To Beat COVID-19, Social Distancing is a Must
Posted on by Dr. Francis Collins
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
Questions on Covid-19
1. don’t have washer and dyer. Hand wash ok?
2. Walk am and pm. keep away and try not to touch anything , keep 6 plus distance. OK
3. back home what about clothes, etc since I don’t have washer. Take shoes off immediately plus clothes and change?
4. Tooth brush. peroxside?
5. best disinfectant: choride, lysol, alcohol (70% and above or 90%)
6, Need to Meditation
Lastly, thank each of you for your service and stay healthy & safe
Thanks for your comment. You can find answers to many of your questions, along with a variety of other resources on protecting yourself and your loved ones from COVID-19, at this NIH web site: https://www.nih.gov/health-information/coronavirus. Keep safe!
Even in Germany there are already “Ghost Citys” … On the other hand, like in Munich, the people are enjoying the good weather. I think there is no way for a nationwide lock down – the best practice for Social Distancing?
Thanks for the link below. A 20-second-long hand-wash is enough I think?
Is there any chance that those of us with cats as house pets could have antibodies to help patients who have severe illness?
Kitties who are malnourished or sick can get a different form of corona virus- a fatal untreatable condition called FIP/ feline infectious peritonitis . It is not passed on to humans. I have 6 rowdy adopted street kitties including 1 whos daddy must have been definitely a mafia don – all who drive me crazy. They were all tested for the COV and negative when I adopted them. No one is ever let out of the flat and I suspect big time fights going on in my absence. Wished I could understand their language
I am just trying not to go out and the doctor is going to be doing a Telemedicine Appt, but I am very very concerned about the medications prescribed and getting enough to last through this long time of uncertainty? My family is living in Bergen County-, the HotZone “ Holy Name Hospital 🏥 is closed!?!
The medication “ Hydroxycholoroquoinre ? ( spellcheck?) is the Drug my sister-in-law is on for Lupus; but the adverse effects are the very important issue of just prescribing to the public!?!?
This issue has so many elements to it. I had no idea of the economic impact until reading an article from an Economist in South Australia (Adelaide) … talking about the fallout.
I feel like we will get more indirect deaths by people becoming jobless, homeless, cashless etc and thus the economic side is far worse than the actual virus.
How do we get our medicines from the doctor and how long is this going to last assault time are long-term and how about the schools when are they going to be reopen far children to have education to learn for now they’re in the house and most of all staying in the house or staying out of the house but not leaving is that okay
I am a healthcare worker, on behalf of all of us, I thank you all for work the National Institute of Health has done thus far in this unprecedented time our country is facing. However, I do have a question. In today’s White House press conference Dr Fauci showed a chart of 15 steps to curb the transmission of Covid-19. Can I obtain a copy of those 15 recommendations?
Thanks for your comment, Maria. You can find answers to many of your questions, along with a variety of other resources on protecting yourself and your loved ones from COVID-19, at this NIH web site: https://www.nih.gov/health-information/coronavirus. Keep safe!
An enlightening update from Dr. Collins, Director NIH, USA, highlighting the critical clinical aspects of the emerging global Coronavirus pandemic Covid-19; viral replication, person-to-person human transmission, symptomatic manifestation as evident in the Covid-19 screening, timely identification of at-risk susceptible population-subsets of varying genetic landscapes, physician-patient ethical interventions, quarantining, social distancing and eventual treatment protocols, including innovative development of patient-friendly Covid-19 specific vaccines, are warranted to provide eventual clinically significant outcomes with diminished morbidity-mortality trends in Covid-19 on a global platform.
Public health experts and policy-makers should promote cost-effective Covid-19 prevention protocols with a specific aim/objective to implement patient-friendly quarantining/social-distancing/vaccination/treatment interventions with scientific integrity; moreover, Covid-19 awareness campaigns should be organized for strategic and successful timeline-driven Covid-19 control, prevention and eradication in populations worldwide!
Does heat and humidity helps to slow down the virus spread?
