Eliminating COVID-19: A Community-based Analysis

 Eliminating COVID-19: A Community-based Analysis

This is a valuable paper that delineates the critical and timely actions that must be taken to stop the spread of contagion. Everyone should read this in its entirety, but I will summarize relevant points to remember.

Eliminating COVID-19: A Community-based Analysis

A central point to this analysis is the community-to-community spread of the contagion, no matter what "size" that community may be. It can the size of a country or as small as a city, so long as disease transmission within communities is far more frequent then disease transmission between communities. The goal here is to stop the spread within communities first, then deal with the lower cases of disease transmission between communities.

a) A community is defined as infected if someone with the infection enters the community.

b) If the infection is not immediately contained, the infection spreads at an exponential rate.

c) Aggressive social distancing and isolation measure cause the number of active infections to decrease.

d) These measure can only be lifted once there are no remaining active infections in the community; or when the community is fully contained.

e) Each infected community infected uninfected communities proportionally to the number of active infections through travel to other communities, sustaining the spread to new communities, including reinfections.

f) The frequency of travel from an infected community increases the possibility of spread.

g) A reduction in travel from communities results in a proportion reduction in infection.

h) Improvements in testing, contact tracing, and quarantines result in a proportional reduction in infection.

i) Preemptive reductions in large events such as conferences, as well as social distancing reduces "super spreader" events as well as general transmission.

j) Without timely implementation of aggressive social distancing measures, restricting travel from infected communities serve only to delay the spread of the outbreak. Both must be implemented as soon as possible.

k) Social distancing, along with restricting travel, will be in some cases the deciding factor in determining whether or not the outbreak is eliminated.

l) Travel reductions can greatly decrease the duration of the outbreak, and therefore decrease the total number of illness and death.

m) It is of paramount importance that communities and governments act as soon as possible. Once infection has taken hold in a community, exponential growth ensures that it is only a matter of time before the infection becomes widespread.

n) Thus, government action is inevitable, and delaying action not only linearly increases the expected total amount of time for with distancing measures will need to remain in place but also exponentially increases that probability that another community will become infected.

o) Delaying actions only becomes increasingly costly, and the longer a community waits, the more important it becomes to avoid further delay.

p) There is no advantage to delaying at all: immediately implementing aggressive social distancing measures as soon as there is evidence that the disease is actively spreading with the community will reduce the total amount of time for with such measures will need to be implemented, exponentially reduce the number of infections within the community, and exponentially  reduce  the  probability  of  infecting  another community.  While the risk to individuals may be low in the early stages of a community outbreak, the collective risk at the community and global levels is extremely high.

q) Finally, just as transmission within a community is an exponential process in which the need for immediate action is not always apparent (due to a deceptively small number of initial cases), the transmission between communities is also such an exponential process. 

At first the number of infected communities is deceptively small, but without  rapid  action this number exponentially grows.The sooner a set of communities decides to adopt a protocol that reduces rate of transmission (below 1), the shorter the amount of time  between the adoption of the protocol and the elimination of the disease.

Early action is therefore, absolutely paramount to stopping the disease.


This is why shutting down non-essential activity is so critically important. It is the only way we have to stopping the rising death toll and rate of infection. Failure to shut down non-essential activity guarantees failure, overwhelming the medical system to provide sufficient care, and in all probability,  provided enough time, collapsing almost everything else. Without adequate medical care, the number of sick and dying will also overwhelm the declining resources of the survivors.

The Governor must act - immediately.