Social Distance: Prevent Spreading Covid-19
We all have an inherent gut reaction to keep away from disease; and that reaction has served us well. The comments in response to a post on restricting movement during pandemics got me thinking about how we translate that natural aversion to disease into action. Now that we know more about how people catch diseases, we can refine the notion of ‘social distance’ to make it more effective.
What is ‘social distance’?
Public health people use the term ‘social distance’ to mean keeping away from other people enough to stop disease transmission between them. The ‘don’t be in a crowd of strangers’ part makes perfect sense to us. That literal interpretation also does a lot to reduce disease transmission. There’s more to it, though.
Social distance, from the germ’s point of view
Germs pass between people by four main routes.
The most effective way to catch any germ is by getting their body fluids mixed in with your body fluids. If you have to get this intimate to catch a disease, it’s usually considered an STD (sexually transmitted disease) because that’s the main way non-health-workers get intimate contact with somebody else’s body fluids. Social distance for a germ that needs this route might be kept even when you’re giving the infected person a big bear hug. HIV and Ebola virus use only this route.
This is still appropriate social distance, for some germs that need direct body fluid transmission.
Some germs hitchhike on insects or other animals to get from host to host. Social distance in this case is best kept from the mosquitoes or ticks or whatever. Sharing a bench with a person with malaria or Lyme disease will not get you sick.
For some diseases, you need social distance from the mosquito, not the person who’s being bitten.
Other germs travel wonderfully on little drops of spit or nasal mucus. One person coughs or sneezes the little droplets out and they get inhaled by the next victim. This is one place where our basic feel for ‘social distance’ really helps. Sharing an elevator with a coughing person sure *feels* like our social distance is being violated; and yep, we’re getting exposed.
The new coronavirus, COVID-19, is most often transmitted by this route.
Social distance for the worst epidemics looks a little different
The worst epidemic diseases use an even sneakier transmission route. They go dormant outside of their hosts and survive for some time out there in the inanimate world. Eventually, some sucker comes in contact with the dormant germ and starts spreading it to other things they touch. Eventually it lands in another host and its Game On.
Colds and flu viruses mostly travel this way, although they can use the ‘direct sneeze’ route. Many of the nasty hemorrhagic fevers do too; although thankfully they’re not as robust in their dormant state as cold and flu viruses. This means most of the hemorrhagic fever viruses will die before the new host can pick them up.
I shudder to think about what the epidemic would look like if Ebola was as easy to catch as a cold. The new coronavirus, COVID-19, can be transmitted by inanimate objects in this way. Thankfully, it’s not terribly robust (details are still hazy) so it isn’t great at passing by this route.
Social distance for a touch transmission disease
Here’s one place where our natural understanding of ‘keep away from sick people’ isn’t quite sufficient. Suppose there’s a plague on, so you’re ordering your food in by mail order. Some sick but valiant soul drags her tail into work; neither snow nor rain nor dark of night nor a fever keeping this carrier from these her appointed rounds. She coughs onto your package as she puts it in the truck.
Pick up that package and scratch your nose, and you’ve just lost social distance with a dozen random strangers.
You peer out of your curtains, seeing the mail get dropped off but not wanting to interact with people during a plague. Then you go pick up the package, scratch your nose, and get the germ. Social distance fail.
Keeping social distance from touch transmission
The good news is, the staying away from high traffic areas and crowds still helps here. Germs don’t live forever on surfaces (it varies by germ and conditions), so the most infective objects are found where there have been a lot of people lately.
The bad news is you have to think about everything you come into contact with that’s been out in the germ-filled world. Doorknobs, elevator buttons, remote controls in hotel rooms, sure. But also the mail, the paper handed to you by a co-worker who has a toddler (lovable little germ spreaders), the plastic wrap on the outside of that individually wrapped sanitary spork that came with your takeout.
How do you protect against All that if you can’t be a total hermit?
The last bit of social distance
If the germ never makes it to your mucus membranes — inside the mouth or nose most often — you generally stay well. You have control over that last few centimeters, if nothing else.
Hand wash often, and always right before eating. I know we say it a lot, but that’s because it works. Hand sanitizer is a good second choice if washing’s unavailable.
Become aware of how much you touch your face, and stop it. Don’t think you do this? Well, maybe; but here’s something to try: Ask a friend or family member not to touch their face or put anything in their mouth. Just hang out with them for a period of time; anything longer than a couple of minutes.
Pay attention to what they’re touching. Pay *close* attention; these behaviors are so ingrained in all of us we often don’t even notice when we’re watching someone else do them. Or take a look at this link that reports some observational studies. You can learn to break the habit, as all of us who work with sterile conditions have had to, but it takes effort. Train it now and you’ll have the habit when you need it.
Redefine social distance to stay healthy without having to be a hermit
The brute force ‘no strangers allowed’ approach to social distance isn’t a reliable answer, by itself. Germs find a way, and most disease transmissions are not among strangers anyway. They’re among family and friends.
Instead, think about keeping social distance between everyone and your mucus membranes and you’ve got a much better shot at staying healthy. Plus, you don’t necessarily have to hole up by yourself for some unknown length of time. Prep food cooking can get old.
Salty’s Note: In an article that this one supercedes here on 3BY on a similar subject, our regular reader and sometimes contributor Michael made the following comment I wanted to share:
Michael: Keeping your immune system as strong as you can, all of us are constantly exposed to various germs but a strong immune system works well for most things. Good nutrition and sleep habits are basic.
Avoiding the unwashed hands to nose, eyes and mouth contact eliminates the most common vector for bad bugs. Train that habit into your family to reduce intra family exposures. Social distance/avoidance is a good idea but hard to pull off all the time. Although a M95 mask is nice (If Socially Awkward) even a simple scarf over your nose and mouth when someone is coughing is pretty useful.
Having an medical isolation Kit and procedures already worked out to isolate family members when they look sick or were likely exposed to bad bugs can reduce effects and allow the healthy family members to help them recover. If most or all of your family is down who keeps the sick care, firewood, water, food and security going? Planning ahead with easy to cook foods, water and ready split-stacked firewood etc. helps when things go south.
