 The SARS-CoV-2 virus that causes COVID-19 continues to spread across the country at an alarming rate. As of March 18, there were 7,323 confirmed cases and 115 deaths in the U.S. As a result, our country faces unprecedented closings and tremendous strain on our healthcare systems, businesses, and our overall economy. Are All the Closings and Precautions Necessary? Working from home, closed schools, daycares, restaurants, and gyms make for an extremely frustrating and inconvenient situation. Most people who contract COVID-19 only have a mild illness. So, why are we taking such seemingly extreme precautions? Lessons Learned from Italy Italy, with the second highest disease rate after China, is recommending that other countries learn from their example and increase healthcare resources to prepare for COVID-19. On March 16, Italy reported 368 more COVID-19 deaths, its biggest one-day increase, for a total death toll of 2,158. Hospital systems and ICUs in Italy are overwhelmed with the pace of disease spread and are experiencing shortages of personal protective equipment resulting in exposure for healthcare workers. In fact, approximately 1,700 healthcare workers are infected and several have died. Disease Progression While many of those who contract COVID-19 will not have severe symptoms, they are still contagious. In addition, the way COVID-19 infects the body adds to the confusion around contagion and the need for quarantine. COVID-19 hits patients in two phases. The virus enters the body and binds to receptors in the lungs or gut and replicates. For most people, a healthy immune system keeps the virus in check and symptoms are not severe. However, in patients who tend to be older, or have comorbidities (e.g., cardiovascular disease, hypertension, etc.) there is a secondary adaptive immunity phase, during which patients get worse—after a deceptive phase of improvement. In this secondary phase, viral replication goes down, but there is a big immune response that results in lung damage and from there can rapidly decline into sepsis, organ damage, and death. Flattening the Curve In addition to a widely mixed disease presentation, the U.S. was slow to start testing and managing communication, leaving us in a reactionary situation. The U.S. is headed toward the scenario represented by the tall, thin red curve in Figure 1, that demonstrates a rapid widespread infection rate. This type of curve occurs when proper containment steps to prevent the virus from spreading are not immediately taken. Though many sick people will not require hospital care, there is strong concern that a large number of patients will need ICU beds, and if this happens at an exponential rate, our healthcare system will be overwhelmed, much like Italy. In an overextended system, patients who need an ICU bed unrelated to COVID-19 may not receive proper care. What we need in the U.S. is to flatten the curve, a term common among public health officials that many of us are learning about this week. If we can begin to slow virus spread and flatten that curve into the second, lower, green curve shown in Figure 1, our hospital systems are more likely to be able to manage the rate of illness. To slow the spread of the virus, individuals need to practice social distancing in order to stretch out the number of confirmed cases across a longer period. As the figure shows, the lower curve does not cross the threshold of our healthcare system’s maximum capacity and allows the system to more easily take care of everyone who is sick. This lowered curve (or rate of spread) can decrease the number of total virus-related deaths and deaths from other causes. This also allows time for the development of new medications and eventually a vaccination. In addition, less healthcare workers are likely to catch COVID-19 in the lowered curve scenario. Orchard’s Commitment In a crisis like the COVID-19 pandemic, we need to avoid panicking and work together to do our part to try to prevent COVID-19 spread to ourselves and throughout our communities. Orchard is committed to assisting laboratories that are involved in collection and testing for COVID-19 by efficiently integrating software tools and providing customer service that promotes timely testing. As always, we intend to keep you informed and be a trusted resource you can turn to for industry-related education. Follow us on Twitter at @OrchardSoftware and feel free to respond to this post by emailing us at news@orchardsoft.com. Notes
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