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To Beat COVID-19, Social Distancing is a Must

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Even in less challenging times, many of us try to avoid close contact with someone who is sneezing, coughing, or running a fever to avoid getting sick ourselves. Our attention to such issues has now been dramatically heightened by the emergence of a novel coronavirus causing a pandemic of an illness known as COVID-19.

Many have wondered if we couldn’t simply protect ourselves by avoiding people with symptoms of respiratory illness. Unfortunately, the answer is no. A new study shows that simply avoiding symptomatic people will not go far enough to curb the COVID-19 pandemic. That’s because researchers have discovered that many individuals can carry the novel coronavirus without showing any of the typical symptoms of COVID-19: fever, dry cough, and shortness of breath. But these asymptomatic or only mildly ill individuals can still shed virus and infect others.

This conclusion adds further weight to the recent guidance from U.S. public health experts: what we need most right now to slow the stealthy spread of this new coronavirus is a full implementation of social distancing. What exactly does social distancing mean? Well, for starters, it is recommended that people stay at home as much as possible, going out only for critical needs like groceries and medicines, or to exercise and enjoy the outdoors in wide open spaces. Other recommendations include avoiding gatherings of more than 10 people, no handshakes, regular handwashing, and, when encountering someone outside of your immediate household, trying to remain at least 6 feet apart.

These may sound like extreme measures. But the new study by NIH-funded researchers, published in the journal Science, documents why social distancing may be our best hope to slow the spread of COVID-19 [1]. Here are a few highlights of the paper, which looks back to January 2020 and mathematically models the spread of the coronavirus within China:

• For every confirmed case of COVID-19, there are likely another five to 10 people with undetected infections.
• Although they are thought to be only about half as infectious as individuals with confirmed COVID-19, individuals with undetected infections were so prevalent in China that they apparently were the infection source for 86 percent of confirmed cases.
• After China established travel restrictions and social distancing, the spread of COVID-19 slowed considerably.

The findings come from a small international research team that included NIH grantee Jeffrey Shaman, Columbia University Mailman School of Public Health, New York. The team developed a computer model that enabled researchers to simulate the time and place of infections in a grid of 375 Chinese cities. The researchers did so by combining existing data on the spread of COVID-19 in China with mobility information collected by a location-based service during the country’s popular 40-day Spring Festival, when travel is widespread.

As these new findings clearly demonstrate, each of us must take social distancing seriously in our daily lives. Social distancing helped blunt the pandemic in China, and it will work in other nations, including the United States. While many Americans will likely spend weeks working and studying from home and practicing other social distancing measures, the stakes remain high. If this pandemic isn’t contained, this novel coronavirus could well circulate around the globe for years to come, at great peril to us and our loved ones.

As we commit ourselves to spending more time at home, progress continues to be made in using the power of biomedical research to combat this novel coronavirus. A notable step this week was the launch of an early-stage human clinical trial of an investigational vaccine, called mRNA-1273, to protect against COVID-19 [2]. The vaccine candidate was developed by researchers at NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and their collaborators at the biotechnology company Moderna, Inc., Cambridge, MA.

This Phase 1 NIAID-supported trial will look at the safety of the vaccine—which cannot cause infection because it is made of RNA, not the whole coronavirus—in 45 healthy adults. The first volunteer was injected this past Monday at Kaiser Permanente Washington Health Research Institute, Seattle. If all goes well and larger follow-up clinical studies establish the vaccine’s safety and efficacy, it will then be necessary to scale up production to make millions of doses. While initiating this trial in record time is reason for hope, it is important to be realistic about all of the steps that still remain. If the vaccine candidate proves safe and effective, it will likely take at least 12–18 months before it would be widely available.

In the meantime, social distancing remains one of the best weapons we have to slow the silent spread of this virus and flatten the curve of the COVID-19 pandemic. This will give our health-care professionals, hospitals, and other institutions more valuable time to prepare, protect themselves, and aid the many people whose lives may be on the line from this coronavirus.

