Social distancing? Quarantine? Lockdown? Take a breath… now take another, and read on:

I thought you might like to see some of the data being used to inform public health decisions being made across the country.  

Here is a news article summarizing a preprint (not yet published) of data from small sample sized cohort of coronavirus patients: https://www.statnews.com/2020/03/09/people-shed-high-levels-of-coronavirus-study-finds-but-most-are-likely-not-infectious-after-recovery-begins/

The study looks at viral shedding over the course of an infection. Viral shedding is how much virus an infected person releases into the environment, and knowing the timing and amount of shedding over the course of an infection is critical in helping public health officials make appropriate decisions about how to manage an infection.  For example, if a person is not shedding virus until after they definitely feel sick, identifying and isolating sick people can stop the chain of infection.  IF, however, people are shedding virus BEFORE they feel obviously sick, isolating sick individuals will do little to nothing to reduce infection rates.

You will see from this article that in the earlier SARS outbreak (2002-2004), which was successfully ‘shut down’ by quarantining a very limited number of people, viral shedding only happened well into the progression of the disease.  In COVID-19 infections, however, infected individuals shed large numbers of virus before they feel fully sick. Worse than that, one study showed that, while the coronavirus particles can stay viable in air for minutes to maybe an hour, once they land on a surface they can stay infective longer: on cardboard for less than a day, but up to three days on STEEL and PLASTIC surfaces. In this case, identifying and quarantining sick individuals will fail to contain this virus, and that is exactly what we are seeing happen. The only way to tackle a situation like this is to reduce EVERYONE’S social contacts, even if you are feeling healthy. (Link for that info: https://www.livescience.com/coronavirus-can-spread-as-an-aerosol.html)

I hope you see now that, while they are freaky and anxiety-inducing, the closures and quarantines being put in place throughout the country and the world are not because this disease has a scary high mortality rate (like ebola) or because it will turn us all into zombies. Rather, the only way to get ahead of this infection is to break infection chains we don’t even know about, and the only way to do that is to reduce the total number of contacts each individual person has, and to keep those contacts local and predictable.

The ultimate goal of these policies is to reduce the rate at which infection numbers rise. Most people who are infected (and many or all of us will catch this), will be absolutely fine. In fact, children, teens and twenty-somethings rarely experience more than flu symptoms (or even no symptoms at all). People over 60 have an especially hard time with this infection, and are more likely to require hospitalization or even intensive care intervention.  As a country (and a global community) we need to make sure we have enough HOSPITAL BEDS for the seriously ill.  If this infection spreads as fast as it has been, ALL COUNTRIES will exceed their health care resources, and people will die who might have been saved if ICU facilities had been available. So, as a nation, and as a world, we need to look out for each other and SLOW THE SPREAD, reducing the number of people who are seriously ill at any given time to under our maximum health care capacities.

So take care of those around you, in your own town, and in countries on the other side of the world, by SOCIAL DISTANCING and LIMITING THE NUMBER OF PEOPLE YOU COME INTO CONTACT WITH. Make your life small, socially. You can still hang out with friends and family but make that group small, and contained (people in the group only hang out with each other, and not other groups). You can call, text, message, FaceTime or Skype as much as you want. You can spend as much time outside as you want, as long as it is in areas where the density of people is low. And if you touch or handle things others outside of your group have touched (especially metal or plastic), WASH YOUR HANDS! Face masks and gloves are not helpful to prevent infection because most people pick up this virus from touching things and then touching their face (eyes, nose, mouth). If you wear gloves and a mask, but touch your eye (or nose) with your gloved hand, you can get infected.  However, if you are NOT feeling well and need to be outside of your home, wear a mask to limit how many viral particles you shed onto the surfaces around you.

This isn’t going to resolve quickly.  There is no ‘quick fix’ around the corner.  Exercise patience, resilience, and flexibility.  We are in this one as a global population.  Truly this is remarkable moment for all of us.  Let’s approach it with the best energy and intentions we possibly can.

All the best,

Erin

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