The events of this past week are mind-boggling to many of us. All of a sudden, colleges are asking their students to not return from spring break, cancelling face-to-face classes, cancelling athletic events, and completing the semester by asking faculty to teach out their classes online. The governor of the state of Maryland, Larry Hogan, closed all public schools for two weeks and has banned all public gatherings of more than 250 people. In addition, many companies have asked non-essential employees to work from home. Why, you may ask? It’s the math.
My nephew, Asher Rosinger, is an anthropology professor at Penn State University. He is also one of only two anthropologists to serve as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention in Atlanta. He provided the following lesson on social media yesterday.
“When I teach my students about epidemics and the basic rate of reproduction (Ro), I discuss different diseases like measles, which has an Ro of ~15, meaning that one case on average leads to 15 new cases. So, with COVID-19, a disease with an Ro of ~2 to 2.5 doesn’t sound like much. But then I show my students a doubling exercise. If this doesn’t highlight how uncontained epidemics work, then nothing will. Take a penny and double it for the next 30 days:
Day 1: $.01
Day 2: $.02
Day 3: $.04
Day 4: $.08
Day 5: $.16
Day 6: $.32
Day 7: $.64
Day 8: $1.28
Day 9: $2.56
Day 10: $5.12
Day 11: $10.24
Day 12: $20.48
Day 13: $40.96
Day 14: $81.92
Day 15: $163.84
Day 16: $326.68
Day 17: $655.36
Day 18: $1,310.72
Day 19: $2,621.44
Day 20: $5,242.88
Day 21: $10,485.76
Day 22: $20,971.52
Day 23: $41,943.04
Day 24: $83,886.08
Day 25: $167,772.16
Day 26: $335,544.32
Day 27: $671,088.64
Day 28: $1,342,177.28
Day 29: $2,684,354.56
Day 30: $5,368,709.12
Now imagine a penny represents a case of COVID-19 and tell me social distancing is an over-reaction.”
Thanking Asher for the simple lesson, I’d like to expand it using the state of Maryland as an example. Maryland’s official population is 6,043,000. In the fall of 2010, 369,320 students were enrolled in 55 Maryland colleges and universities. In the fall of 2019, there were an estimated 871,360 students in public schools, grades K-12. In those concentrations, it doesn’t require a high IQ to figure out that if you want to slow the expansion of a contagious disease like COVID-19, you shut down the schools, colleges, and universities where large numbers of people are clustered as well as the gatherings of 250 people or more.
Why do we want to slow the spread of COVID-19? A simple New York Times chart has been circulating in the past few days. In this chart, the expansion of cases is compared to a flat line of healthcare capacity. Continuing to use Maryland as an example, there are 9,555 acute care hospital beds in Maryland serving its population of 6 million people. If Governor Hogan had not taken any action to reduce social interaction, you can see how quickly the hospital beds would be filled beyond capacity.
One example of an area that did not move to flatten the curve is Northern Italy. In this recent NY Times article, the consequences of allowing the number of cases to spike is an example of what can happen when a disease is unchecked. Hospitals are overwhelmed. Physicians are making choices of which patients they’ll try to save by moving them into an intensive care unit and which ones they will leave in a makeshift ward. Medical supplies are scarce due to a supply system that is not ready to provide so many patients with specific drugs and medical supplies.
Our university operates totally online with students studying from all 50 states and 130 countries, as well as faculty members teaching from all 50 states and several countries. Supporting that infrastructure requires staff who are clustered in West Virginia and Virginia. We are in the process of evaluating the timing to require all non-essential staff to work from home for a period of time, reducing the numbers in our West Virginia and Virginia locations and contributing to flattening the coronavirus curve.
