Editor's note: In late March, the World Health Organization recommended using the term “physical distancing” to reinforce the need for people to remain connected socially while they remain physically separated to prevent the spread. Read more about this change in the Washington Post.
So, we’re all supposed to be social distancing. What the heck is that?
This weird new quasi-dystopic phrase has been at the top of every public health hit list as one of the best ways to squelch the new coronavirus currently cutting a brutal swath through the sick, the elderly and the vulnerable of the world, including those being treated for cancer.
While the term may be puzzling and new, the concept is actually quite old. We’ve been “distancing” ourselves from sick people for ages. Ostracizing people with leprosy was a harsh (and wrongheaded) form of social distancing back in the day. The strategy was used to much better effect in the influenza epidemic in 1918 where cities that quarantined sick patients and closed schools, theaters and churches cut their death rate in half.
Hunkering down is just something humans have to do now and then to keep weird new diseases from trying to take us out. But almost none of us have had to do it within our lifetimes so it seems incredibly odd, even in the increasingly disconnected internet age.
But look at the data. Take in the graphs, the number of countries involved (it’s at 125 now). In Washington state, where the U.S. outbreak has been the largest so far, scientists believe the number could grow to 64,000 cases by May if unchecked. It’s led officials to enact dramatic public health emergency restrictions.
COVID-19 is here. And without a vaccine or any known therapy, the resulting number of infections may quickly overwhelm hospitals and health care systems. Particularly since none of us have immunity to this virus.
Thankfully, we have myriad ways to stay connected when it becomes necessary to distance ourselves from each other in order to stop a rampaging pandemic in its vicious little tracks.
Many of us can telecommute, for instance, and stay in touch with our buddies and colleagues through a gazillion online apps. We can exercise with YouTube videos and take our classes online. We have books (or Kindles) and TVs with all kinds of programming plus grocery delivery and restaurant apps, some of which have even started offering "non-contact" food delivery.
Flummoxed at what social distancing in the 21st century even means? Or why we have to do it? Local public health experts and scientists at Fred Hutchinson Cancer Research Center are here to help. Read on for their insights on how we can work together to crack this coronavirus.
It’s an awkward term but it covers the basics. Stay away from others — literally.
Forget hugs and handshakes. Use foot taps or jazz hands or place your hand over your heart to greet friends and colleagues (best to skip the elbow bump). Work at home, if you can. Wear gloves when out and yes, wash your hands meaningfully (at least 20 seconds; song optional) and often. Travel with hand sanitizer and use it. Skip concerts, conferences, and the soccer game. Or as The Atlantic says, cancel everything. Prepare, don’t panic.
The Centers for Disease Control and Prevention advises those in communities where COVID-19 is spreading to “take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.” Check out their full COVID-19 guide here.
Stay home as much as possible, they recommend. Consider ways of getting food brought to your house through family, social or commercial networks.
Fred Hutch and Seattle Cancer Care Alliance infectious disease expert Dr. Steve Pergam agreed that avoiding crowded public events and gatherings and even limiting close interactions with friends and coworkers is imperative this year.
“I do this every year with respiratory virus season,” he said. “But this year, with the social distancing, it’s just more extreme because COVID19 is much more extreme. What people should think about now is how they can avoid being in a public group. That means staying home for movies and meals instead of going out. And having your pharmacy deliver your medications to your home.”
Pergam praised organizers who’ve already cancelled large events such as Seattle’s Emerald City Comic Con and SXSW in Austin and said many medical meetings and scientific conferences are also smartly cancelling or postponing events. Ditto for sports leagues, which are taking action to cancel or postpone games.
“We all need to model good practice,” he said. “We have to do these things. It’s critical to save lives.”
He also stressed these measures aren’t going to last forever. Just until the virus is slowed. They’re already doing much better in China. Acting quickly now saves many more lives later.
“It may feel funny to be doing this with about 1,000 cases in the U.S., but most major experts feel COVID-19 has spread much further than that,” Pergam said. “It comes in waves. And I expect the next few weeks to get much worse.”
Pergam said this doesn’t mean you have to become a total hermit.
“If you need to get out and walk your dog, that’s great,” he said. “Public spaces are fine, as long as people aren’t close by. But limit close interactions. If you’re 6 feet away, you’re OK.”
