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A graph showing the difference flattening the epidemic peak makes in the number of cases over time. Department of Health

What 'flattening the curve' means and how you can make a difference

Chief Medical Officer Dr Tony Holohan said the next seven days are “vital” with Covid-19.

THERE HAS BEEN a lot of talk about “flattening the curve” of Covid-19, but what does this actually mean?

As cases of the coronavirus increase day by day in Ireland and across the world, the number of  cases has differed from country to country.

Countries like Italy saw a large spike in cases over a short period of time, whereas others, like South Korea, have had a much steadier increase over the past few months. 

In an effort to spread out the number of diagnosed cases here, the Irish government has said it is trying to ‘flatten the curve’ of the epidemic. 

What does this mean?

Flattening the curve of Covid-19 cases is about slowing the spread of transmission over a longer period of time through measures like social distancing, and closures of schools and workplaces.

If we picture this increase on a graph, the ‘curve’ refers to how the increase in transmissions can be visualised. Flattening the curve is about making this look less extreme.

It also means that there is less pressure on the health service as there isn’t as large a number of people being diagnosed at the same time.

Instead, things are spread out and the health service has more time to deal with and plan for cases.

This image from the US’s CDC shows how we can visualise ‘flattening the curve’:

PastedImage-83523 CDC CDC

“In a pandemic like this where the virus is pretty good at transmitting from person to person, we can have an exponential increase in the number of infected people and that can lead to a peak of epidemic that completely swamps the health service,” explained Dr Kim Roberts, leader of the virology research group in Trinity College Dublin. 

Roberts said measures like social distancing are aimed to slow down this transmission. 

“So we slow down how the virus spreads through the population and we reduce the size of that peak so that although overall the same number of people might become infected, it will be over a longer period of time and the health service won’t be overwhelmed.” 

How is Ireland trying to flatten the curve? 

Countries around the world have taken different approaches to tackling the spread of Covid-19. 

In Ireland, schools, colleges and childcare facilities have been closed since last Friday. Pubs closed yesterday and workers who can continue their jobs from home have been advised to do so. 

The government has informed people about social distancing and avoiding large groups in an effort to reduce a large surge in transmissions. 

To limit the spread of the infection, Kim Roberts explained that reducing social interactions can have a huge influence on numbers. 

“If we assume everyone who has Covid-19 will pass the virus on to an average of 2.5 people, and that transmission occurs on average five days after exposure, then within a month a single infected person can contribute to the infection of 244 people,” she said. 

“If the transmission rate is reduced to 50% and each infected person instead passes the virus on to an average of 1.25 people then in a month, that infected person only contributes to the infection of four people.”

How can people help to reduce the transmission of Covid-19?

Chief Medical Officer Dr Tony Holohan gave a list of advice for people to follow yesterday.

His advice is:

  • Reduce your social contacts – see only a handful of people in your network
  • Distance yourself two metres from people in shops and supermarkets
  • Stop shaking hands or hugging when greeting people
  • Avoid touching your eyes, nose or mouth
  • Wash your hands regularly and practice cough and sneeze hygiene
  • Clean and disinfect frequently touched objects and surfaces
  • Check on your vulnerable family members and neighbours
  • Work from home where possible

Kim Roberts said people need to “be reasonable about risk and assessing the transmission risk”.

“Going to a supermarket to pick up essential supplies, if you wash your hands as soon as you get home and the shop isn’t full of people, that has a low transmission risk,” she explained. 

However, going to a crowded bar and being close to a lot of people has a higher transmission risk. 

“Similarly, meeting a friend in a park is going to be less of a transmission risk than going to somebody’s house or meeting in a cafe.

“It’s about thinking about what the risks are and trying to live as normally as possible, but change behaviours so that we minimise transmission risk.”

“We all need to realise that staying home saves lives… We also need to realise that we’re not trying to stop all transmission, we’re trying to slow it down.”  

Dr Anthony Staines, a professor of health systems in Dublin City University, said people during this time should mind their neighbours and offer social supports, while maintaining social distancing. 

“Contact tracing, testing and social isolation is what controls this pandemic and nothing else will control it,” he said. 

Have these measures worked anywhere else in the past?

Yes. Countries such as China and South Korea have slowed down the spread of Covid-19 during this pandemic already.

In China for the past two months, thousands of new cases were diagnosed each day. There were 36 new cases confirmed in the country yesterday. 

Past examples can be seen during the 1918 flu pandemic which killed around 50 million people worldwide.

In Philadelphia in the US, no social distancing measures were put in place and a parade with crowds of 200,000 people took place during the height of the pandemic. This led to a growth in thousands of infections very quickly.

In St Louis, however, parades were cancelled when the pandemic was at its peak.

