32 | JULY 16 • 2020
Have We Truly
“Flattened
the Curve?”
We asked the term’
s founder.
CORRIE COLF STAFF WRITER
Health
T
hroughout the coronavi-
rus pandemic, the term
“flatten the curve” has
been used by health officials
and federal and state leaders
as a public health
strategy to slow
down the spread of
the virus. The term
was coined by Dr.
Howard Markel, a
local Jewish med-
ical expert and
professor at the University of
Michigan.
Markel is the George E.
Wantz, M.D. Distinguished
Professor of the History of
Medicine and director of
the Center for the History of
Medicine at the University
of Michigan. He has writ-
ten multiple books about
infectious diseases, including
Quarantine! East European
Jewish Immigrants and the
New York City Epidemics of
1892 and When Germs Travel:
Six Epidemics That Invaded
America since 1900 and the
Fears They Unleashed.
The term “flatten the curve”
was coined by Markel while he
was conducting research on the
1918-1919 Spanish Flu pan-
demic, which he did following
the SARS pandemic in 2004.
“I was eating a very bad noo-
dle dish while we were working
late at night,
” Markel said. “The
noodles were in some kind of
Styrofoam container, so they all
formed one big flat noodle, and
it was a joke that the flattened
noodles were like the curve.
And that’
s where ‘
flatten the
curve’
came from.
”
After the SARS pandemic
in 2002-2004, Markel was
asked by the George W
. Bush
administration to work with
the Centers for Disease Control
and Prevention (CDC) to help
develop guidelines for a nation-
al response for future pandemic
outbreaks.
“The one thing we were
concerned about back then
was avian influenza, or ‘
bird
flu,
’
so that was the emergency
or the thing that spurred this
on,
” Markel said. “The bird flu
became a big problem for birds,
but not for humans.
”
During the Obama adminis-
tration in 2009, there was also
a flu pandemic, known as the
H1N1 pandemic. According to
Markel, that one was not much
more lethal than seasonal flu
and did not require the same
extensive measures of quaran-
tining and lockdowns. But now
the COVID-19 pandemic is
different: a much more serious
outbreak that has necessitated
extreme measures.
“Because these measures are
so disruptive, economically and
socially, you only use them for
very deadly pandemics, such
as the 1918-1919 flu pandemic
and now with the coronavirus
pandemic,
” Markel said.
Markel’
s research focused
mainly on response measures
known as non-pharmaceutical
interventions, which use isola-
tion, social distancing and lock-
downs to slow down the spread
of the virus.
During that time, cities
throughout the U.S. had their
communities quarantine,
self-isolate, close schools
and limit public gatherings.
Throughout Markel’
s study, he
found that cities that enacted
these measures early on were
much more effective than other
cities that lifted their measures
too early and saw another rise
in the number of cases.
His findings from his
research on the 1918 pandemic
are very similar to how the
country is reacting today to the
lockdown and social distancing
guidelines.
“The people got restless,
just as they did in 1918, and
they wanted the various things
lifted back then and currently,
”
Markel said. “So, even though
we lifted all those regulations,
the virus is still circulating and
is still out there. We’
re now
seeing bumps in several places,
and so the curve is no longer
flat. We have done all of these
measures and we have endured
a lot of economic problems, all
for nothing because now we
have a rise in cases.
”
Markel’
s research is reproduc-
ible and has helped influence
policies that remain in place
today for the country’
s response
to pandemics. Michigan Gov.
Gretchen Whitmer has even
used some of Markel’
s graphs
during her press releases
throughout the course of the
coronavirus pandemic.
As the country begins to
open, Markel believes that we
are going to see another rise in
cases and that as a whole, “we
are not out of the woods yet.
”
Markel reminds people to
continue to wash your hands,
stay home if you’
re sick, wear a
face mask and try to minimize
your exposure to the public.
“
All our research does is help
you hide for a while from an
infectious disease, but it doesn’
t
cure it. The thing that ulti-
mately will cure it is a vaccine,
”
Markel said. “The epidemic has
certainly not gone away, and
if we don’
t start doing these
measures again, a lot of people
are going to get sick and some
of them are going to die. It is a
very vicious virus.
”
Dr. Howard
Markel
U-M
“The epidemic has
certainly not gone away.”
— DR. HOWARD MARKEL