data on other types of communicable in- fections, both respiratory illnesses, diar- rheal diseases, and conjunctivitis. In a short analysis she posted on Twitter, Rivers noted that rates of these other infections declined after stringent social distancing practices were put into place. “The things that are also spread


through close contact have fallen dra- matically, and so that tells me it’s individ- ual-level social distancing behavior that is contributing to the control,” she said.


Isn’t South Korea a different case? Indeed, the Republic of Korea has had


a different trajectory than Hong Kong, Taiwan, and Singapore. The new coronavirus took root in a


large and closely knit religious sect, a development that led to an explosive out- break, which the other three have not experienced. As of mid-March, South Korea has reported just over 8,400 cases and 91 deaths. But whereas Western countries that


have reached numbers like those see daily and every larger rises in their case counts, South Korea’s outbreak curve has been beaten back. From a one-day high of 909 new cases on Feb. 29, South Korea has seen its daily case count rise by as few as 74 cases on March 16. That swung back up, though, on March 19 to 152. The country is testing aggressively —


more than a quarter of a million people had been tested by March 15, Foreign Minister Kang Kyung-wha told the BBC recently. “Testing is central because that leads


to early detection. It minimizes further spread and it quickly treats those found with the virus,” she said, suggesting early detection and treatment may explain why South Korea’s death rate is lower than other places with large numbers of cases. South Korea introduced drive-through


testing, allowing people to be checked for disease without even leaving their vehi- cles. Travelers returning from abroad have to provide contact information and report their health status for 14 days after their return via a mobile app, the South Korea CDC website reports. It has recommended Koreans refrain


from international travel at this time and urged people to avoid large gatherings and church services. Companies have been encouraged to allow workers who are able to work from home.


APRIL 2020 17


Can these techniques be applied else- where? Is it too late in places like the United Kingdom and the United States? Many epidemiologists and mathemat-


ical modelers who have been plotting the possible trajectory of this pandemic think there is no choice but to try some of the serious social distancing measures other countries have taken. But Marc Lipsitch, an infectious dis-


eases epidemiologist at Harvard’s T.H. Chan School of Public Health, said the possibility of containment — stopping spread — through rigorous tracing of all contacts of known cases is not realistic. That window has closed, he said. “I think one thing to learn from those


experiences is that what’s appropriate when an epidemic is small and mostly ascertained is not appropriate when an epidemic is large and mostly not ascer- tained,” he said. “I would say put in place as intense


as possible social distancing and get the messaging from the White House consis- tent with that,” Lipsitch said. “Right away, everywhere, with the short-term goal of trying to reduce the … demand on the health care system.” Any universities still in session should


send students home, especially those liv- ing in dormitories “which are one step away from cruise ships in terms of density and poor ventilation,” he said. Lipsitch said time is limited to make


a difference. “The data that we just assembled from


Wuhan about the timing and magnitude of the peak demand for critical care shows first that it can very quickly — even with- out that many people being infected com- pared to the whole population — exceed per capita bed capacity in the United States,” Lipsitch said. He noted there was a four-week lag


between the shutdown of Wuhan and the overwhelming of critical care units. “So if you wait till you see a problem, then you have another month of agony, at least.” It appeared that was the kind of mes-


sage Britain was not heeding. There was a huge controversy late last


week when it seemed like the country intended to simply allow enough people to become infected so that the population would develop “herd immunity.” Adam Kucharski, an associate profes-


sor of infectious diseases epidemiology at the London School of Hygiene and Tropi- cal Medicine, said it was never the govern-


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