A month after the parade, more than 10,000 people died from the flu in Philadelphia, according to the Centers for Disease Prevention and Control (CDC). In St Louis, the death toll did not rise above 700. 

The CDC in the US cited this as a “deadly example” to show the benefits of cancelling mass gatherings and introducing social distancing during pandemics. 

During the Severe acute respiratory syndrome (SARS) epidemic, Anthony Staines said “stringent quarantine measures were put in place and that worked in China and Canada”.

China was the worst affected country by this coronavirus, with over 5,000 confirmed cases.

In Canada, over 250 cases were confirmed, by far the highest number of any country outside Asia.

When will we know if social distancing measures are working to flatten the curve? 

Tony Holohan said yesterday that the next seven days will be “vital” in the spread of the disease. 

Anthony Staines said it will take “at least a week to 10 days” to see if the measures are working.

“What we see today is infections from between five and 10 days ago,” he explained. 

What will happen even if we do nothing, at some point it will go up and then it will reduce no matter what we do.

However, by flattening the epidemic curve the numbers will be spread out over a longer period and the health service will be less overwhelmed. 

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    Mute David F. Dwyer
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    Jan 31st 2022, 8:22 PM

    ‘The State shall, therefore, endeavour to ensure that mothers shall not be obliged by economic necessity to engage in labour to the neglect of their duties in the home.’

    When my grandfather died young, my Granny had to go out to work to keep food on the table and a roof over the heads of their seven children, the youngest of whom were 10 years of age. The state did sweet f.a. to ensure that she wasn’t obliged by economic necessity to engage in labour to the neglect of her duties in the home, in fact they took his medical card off her because it was in his name.

    Article 41.2 is sexist, mendacious, outdated rubbish that isn’t fit for purpose. Get rid of it.

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    Mute Thomas O' Donnell
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    Jan 31st 2022, 8:28 PM

    @David F. Dwyer: Not sure what getting rid of the article would do in that situation. In fact, if that article was followed, your grandmother would have been properly looked after?

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    Mute David F. Dwyer
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    Jan 31st 2022, 8:46 PM

    @Thomas O’ Donnell: It wasn’t followed. It never is, as this article elucidates. What is the point of having something in the constitution that serves no purpose beyond being a bit insulting and making false promises?

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    Mute Joseph Mc Dermott
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    Jan 31st 2022, 10:16 PM

    @David F. Dwyer: plenty of mothers out there that wish to stay at home to bring up their children. What your proposing is taking that right away. I believe it should be more gender neutral. It should apply to mums or dads and not be exclusive

    35
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    Mute David F. Dwyer
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    Jan 31st 2022, 10:31 PM

    @Joseph Mc Dermott: The hell I am. Mothers would have the right to stay at home regardless. The article does protect them and never has. What’s the point of it if it isn’t enforced? And it won’t be either. If it hasn’t since it’s inception, it’s not going to now with the current shower.

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    Mute David F. Dwyer
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    Jan 31st 2022, 10:39 PM

    @David F. Dwyer: The article doesn’t protect them and never has*.

    17
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    Mute Fachtna Roe
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    Feb 1st 2022, 12:26 AM

    @David F. Dwyer: Your point is clearly and cogently made. The State for all it’s false Roman piety is hypocritical in it’s practical effect.

    22
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    Mute Dearbhla O Reilly
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    Jan 31st 2022, 8:35 PM

    Ahhh McQuaid. What a peach he was. Took on his role with gusto. His legacy and the church’s legacy lives on. Lucky us eh? Especially women.
    And thanks Dev too.

    112
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    Mute Benny McHale
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    Jan 31st 2022, 8:26 PM

    Just needs a tweak. Change “woman” to “A citizen”, and “her” to “his/her”

    73
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    Mute The Bolt
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    Jan 31st 2022, 9:28 PM

    @Benny McHale: Isn’t it mad how something so simply solved, has people losing their brain over it. People are getting too touchy over terminology.

    42
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    Mute David F. Dwyer
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    Jan 31st 2022, 9:47 PM

    @The Bolt: ‘People are getting too touchy over terminology.’

    The fact that it promises safeguards that it does not and never has delivered on is the problem. Terminology is the cherry on top. And to the OP, it needs more than a ‘tweak’, it needs enforcement or to be scrapped altogether. Obviously one is cheaper than the other.

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    Mute The Bolt
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    Jan 31st 2022, 10:00 PM

    @David F. Dwyer: Well scrapping it serves no one. As you say, enforcement is what people should be fighting for, not terminology. I read your point about your nan, and no doubt its happened to many others. The fight should be that this shouldn’t happen to anyone, and hopefully and amendment would ensure that.