Importantly, saving lives from COVID-19 requires all of us—young, old and in-between—to take part. Healthy young people, whose risk of dying from coronavirus is not zero but quite low, might argue that they shouldn’t be constrained by social distancing. However, the research highlighted here demonstrates that such individuals are often the unwitting vector for a dangerous virus that can do great harm—and even take the lives of older and more vulnerable people. Think about your grandparents. Then skip the big gathering. We are all in this together

References:

[1] Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, Shaman J. Science. 16 March 2020. [Preprint ahead of publication]

[2] NIH clinical trial of investigational vaccine for COVID-19 begins. NIH News Release, March 16, 2020.

Links:

Coronavirus (COVID-19) (NIH)

COVID-19, MERS & SARS (National Institute of Allergy and Infectious Diseases/NIH)

Coronavirus (COVID-19) (Centers for Disease Control and Prevention, Atlanta)

NIH Support: National Institute of Allergy and Infectious Diseases; National Institute of General Medical Sciences

48 Comments

  • Juan Manuel N. says:

    Hello, I´m a Graves-Basedow’s disease patient. I would like to know if I’m at a higher risk for my life from COVID-19. I have read that patients with health conditions have higher risk

  • Kirk Hullion says:

    Please show the large scale clinical trials with test groups to support the theory of social distancing.

    How do you know empirically that the virus had not already run its course and that social distancing did not have any impact to the overall hospitalization and mortality rate?

    Will we pass the 61,000 people that died from influenza alone last year and that was with a flu vaccine available?

    Will the loss of over 15 million jobs so far and the $2 Trillion deficit added to our budget not do more harm to people in the long run? Many social programs will be impacted for years to come with cuts to Medicare, Medicaid, Social Security and others that will kill more people than the virus especially for the Covid-19 high risk groups that badly need these programs.

    Just as no “cure” should be rushed into use without significant empirical evidence, social distancing forced with not supporting date not only stomps on the US Bill of Rights but will do more harm in the long run.

    • Jim Tobias says:

      Well, Kirk, I guess you got your answer regarding the # of deaths: 123,292 as of 23Jun — more than 2X the # who died from influenza last year. And the CDC’s national ensemble forecast (compiled from 21 individual forecasts) suggests there will likely be between 129,000 and 145,000 total reported COVID-19 deaths by 11 July …

  • Richard Gaylord says:

    Utilization of Limited testing resource (Covid-19)

    1. Hospitals should assume that anyone coming in with acute respiratory disease are Covid-19 positive; they should NOT test. They should begin tracking contacts as if any such patient IS positive. This will conserve tests by reducing tests for likely positive individuals.
    2. When there is a potential exposure and contacts are known, all contacts should be tested (insofar as resources allow). This will help to prevent those who are asymptomatic from shedding the virus without knowledge and moving into the public at large.
    3. The idea of two weeks quarantine is questionable… I have not found any data that would lead me to believe that anyone knows what the required quarantine period actually is. Is there data?

    Thanks for your difficult work!

  • John S Petersen says:

    Let’s use better language – we want physical distance, not social distance (WHO language). More than ever we need strong social connections maintained at a safe distance.

    • Cynthia Ramona says:

      Thank you for saying this! Agreed!!

    • Eve says:

      Agreed. It’s PHYSICAL distance not “social”. (Please Stop all the double speak and confusion…it’s very definitely NOT helping).

      Physical distance MORE than 6 ft (otherwise in a wide open space people try to get as close as possible often MIS-calculating one person’s 6 feet is another person’s 4. STAY OVER OVER WAY OVER 6 feet away. PHYSICALLY DISTANCE and MAINTAIN IT!