In regards to the shortage of face masks for healthcare professionals, has anyone considered the military masks? I do not know what they are called, but I am thinking about the hard masks. If these masks still exists, can a mask be distributed to 1 per healthcare provider and then disinfected in the bleach water solutions before reused?
I tried to buy some N95 masks for $200. They came from Canada and the U.S. Customs and Border Protection cut into the package, so they had to be thrown away due to questionable safety.
Has anybody ever considered money? I mean, the dollar bill. Cash money or paper money? Money changes hands daily. Could it be possible for this Coronavirus to be hitching a ride on something used everyday by so many people worldwide with the highest transfer rate between people than most any other object?
People don’t really hand over credit or bank cards, but the paper money changes hands so much in just one day that the possibilities are there, Right?
Could this possibility perhaps explain the widespread transfer of the Coronavirus? I mean, how often does anyone think to disinfect money? Even if laid down on a counter at a store for a cashier to pick up, does the cashier not gain the potential risk of also picking up the Coronavirus?
Scary. Now even most cards have to be swiped with some exceptions that have to be just touched or if using a mobile or cash wallet. If the authorities can introduce a scanner for cards and iris scanner for confirmation- sounds far fetched but possible. Now even credit cards that are swiped – suggest use a disinfectant tissue to wipe. As usual everywhere in the world- the poor will suffer the most- most would not even have a credit card; let alone money …
I NEED TO SUGGEST USING UV LIGHTS TO SANITIZE AND RE USE MASKS WHERE ,WHO AND HOW CAN I DO THIS
Since “germs” were named as a vector, standard policy to limit transmission of any infection has included finding the source (i.e., the current novel corona virus), avoiding unnecessary exposure (i.e., social distancing), cleanliness (Mama always said to wash your hands). When the peculiar characteristics have been identified (methods of transmission, detection protocols, symptoms, risks to life or disability, primarily vulnerable population) possible treatment or prevention options can be offered and their effectiveness can be evaluated.
An open exchange of information can assist this process. Unfortunately the public perception and interpretation of information often negates common sense. Many people have question or concerns – why must it be reported as a PANIC? If anyone does read this comment, please make an effort to object whenever public or social media overextends their verbiage:
Use of repeated images of “disinfectant”(?) being sprayed on sidewalks and street signs
The TV commentator says that “Governor recommends” and the onscreen lead line reads “State has ordered”;
The number of deaths in an area where no testing was done are reported as “caused by”;
“Patient denied a test” vs.”viral exposure wouldn’t make a difference in patient’s treatment.”
Are ratings or the number of hits on post really that important?
Good evening from Washington DC.
I need your guidance. While we are facing this challenging times, Church leaders bend the rules to comply with government and health officials working to stop the spread of the coronavirus pandemic, some commonly held practices are being called into question. The universal “Orthodox church” is currently under fire for sharing communion cup, spoon among congregants amid pandemic. In Australia, the country’s medical association (AMA) said Orthodox churches are putting their believers at risk by using the same spoon for hundreds of congregants to sip wine during communion.
Concerns about the impact of religious services have grown after it emerged that the husband of the first person to die of coronavirus in Poland was working as a priest’s aide and had given out Communion at a church. People who attended that Mass are now in quarantine.
We the believers strongly believe that the Body and Blood of Jesus heals the physical and spiritual ailments. However, we believe that the shared spoon from infected mouth to mouth, shared chalice, and shared hands from mouth to mouth administering the Holy Communion WILL spread the Coronavirus. As we are trying our best to Stop the Spread of this disease in our nation, please I beg for AMA to issue some strong opinion on this matter as soon as possible as Australia’s AMA did above. I am so grateful for your kindness and support.
This is the first ever pandemic to be a Coronavirus. This virus is record breaking! American schools and colleges haven’t had to ‘black out’ like this for a few years, or decades, and when they did, there was no school at all (there was no tech, duh). I’ve spent a lot of my spare time this month just researching this virus. Heck, I thought of this theory Greenland is hard to get infections, but it has a few cases. And about payments. How is everyone going to get their money? This virus is going to be sticking around for a few months, we can’t have everyone run out of money, and then food.
