Crushing the Curve

What the “dance” looked like at the end of the SARS 2002–2003 epidemic

The analogy of flattening the curve has managed to persuade many people to give up their personal freedoms for long-term again. But in an interview published yesterday, former dean of Harvard school of public health, Harvey Fineberg, emphasized we should be “crushing the curve”, not “flattening” it.

Looking back at the viral article on the hammer and the dance, it is tempting to interpret the “dance” when the curve is flattening as “celebratory”. In fact, careful reading of the article reveals that it is more like a wary “dance” around the edge of a cliff, which is proving to be crucial, if we are to avoid the “second-wave” cases predicted in some countries.

I moved to Singapore and worked in a hospital towards the end of the SARS 2002–3 epidemic. My colleagues had become so accustomed to wearing masks and gowns that they did not recognize each other if they met outside of hospital. Communication over the phone had become the default mode; it was more persuasive than attempting to convince someone in-person to change their position. For one, moving from one area to another required us to change our gowns and masks. Even if we did do so, upon arrival, we could no longer rely on non-verbal cues to read someone or use body language to open someone up.

It would be a good two months between the last diagnosed SARS case, and WHO declaring Singapore SARS-clear. We did not give a celebratory yelp as if it was the New Year. It was more a sigh of relief and a chuckle when stopping ourselves, still instinctively reaching for masks and gowns, like the dog salivating in Pavlovian’s experiment. This scene was probably repeated in a handful of countries around the world, as SARS had been nowhere near as infective (and a lot more lethal) than Covid-19.

We are now in a different situation, as almost no continent has been spared. We are being forced to take part in the biggest marshmallow test (instant gratification of one marshmallow, versus waiting to get two marshmallows — considered not just a measure of self-control, but also of trust) in our generation’s memory. That includes forgoing parties, school, walks in the park, blind dates, and many other things that, until recently, many people have taken for granted.

Some things, unlike the marshmallow test, were forced upon us: unemployment, closure of childcare, bereavement, and even worse than death —guilt, the guilt that some of our loved ones died alone.

Now then, the voices start to ask, when does the curve flatten enough for us to get back to normal? Friends turn to me, the armchair epidemiologist. I, in turn, look to other friends whose armchairs witness epidemic curvature analyses way more often than my armchair.

Using the timeline from SARS, from H1N1, from the first few places affected by Covid-19, from the internet of tons of data and known knowns and known unknowns — all of us put in guestimate timelines, privately, to each other. Sometimes, timelines that looked pessimistic last month, look optimistic now, and vice versa. If only the stakes were not death, if only all of us huddling with our predictions did not witness death regularly in our day jobs, or else it might have been as exciting as predicting football game scores.

Then, I read the interview with Professor Fineberg, whose armchair has seen more epidemic curves than my friends' and mine, put together. I think back to people I knew whose loved ones did not survive SARS of 2002–3.

So when friends ask me “when will…?”, I say:

“Crush that *@#$ curve first.”

Then we can pick up the pieces, pick up what is left of our lives.