“Social distancing has proven to be one of the most, if not the most effective ways to slow and lessen the impact of an epidemic like this,” said Fred Hutch oncologist and public health researcher Dr. Gary Lyman. “Social distancing flattens the curve."
from Dr. Trevor Bedford
Look at any graph and you’ll see the lines of new COVID-19 cases in country after country rising ever higher. Cases are doubling anywhere from 2.5 to 8 days — scientists are hashing it all out as more and more data emerge. The more people keep congregating, though, the more they’ll continue to spread the infection on to others who will then do the same, inevitably overwhelming the health care system with seriously ill patients.
Hutch virologist Dr. Trevor Bedford said the social distancing moves by China “had a huge impact on the resulting epidemic. China averted many millions of infections through these intervention measures and cases there have declined substantially.”
“This suggests that this is controllable,” he wrote in a recent blog post. “We're at a critical junction right now, but we can still mitigate this substantially.”
Lyman, who’s also an adjunct professor of public health at the University of Washington, said one of the most important goals of social distancing is ensuring our hospital and health care systems don’t get swamped.
“If we can start doing this now, those who still get infected and need medical care can actually still receive timely and appropriate care and have the best chance of surviving,” he said.
And while cancelling events and self-quarantining will definitely save lives, the longtime researcher acknowledged it’s not going to be easy.
“Admittedly, this is one of the most difficult measures to observe and regulate, especially in crowded urban settings like Seattle,” he said. “It depends not only on your own adherence but also the adherence of those around you.”
— Fred Hutch / Seattle Cancer Care Alliance infectious disease expert Dr. Steve Pergam
Social distancing is not about you, individually. It’s about the collective “you” — society. It’s about cutting the chain of transmission. Not getting infected yourself and not infecting others. Or as one scientist currently working at home put it, “Why be a vector?”
Let’s say the virus infects you, but you don’t feel all that sick. So you go off to work or a movie or a party at a friend’s house where you hug a few folks and inadvertently infect two other people who go on to infect a few more, some of them grandparents, one with lung disease. It’s a potentially devastating outcome.
And it already happens all the time with the regular old flu.
Unfortunately, it’s happening much faster — and much more ruthlessly —
with COVID-19, which can spread even when people are asymptomatic.
Bedford, the computational biologist who’s been following the outbreak for months and was the first to genetically connect Washington’s community spread to China, refers to this type of spread as undetected or “cryptic transmission.”
All the more reason to stay home: You can actually save lives by sitting on your couch and watching "Outlander."
We break the chain of infection. We all do our part and avoid big groups, and as much as we can, each other.
We ask people who are sick — not the worried well — to wear masks if they have to go out in public. We remind people with runny noses that they’re probably suffering from spring allergies but just to be safe, tell them to stay home and not clog the health care systems.
We wash our hands, again and again. Soap and water (and moisturizer) truly are our friends.
And when the infection starts to spread more rapidly, we self-isolate even more than we normally do here in gray, soggy Seattle.
We put a hold on large gatherings, as Gov. Jay Inslee did this week. We close schools. We stay in and read or binge watch "The Crown" instead of going to that hot new restaurant. We call our doctor if we have a high fever. We Skype with our friends if we have high anxiety.
We look out for the vulnerable and make sure our elderly and immunocompromised friends and family have everything they need. We don’t hoard or treat people with cold or flu symptoms like they're zombies on "The Walking Dead." We keep in mind that every time we hang out together or go to public places, we put ourselves and those who are susceptible to coronavirus complications at risk. We try to connect with our best selves. We hold virtual happy hours, complete with "quarantinis." More tips on life in the time of COVID-19 from the Public Health Insider blog.
We make a huge but necessary change to our way of life, although to be honest, some people in this tech-saturated, infamously reserved city may not even notice.
“These measures won’t entirely control for contact transmission associated with contaminated surfaces,” Lyman said. “But they can reduce the potential for accidental airborne transmission of the virus from a cough or sneeze or normal social interaction.”
Every effort makes a difference, Pergam added, “but the more you do the better.”
These kinds of actions are as low-tech as you can get, but they work and work immediately. And it's what we have to do, Lyman said.
“Social distancing is one of the truly effective and cost-effective measures we can all commit to and ask others to do, as well,” he said. “We truly must act now.”
Diane Mapes is a staff writer at Fred Hutchinson Cancer Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at email@example.com. Just diagnosed and need information and resources? Visit our Patient Care page.
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