“Social distancing” doesn’t mean staying home alone on a Saturday night. It means not being near other people. Quarantine is social distancing imposed on people who are not yet ill, but may be infected. Isolation is social distancing of those already ill (but we’ll use it more generally here).
As I write, on March 12 2020, those terms seem to fit in every second conversation. But is there any point to all this cancelling of public events, with the disease already beyond containment?
Why cancel events if the speed is beyond containment?
We’re clearly getting community spread of COVID-19 at this point. (Yeah folks, I know the actual virus is called SAR-CoV2 and the illness COVID-19 by the pedantic; but I’m not going to join them.) Yet now is when it seems like every event with more participants than a family dinner is being canceled. Is this all just closing the barn door after the horses are out?
Let’s ask Philadelphia.
St. Louis took measures to enforce social distancing. Philadelphia decided to go ahead with their parade. Three days later Philadelphia’s hospitals overflowed and their death rate spiked.
Not every picture is worth a thousand words, but that one sure spoke to me. In case it didn’t speak so loud to you, here’s some text on it: “On September 28, despite the increased infiltration of the disease among the civilian population, a rally for the Fourth Liberty Loan Drive proceeded with minimal debate about the repercussions for public health.”
The head of Philadelphia’s Naval Hospital told the Public Ledger in the days before the parade: “There is no cause for further alarm. We believe we have it well in hand.” So, the parade went forward. “In the streets of downtown Philadelphia 200,000 people gathered to celebrate an impending allied victory in World War I. Within a week of the rally an estimated 45,000 Philadelphians were afflicted with influenza.”
So I got it when my university told my students not to come back after Spring Break (although I’ll miss them). And yet, they’re expecting faculty to come back. What’s up with that?
Nodes of contagion make a difference
Node of contagion…hmmm, sounds like some cyst full of nasty bacteria deep inside a badly cleaned wound. Well, kinda, yeah.
A “node” is is a single point that connects many different elements. They’re important in epidemiology because extremely efficient in spreading infection. Nodes are the destroyers of isolation, in other words.
Teachers are usually nodes, as are schools in general. Sporting events are nodes. And, ask Philadelphia if you don’t believe me, so are parades. Shutting down the nodes does a lot to improve social distancing.
Isolation is still being promoted because speed matters
Speed matters. The more rapidly a disease moves through a population, the worse the outcomes are likely to be.
The .gif is about hand-washing, but the concept is the same for shutting down the nodes or any other means of increasing isolation.
The .gif shows one of the biggest benefits of slowing the pace of transmission. Right now the U.S. hospitals are at about 95% capacity due to normal usage and flu season. Add a lot of COVID-19 patients and there literally won’t be beds for them all. Materials shortages are already getting nasty. (I’m looking at You, N95 masks. Yes, you, the box of masks we bought years ago…)
Another other main benefit of isolation and its flattening of the curve is in the nature of the beast. As microbes move through populations, they mutate. Mutants that make people too sick to move about tend to die out. Mutants that cause less symptoms get transmitted better, as their hosts reduce their social distancing. It’s not a firm rule but it is a trend: Sickness tends to lessen as epidemics age.
The remaining benefit depends on the scientists. Drugs to mitigate the seriousness and vaccines to reduce transmission are both real possibilities — but they’ll take time. Flatten the curve with isolation and more people may benefit.
Isolation even if you’re not worried
To be honest, I’m not that worried about either Salty or me getting COVID-19. We’re not part of the sub-populations it tends to bite hard, so our chances are good for avoiding serious illness. Yet, we’re being very careful to increase our isolation. Why?
We like our neighbors. Our community matters. Social crisis is not our friend (although it’ll be interesting to see how the U.S. populace copes with No Professional Sports). People who are only mildly ill, or even asymptomatic, can be spreaders. We don’t want to be spreaders.
I’d be interested in a conversation about the fallout from isolation though — I’ve already heard of hotels and event centers laying off employees as their calendar full of paid events disappears, and friends and family are nervous that their jobs in the retail and service industry (at mall clothing stores, filling up vending machines in malls, schools, and other public places, at restaurants, etc) are about to vanish as those companies lose revenue due to the closures.
I agree with you that social isolation is important, but I think it’s worth mentioning that for many people prep for an event like this ought to be for the measures needed to get rid of it as well as for the pandemic itself.
I agree in concept about getting rid of it… but for viral diseases, I don’t know what that looks like on a personal level. Beyond self-care to keep good underlying health, which is a MAJOR prep that many overlook but we harp on a lot. As for the economic impact, it is a trade of economics for lives to some extent. And since home economies do also impact long-term survival, it’s not as easy as saying “always lives first”.
Here’s the thing about the closings, though. If we make no effort to slow this, we probably see a strong majority of the population sick at about the same time. That’s likely to mean a lot of things have to close anyway. Even though 80ish % of infections are mild; that’s still a cough and fever with the option to upgrade to pneumonia. Heading out to a restaurant or ball game like that isn’t attractive to most; wisdom of it aside.