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Wednesday, March 11, 2020

Coronavirus: Help Flatten the Curve by Deliberate Early Exposure?

The importance of "flattening the curve" of Covid19 seems to be sinking in, with "social distancing" being the single most important means. Nothing to argue with there. But I have an idea for another, complementary public health measure: what about selective, deliberate early exposure? (NOTE: This assumes that once you get it, you are immune for a while--I think that is a solid assumption.)

Why not expose voluntary cohorts of people to the disease, much sooner rather than later? And then put them in quarantine together (in a motel or whatever).

From a societal/public health standpoint, this would help flatten the curve. But why would people volunteer? I think there are a number of benefits (beyond knowing you are making a contribution to the greater good):
  • Early exposure guarantees sufficient resources for your treatment. Versus getting it at peak, and maybe the hospital is full, or out of respirators.
  • Choosing your time and place of quarantine ensures you aren't stuck on a cruise ship for weeks.
  • Similarly, since the entire cohort would be infected together, the duration of the quarantine would be a predictable 2 weeks. Versus the cruise ship scenario, where every time a new case pops up, it would reset the clock.
  • By getting it over with, you no longer have to endure weeks or months of social distancing--you are free to go about your business.
  • You would have company in quarantine--the rest of your cohort.
  • And of course you would know you are making a major, pro-social contribution by volunteering to be exposed. Ideally, maybe this could earn credits for those near and dear to you who are at high risk--should rationing be required.
I think it would be super-beneficial to do this with healthcare workers. Because that famous curve-flattening graphic? The one that shows the Healthcare system capacity as a fixed, steady-state horizontal line? Well guess what? If healthcare workers are infected, that line plunges downwards.


There would also be a big scientific/clinical dividend. Early data on the disease progression. If done really carefully, it might be possible, to some degree, to group the cohorts in statistically useful ways (vs random) to provide even better data.

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