Image by Lowell Sun/Julia Malakie
03/26/2020
Lowell Sun
By Meg McIntyre
LOWELL — In the face of a global pandemic of COVID-19, officials are urging citizens to practice social distancing by staying home, avoiding gatherings and maintaining a minimum six-foot distance from others when they do go out.
But if social media posts are any indication, some are skeptical of the necessity of these precautions — an attitude experts are warning could substantially decrease the effectiveness of the measures.
The Sun spoke to local experts Benjamin Levy, assistant professor of mathematics at Fitchburg State University, Jennifer Nicoloro, clinical assistant professor and director of the undergraduate medical laboratory science program at the University of Massachusetts Lowell, and Laura F. White, associate professor of biostatistics at Boston University, about the importance of social distancing and what it should look like at this point in the coronavirus crisis.
How does social distancing help combat the spread of COVID-19?
Nicoloro and White said that scientists look at infectious diseases in terms of a measure called R0, which represents how many people, on average, a person with the virus will infect. In the current outbreak, that number is thought to be roughly two to three people.
But the number isn’t set in stone — it can be lowered by limiting contact with others, and the goal of social distancing is to reduce the rate by as much as possible, they said.
“The social distancing measures will slow the rate of the spread of infection so that hospitals can have a more manageable number of patients to care for, just over a longer period of time,” Nicoloro said. “This may sound silly, but it is the difference between doctors having to make war-time decisions on triaging sick patients and determining who to treat, and who not to treat.”
She noted that the coronavirus that causes COVID-19 is a “novel” virus, meaning that until now, no human had ever been infected and, as such, all are susceptible to it. Slowing the spread and limiting physical interaction helps protect those most vulnerable, such as the elderly and those who are immunocompromised, from coming into contact with the virus, she said.
Levy, whose past research has focused on modeling infectious diseases, said interventions such as social distancing are typically based on mathematical models that look at the spread of the disease and examine how different factors could affect the potential outcomes. He compared such a spread to the spread of a forest fire.
“If you wanted to have a fire, you need two things: You need heat and fuel. Well in a disease situation, the fire is the disease, and the wood would be people who are not sick,” Levy said. ” … The way you put out a fire would be to extinguish the flames, is one option, so that would be likened to a vaccine or some kind of cure. Or, another way you can put a fire out is by separating the fuel from the flames.”
White emphasized that at this point, removing the fuel by social distancing is really the only effective countermeasure available.
“The less contact you have with other people the less likely you are to infect other people or be infected, and that generally helps to really start bringing that (R0 figure) down in absence of a vaccine or other treatment strategies, which we just don’t have right now,” she said. “That’s kind of our only tool we have.”
Are strict social distancing recommendations an overreaction?
The short answer from the three experts: No.
White said everything we know about the virus so far indicates that communities must do everything they can to help limit the spread, and said that we likely won’t start to see the effects of the interventions that are already happening for several weeks.
“I think we need to look at Italy, we need to look at the kind of measures China’s had to take to appreciate this is really serious. And like I said, I hope like crazy we have completely overreacted. That would be wonderful news,” White said. “But I don’t think we are.”
When thinking about social distancing, Nicoloro said it’s important to keep in mind that some who contract the virus are asymptomatic and may not be aware they are capable of spreading it, especially because the virus’ incubation period is “upwards of 14 days.”
She stressed that people should follow the guidance of doctors and public health officials who are trained for the current situation.
“I have personally seen many people guilty of not taking the social distancing measures seriously, which is, quite frankly, selfish and dangerous,” Nicoloro said. “A cavalier attitude about the measures, particularly those that have the attitude that it won’t affect them too seriously, and will be nothing more than a bad cold, is dangerous because normal behavior and interactions with multiple people almost guarantees that people harboring the virus will spread it unknowingly to others and the environment.”
Levy also pointed to his previous research on the spread of Ebola, noting that early projections indicated there could potentially be about 1.4 million cases of the illness worldwide within a few months. This resulted in ramped up response efforts, and far fewer cases ultimately emerged than had been projected, he said.
“All that hubbub, all that commotion that was made from the projection, in my opinion, really contributed to the reduction in the cases from 1.4 million to 29,000,” Levy said. “So these kind of, what might be perceived as overreactions can also be really important in (controlling) spread of the disease.”
So what should social distancing look like at this point?
President Donald J. Trump has already urged citizens not to gather in groups of 10 or more and Gov. Charlie Baker has issued a stay-at-home advisory, but some are wondering if they can still safely visit each other or gather in smaller groups. From Nicoloro’s view, it’s safer to stay in unless going out is absolutely necessary.
“If people do not need to go outside for any reason, they should simply stay at home,” she said. “It is reasonable to pick up essential items like food or medications, but otherwise people have no business being out of their homes. Many cities in the U.S. are already telling their populations to ‘shelter in place.'”
According to White, if you do choose to see others in person, it’s safest to do so outdoors and maintain the recommended six-foot distance. The general guidance is to spend time with family and friends via phone calls and video-conferencing rather than visiting each other’s homes, she said.
“I think a term people are using that I like is rather than saying social distancing, let’s just say physical distancing,” she said. “We need to keep our social ties up, but we need to keep the physical distance.”
White acknowledged that this physical separation can come with feelings of isolation or loneliness, and while dealing with those emotions isn’t her area of expertise, she noted that modern technology has given us more ways to connect than ever before — and we should utilize them.
“I think contrasting to 1918, really the only other pandemic we can look at that looks kind of comparable in scope to this, people were a lot more isolated then. It was very devastating. And I think we have the benefit now, we do have ways to stay in touch,” she said. “That’s really important.”
More information about social distancing and combating the spread of COVID-19 is available at www.cdc.gov/coronavirus.