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    Mute David F. Dwyer
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    Jan 31st 2022, 10:35 PM

    @The Bolt: Be realistic, enforcement has never happened and never will not happen. The state isn’t going to pay for anyone who wishes to be a homebody to do so. The article is a false promise. Better off without it if it can’t be fulfilled.

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    Mute Honeybee
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    Jan 31st 2022, 10:02 PM

    The state has never recognised the role of women in the home, first by having laws that on marriage a woman could not remain in employment / lost half her wages on marriage. The role of caring for children/elderly/infirm was never acknowledged, women in the home had no rights, they were not seen as contributing to the economy/commerce and they relied on handouts from their husbands, they didn’t even have entitlement to health care and still have no proper provision for pension entitlements. It was sickening recently to hear Michael Martin speak about how women are valued when our history of how women were and are treated is a different reality. Look at the provisions of Article 41.2 and know they looked the other way when women needed to have their rights addressed under this Act, imagine if any woman had brought a challenge to vindicate her rights under the Act why they would have thrown the might of the state at her as they did in recent actions by women in healthcare on their deathbeds.

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    Mute Dearbhla O Reilly
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    Jan 31st 2022, 11:25 PM

    @Honeybee: well said.

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    Mute Gavin Linden
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    Jan 31st 2022, 9:03 PM

    Maybe I see view this in the complete opposite it was intended but I think it should be viewed as a very positive article in the constitution to support those women (or indeed men) who choose to contribute to both their family and by extension the state by remaining at home full time at a certain period in their children’s life.
    Ok, words such as ‘duties’ are antiquated but it could be a tool to build a positive system for those such people.

    59
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    Mute Anne-Marie Keane
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    Jan 31st 2022, 10:09 PM

    “endeavour to ensure that mothers shall not be obliged by economic necessity to engage in labour to the neglect of their duties in the home”

    Putting the misogynistic view/wording aside for a min, what did they do to ensure a mother didn’t have to work whilst trying to rear children & run a home? Was their monetary value/recognition for the woman? Entitled to a pension? No.

    There should be a vote to keep it but change the language so that it states parents and not mothers. Enforce it to ensure that parents are protected & allowed the time needed to run a home & rear kids without monetary stress/ loss of pensions.
    Childcare costs are so high and it’s women that mainly suffer when it comes to deciding who reduces/leaves their employment to have a quality family life.

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    Mute Neuville-Kepler62F
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    Jan 31st 2022, 9:00 PM

    Kick McQuaid’s can out the window, instead of down the road.

    Don’t miss this unique opportunity to express the positive contribution of equality in the home, care and work of all kinds .. and all the benefits it would deliver for all those currently undervalued by our society.

    Include “The Family Home” special status in the Referendum, to place Family Homes in their rightful place as primary and superior rights supporting primary constitutional values, in particular, human dignity (need for shelter / housing) and self-governance.

    General property rights would ONLY apply to the extent that the property interest immediately serves these primary constitutional values of human dignity (need for shelter / housing) and self-governance.

    https://www.change.org/p/irish-referendum-on-family-home-special-status

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    Mute Peter O'Muiri
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    Feb 2nd 2022, 10:45 AM

    @Neuville-Kepler62F: Few property owners (more than 50% of the population) would vote for what you suggest. They prefer the present arrangements whereby the state can only seize private property under very limited circumstances and subject to full compensation. Neither would foreign direct investment be attracted to a country that might seize or confiscate its property, willy-nilly. The housing crisis won’t be solved by stealing. It will be solved (slowly, because we don’t have sufficient building workers anyway)principally by investment and the taxation needed to fund it. These are matters for the legislature elected by the people.
    (This doesn’t mean that changes aren’t needed to discourage abuses like deliberate dereliction. But this can be achieved by targeted taxes)
    Enforceable property rights, like freedom of expression are fundamental to a functioning civilised society.

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    Mute Neuville-Kepler62F
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    Feb 5th 2022, 4:38 PM

    @Peter O’Muiri: .. good post.
    One couldn’t describe current Irish society as a functioning civilised society with a “locked generation”, rack rents by landlords (getting €7.4 billion of taxpayers money p.a. in HAP) and evictions.

    A referendum on housing was first called for in 1974 (Kenny Report) and if it was passed would have prevented the 2008 crash. We now know why FF & FG buried that one, representing the interests of Developers and Landlords, and the disaster it caused.
    A referendum has been called for again in 2014 by the Constitutional Convention. The German Constitution has such a provision to give special place to the Family home without adversely impacting on the German general property rights.

    We are waiting since 1974 for this Referendum on Housing after many less important referenda have been implemented to fix our badly defective Constitution.