Question about coronavirus: what types of masks, if any, can be washed with soap and water?
… Thanks god you finally recognized this after China warn the world 2 monthes.
Such good content and relatable posts, keep sharing. Thank you!
Dr. Anthony Fauci has stood with our political leaders and has ably represented the viewpoint of scientific community. Some leaders, however, view him as presenting only the harshest solution to this pandemic(i.e., social distancing). Our very limited capacity for testing, not Dr. Fauci, has made social distancing our principal tool for containment. Now that rapid point-of-care diagnostic tests have been FDA-approved, the public needs more education about how combining social distancing with contact tracing might eventually prove successful at containment— particularly in areas that do not yet have a high disease prevalence. More public health officials, both national and at the state level, should supplement Dr. Fauci in explaining how social distancing combined with contact tracing works.
WHY WE CAN AND SHOULD TEST ASYMPTOMATIC PEOPLE FOR COVID-19, AND AS MANY PEOPLE AS WE POSSIBLY CAN
As I this is written, late March 2020, the Covid-19 pandemic is still in its early stages but is already wreaking havoc in our personal and economic lives. We are deluged with information and opinion about every aspect of the pandemic, including testing. The discussion of testing generally centers on the need to test people with symptoms that might be Covid 19, and on the shortage of adequate numbers of test kits. These are valid points, but two aspects are generally being neglected. These are the benefits of testing asymptomatic people and the relative lack of expense in doing so. Based on the costs charged to insurance we can estimate tests at $50 apiece. That cost indicates we could test each of the 330 million people in the United States for about $16 billion. While that is real money, it is a very small fraction (about 1%) of the approximately $2 trillion appropriated by the Federal government to tide the economy over until it is safe for people to interact normally. But when will it be safe? Because vaccine development is relatively predictable, we can be fairly confident that an effective and safe vaccine will be available sometime in the spring or summer of 2021. If an antiviral effective against Covid-19 is available before then that will be wonderful but is not to be counted on—this would be unprecedented speed for development of an antiviral effective against a newly emergent virus. Most likely, under present state of the art in treatment, degree of testing, and strategy of testing, we will need social distancing well into 2021. But the social distancing we are doing now is wasteful, because we are separating people from each other not because they are infectious but because they might be infectious. To the extent that we can reliably identify who actually is infectious, we can quarantine only the infectious and permit the non-infectious to resume normal interactions and restoration of normal social and economic activities—in short, we can chart a path back to normal and productive lives. Until a vaccine is available, we may need to test individuals several times in order to verify continued freedom from infection, so the total cost might be $50-60 billion, which is still far lower than the continued costs of not knowing the infectious status of individuals.
Of course, on the way to testing everybody, initial priority should be given to people in essential occupations, especially health care providers in contact with patients, and other essential workers who must interact with each other and with members of the public. And then contact tracing, beginning with those high risk people. But the ultimate goal should be to test everybody. Various reasons have been given for the inadequacy of testing so far, including scarcity of materials to go into test kits. It must be understood—there is nothing inherently scarce about the materials needed for testing. The scarcity has been the lack of will so far to give comprehensive testing the priority it should have—indeed, must have—to restore our society to health and functionality.
Yes sure. Definitely the social distancing will be a big positive change that can effect the non spreading of Virus to a greater extent. With that also our hands face etc should be cleaned at some intervals in a day for keeping fresh and chance for affection of virus into our body.
Thank you so much for such awareness articles.
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BTW, we need to stop calling it “social distancing” and start calling it “physical distancing” with “social friendliness” or even “affection”
In trying to come up with a treatment, someone should look at Europeans with the genetic mutation known as CCR5-Delta 32. 10% of the population is resistant to HIV, steaming for this mutation that was from a British town that survived the 14th Century black death plague. (Scientists now think it wasn’t bubonic plague but a viral plague.)
Would those people be immune from CoVID 19? Could their blood or bone marrow be used to save our sickest or even prevent issues?