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COVID Curves

There's been a dramatic upward curve in the time spent trying to interpret upward curves. Downward curves too, to be fair. We’ve been mostly behind them, sometimes ahead of them, and constantly trying to flatten them. The mystical Curve of Learning has been frustratingly steep.


My favourite set of COVID curves was one of the first that I saw[1].

It warned that, just as the initial acute phase was underway, we needed to prepare for a series of aftershocks. There would be four waves:

  1. Immediate mortality and morbidity followed by recovery from intensive care and admission

  2. The damaging impact as people kept away from emergency care for non-COVID but still urgent conditions

  3. The delayed effect of interrupted care on long-term, chronic conditions as people stayed at home and the scope and scale of non-acute services were reduced

  4. A legacy of psychic trauma, mental illness, economic hardship, burnout, and more.


In the intervening months, we’ve seen that while the steepness of curves will differ in response to demographic variables, the force of all four waves will be felt at once.

As we face the potential of a second COVID Wave, I suspect we'll learn two more things.

First, we’re likely to see that each of the four within-Wave-waves (if you get my drift) will occur for a second time. In other words, we’ll have eight waves bearing down on us. And then twelve, and so on.

The second lesson, I fear, will be that the cumulative effects of the fourth waves will become uncontrollable. I’ve written previously about the crisis faced by our charities and the devastating impact on the most vulnerable. We ain't seen nothing yet.


Early intervention will be the most effective way to minimise the harm to our mental health. In the same way, we need now to plan how we will try to stop and manage to survive the tsunami effects of the combined fourth waves.

In the coming weeks, I’ll argue the case for cross-sector systems as the only viable solution to the challenge. I hope you’ll be willing to join the debate.


[1] The original version of this infographic was created by Dr Victor Tseng, Assistant Professor of Pulmonary & Critical Care from Atlanta, Georgia, and shared via Twitter on 30 March 2020.

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