    “All Irish citizens should be able to afford to own their own homes on average incomes in their own country” – NK62F

    Failing to permanently resolve housing by way of a Referendum will ultimately lead to civil unrest – one small spark!

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    Mute eitrebor
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    Jan 31st 2022, 11:45 PM

    Have never come across any instance of this being legally tested through the courts but would enjoy knowledge if it has – the language appears clear on ‘economic necessity’ & I genuinely have wondered to myself why women & their partners have not tested it where maternity benefit was not topped up by the state to the level of their wage/salary to allow them the first few months with newborns in particular where they may wish to but cannot stay with them due to their economic necessity, lack of funds, needing to return to work etc. Generally economic issues are non justiciable due to Art 45 but this is a clear statement signalling economic circumstance & a positive requirement on the state. Have thought about this aspect several times whilst noting the anachronistic nature of the text.

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    Mute Peter O'Muiri
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    Feb 2nd 2022, 10:15 AM

    @eitrebor: I witnessed one instance. At the end of a Circuit Circuit Court sentencing hearing of a woman convicted of defrauding pensioners in a scam which netted her almost €10K. The defence counsel pleaded that because she was mother of two children sending her to prison risked the children being taken into care, and this would , inter alia, be in contravention of the Article. In any case, the judge didn’t imprison her, but didn’t indicate whether this decision was influenced by Article 41.2, or just by the reluctance of Irish judges to lock up female criminals generally.
    Perhaps the present wording should be removed and replaced by one to compel gender-neutral sentencing!

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    Mute eitrebor
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    Feb 2nd 2022, 5:44 PM

    @Peter O’Muiri: thanks for the insight. I suppose in one sense given the interpretation/applicability of Art 34 a Circuit Court judge would correctly leave constitutional interpretation to the superior courts and not seek to advance new ground obiter in such a sentencing.

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    Mute Cian
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    Jan 31st 2022, 8:54 PM

    The only people I can see it insulting is men? How is it ensuring to women to get preferential treatment haha

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    Mute Tom Molloy
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    Jan 31st 2022, 11:21 PM

    @Cian: A positive take on it is needed. The father of the children is been exhorted to provide for his wife and his offspring. Maternity hospitals are stressing the benefits of breastfeeding, will that be next to be called sexist instead of the wonderful and healthy option. ?

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    Mute andrew
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    Jan 31st 2022, 11:30 PM

    Its all about having a conversation about what we want in and out of the constitution we took out articles 2 and 3 to agree to the Good Friday Agreement 1998 and their are those that would like a right to a home to be a constitutional right, its apalling we have such homelessness so it is welcome we are talking about changing the constitution.

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    Mute Dearbhla O Reilly
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    Jan 31st 2022, 11:49 PM

    @andrew: people have been asking for this particular change for decades. So I guess its a priority for a great many. As for changes and conversations, we have had 33 f them leading to amendments. It’s a well written document despite the church’s input. Robust and more democratic than many and more changes can still be made. The right to a home is a good debate to have on it. We are good at debate on constitutional issues. Bring it on.

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    Mute Peter O'Muiri
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    Feb 2nd 2022, 10:31 AM

    @andrew: Some people are under the illusion that creating ‘paper’ rights is the answer to all our problems. It isn’t. The present Russian constitution contains express rights to housing and free health-care. Visitors to Moscow will bear witness to the thousands sleeping on the streets (in spite of constant police harassment and violence). Russians also enjoy a life-expectancy almost 10 years less than we do in Ireland and Western Europe.
    Creation of social entitlements, and how they are to be paid for are best left to the legislature answerable to the people – and sackable by them. Like in Sweden and the other Nordic nations which have short constitutions which set out the organisation of the state, the balance and division of state power, and a few fundamental rights (such as freedom of expression and assembly)

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    Mute Lyn Brookes
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    Feb 1st 2022, 5:55 PM

    How many women have actually taken the state to court to in order to receive financial hep and benefits to raise their family rather than having to head out to work every day. How many women have to leave the family home due to having an abusive partner and have to fight tooth and nail to get housed and then live on the poverty line. Most women have to go out to work in order to provide the household with essentials, one wage is simply not enough any more. The constitution is quite clear, so why are women being forced to take jobs in order to provide heat and food.

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    Mute Máire Daly
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    Apr 5th 2022, 9:06 PM

    I was talking to a Community Welfare officer about this, he said ‘this clause in the constitution is the reason we don’t force lone parents to get a job, as if they were on the dole, it gives them space to raise their children’.

    So yeah, it’s a good clause, that has benefited lone (male) parents too.

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    Mute Peter O'Muiri
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    Feb 2nd 2022, 10:02 AM

    Remove it. Period. The creation of social entitlements, and how they are to be paid for, is properly a matter for the elected legislature.

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