      Keep on the MASK too! (Also eyewear/goggles/safety glasses to protect yourself). Please stop speaking unnecessarily through your flimsy mask with gaps all around it falling off your nose…it’s ridiculous. USE masks with that are form fitted and not loose. Wear a mask and a bandana over it. Three layers of material is recommended.

      Cooperate this is not political. It’s life and death, for you AND your neighbor, and your family and friends and coworkers, and your doctor/nurse/maintenance person and their families, and your community members, and faith communities and everyone. No one knows how hard any one person will get the virus no matter who what where when you are, no matter your bank account or color or age, no one knows if tomorrow they will be struck with cancer or some other unfortunate ailment or disease that will render them, perhaps even more at risk of death, so do not be so arrogant, in denial, cavalier, reckless, senseless selfish and wicked. You aren’t allowed to walk down the street or in your buildings naked, you would be arrested, and this just for offending sensibilities not risking your or another’s life. We have speeding, seat belt and failure to signal tickets– we desperately need face mask tickets or fines and lose your drivers license or other privileges one has in our civil society.

  • Joymalya chakraborty says:

    We need to increase social distancing from 3ft to more in possible hot spots post quarantined, after lock down opens. A study reveals that for 20mins after sneezing the germ stays in a 10/10 room space. After lock down to non vulnerable spots we will see much casualties figures going down.

  • Mark says:

    Thanks for the article. No one knows how tough the pandemic will be on us. We need to know everything about it for the safety of ourselves and our loved ones …

  • Joe says:

    The government and most reports are claiming that distancing is extremely important aswell as other actions.
    It’s also stating what the symptoms are of the COVID 19 and to STAY HOME.
    We’re told that some people don’t show any symptoms at all but can still carry the virus. Hello, why aren’t people staying home that aren’t symptomatic ?
    Is it not possible that these people are spreading the virus without knowing it ?
    Also, if the elderly are more at risk because of weaker immune systems, how is this virus entering the nursing homes in the first place ?

  • Myreen says:

    Is the need for physical distancing greater indoors than outdoors in the sunshine? Are outdoor activities safer?

  • ABS says:

    I own a paintless dent repair company. I ask a lot of people, since I am often going to their homes, to lay down their keys on the driveway if I have to enter into their vehicles. Great read.

  • Frankie Chal says:

    How in the world did “NIH” funded scientists not figure Sars or SARS2 out? It seems like big sloppy government work like the VA system over the past 8 years. Following their trail of $$$ is not reassuring. The “distance plan” they are now producing and being over 1000% off on the statistics is another concern.

  • Dale Misiek says:

    All of this computer modeling is fine, but we all know how inaccurate computer models can be. Also, this paper in no way addresses social distancing as a data proven method of controlling disease spread. There are no controlled studies to prove effectiveness. The only answer the so called experts have is, “it makes sense”. We know that Sweden had it right when they did not employ social distancing. The only thing stay at home orders and social distancing did was increase the incidence of suicide, domestic violence, child abuse, alcoholism and drug abuse, not to mention permanently damaging the world economy.

  • Sam Sangeeth says:

    Lets maintain 6feet distancing for soon remedies

  • Eve says:

    Immediately Mandate and enforce (tickets/fines) face mask covering anywhere that a more than 6 feet distance cannot consistently and completely be maintained (children (ie; who can never suppress sneeze) especially over age 2, and adults). Particularly in multiunit dwellings/residences (condominiums, apartment buildings) in all halls, lobby’s, entering/exiting, elevators, stairwells, garbage, laundry, mail rooms, and other common air forced shared spaces. Until pandemic and threat is declared completely over.

  • Mounika Kotakonda says:

    Let’s stop moving outwards and maintain social distance to stop the spread of coronavirus. It’s very essential us to participate in stop spreading coronavirus through following some simple steps such as wearing masks, maintaining social distance, staying indoors for a while (till the spread stops) and eating healthy food to boost the immune system.

  • ljb says:

    dont tell me what to do its a free country I can do what I want

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