so as the health services can deal with the increased caseload and demand in intensive-care beds. Without social distancing, the rise in the number of cases will be sharp, but the health service will not be able to cope with the flooded of cases which will lead to doctors have to make the hard decision on who gets intensive care and who does not. Believe me, it is not a decision you want to make and explain it to someone’s family.

The other form of public health intervention is described as moving the curve. So basically, you try to move the whole curve of exposure in a good direction. E.g. let examine the relationship between the diagram below.

The red curve represents the number of a population where at a certain level of risk an “X” disease will develop. To reduce the number of people who will go on and develop the disease we can try and shift the whole curve “population” to the left. This will reduce the risk to the whole population and eventually will lead to fewer people developing the disease.

An example is the advice given to the whole population regarding coronary heart disease. This can range from exercise, a balanced diet, to the cessation of smoking. This is easier said than done but the reward is huge and in the number of prevented incidence of the disease and cost to health service.  

As this Pandemic continues, more public health topic and intervention will become the mainstream. What I hope will increase the interest in Public health and will encourage more doctors and others into the field.

What do you think?

Sources:

1. [Flattening the curve: OUWB experts explain how novel coronavirus can be stopped](https://oakland.edu/medicine/news/auto-list-news/2020/Flattening-the-curve-OUWB-experts-explain-how-novel-coronavirus-can-be-stopped)

2. Geoffrey Rose, Sick individuals and sick populations, International Journal of Epidemiology, Volume 30, Issue 3, June 2001, Pages 427–432, https://doi.org/10.1093/ije/30.3.427