In the past week, mass gatherings have ceased nationwide. Restaurants, theaters and museums have shuttered, vacating the streets now suddenly silent. Residents of the Bay Area have been put under shelter-in-place orders, which direct them to remain at home as much as possible for the next three weeks. Recommendation from the federal government, issued at a White House news conference on Monday, advises Americans to avoid congregating in groups larger than ten people.
These strict measures all fall under the vague umbrella of social distancing—a swath of precautions meant to reduce close contact between people in hopes of slowing the spread of COVID-19, the viral pandemic sweeping the globe. But the specifics of this behavioral campaign aren’t always consistent, or easy to parse. Social distancing has officially blurred the line between social activities that are wanted and needed, leaving many wondering whether double dates, trips to the gym or playdates for their kids could be imperiling the wellbeing of others.
As Kaitlyn Tiffany reports for the Atlantic, even the guidelines put forth by the Centers for Disease Control and Prevention (CDC) acknowledge that a community’s size, density and health care access can shift the specifics, caveating that social distancing measures may “be scaled up or down depending on the evolving local situation.”
But many experts have advised erring on the side of caution, and taking a conservative approach. “It is better to operate under the pretense that there is transmission in your community already,” Syra Madad, an New-York-based special pathogens specialist, tells Leslie Goldman at Vox. “There’s going to be disruption to daily life, but we want people to feel empowered by this. The decisions you make will ultimately affect the trajectory of this outbreak.”
Here, we break down some of the basics of social distancing, and explore some oft-raised concerns.
Experts are saying we must aim to #StopTheSpread rather than just #FlattenTheCurve. So here's the new GIF by @XTOTL and me. Explanation & important links in the thread below. Please share far and wide & translate if you can! #Covid_19 #COVID2019 pic.twitter.com/E8p1jA6vA5— Dr Siouxsie Wiles (@SiouxsieW) March 14, 2020
Why social distancing works
At a bird’s-eye view, social distancing means putting physical distance between yourself and other people—in this case, about six feet—by steering clear of others and the crowded places they’re found. This reduces the opportunities SARS-CoV-2, the virus that causes COVID-19, has to hop from human to human. Though the specifics of this virus’ mode of transmission are still being worked out, it almost certainly spreads through airway fluids like mucus, including the spray of droplets produced when infected individuals cough or sneeze. (Even those without COVID-19 symptoms can pass viruses to others through the many mucus-y things that happen in winter and spring, when allergies and flus often spike.) A wide berth of six feet should, in theory, keep people out of that infectious splash zone.
In a simulation made by the Washington Post’s Harry Stevens, he powerfully illustrates how quickly infectious pathogens can spread within a close-knit population. Each newly infected individual becomes yet another starting point for a virus, leading to an exponential increase in illnesses.
The story features RANDOM simulations, so every time you read it, your results will change. Even with different results, moderate social distancing will usually outperform the attempted quarantine, and extensive social distancing usually works best of all. https://t.co/28CQLp0Xfc— Harry Stevens (@Harry_Stevens) March 14, 2020
But disease isn’t just a product of a fast-moving microbe: Pathogens capitalize on social species, who mingle and give germs plenty of chances to move from host to host. Isolating individuals from each other starves infectious agents like SARS-CoV-2 of these interactions, quickly curbing transmission.
Now more than ever, your home is your safehouse.
This is the physical space over which people have the most control: where they can clean surfaces, store supplies and practice self-care. People can continue to leave their homes to gather essential resources like medicine and food, ideally during off-peak hours. They can also go outside for exercise, as long as they maintain distance with others. (Working out indoors, perhaps with the help of an app or online video, is a great option too.) Haircuts and other non-urgent errands, however, should be put off, Marc Lipsitch and Joseph Allen of Harvard’s School of Public Health write for USA Today.
Those who have access to grocery or food delivery services may choose to rely on them, while being mindful of the risks posed to the people performing these services. As Carolyn Cannuscio, the director of research at the Center for Public Health Initiatives at the University of Pennsylvania, tells the Atlantic, delivery workers might want to leave items on doorsteps and ring bells to avoid face-to-face interactions.
Stay connected to others.
As Neha Chaudhary, a psychiatrist at Harvard Medical School, tells Apoorva Mandavilli at the New York Times, “Social distancing is not social isolation.”
The world is now more connected than ever, and many can greatly benefit from staying in close virtual contact with friends and family via emails, phone calls and webcams. And unless someone is sick, interactions within households can continue, with extra attention to hygiene-conscious behaviors, especially handwashing. But in large part, in-person gatherings like house parties, game nights and dinner parties should be cancelled or postponed whenever possible—especially if anyone is experiencing symptoms.
Some have raised concerns about play dates between kids—an option that many parents turn to when schools are closed. In an interview with Vox, Kate Vergara, a public health and infectious disease specialist based in Chicago and New York City, points out well-managed play dates are less risky than keeping kids in close quarters in classrooms. But these interactions should be preceded by a thorough wipe-down of frequently touched surfaces, and be punctuated by frequent hand-washing.
Well done, lads. pic.twitter.com/5BjgTM30XX— Ben Stanley (@BDStanley) March 16, 2020
Others, however, worry that even small playdates could defeat the point of school closures.
“The risks of underreaction are so much more catastrophic than the risks of overreaction,” Leah Lagos, a New York City-based psychologist, tells Vox.
To maintain mental health and to care for each other, limited visits from close family members who are young and healthy are probably okay, Jeanne Marrazzo, director of infectious diseases at the University of Alabama in Birmingham, tells the New York Times.
“The smaller the gathering, the healthier the people are to start with, the lower the risk of the situation is going to be,” she says.
The long haul
The positive outcomes from social distancing won’t be immediately apparent. Recently infected individuals, for instance, may not begin to show symptoms for days or weeks. We’re waiting for a negative situation to dissipate, which takes time.
“We are social distancing now to reduce the strain on our health care system several weeks from now,” Lipsitch and Allen write for USA Today.
As the pandemic continues to evolve, experts hesitate to forecast a timeline for social distancing measures. Even when transmission does begin to abate, the world shouldn’t necessarily relax: Doing so could ignite another round of infection before the virus is purged from enough of the population. While some sources cite at least a month of social distancing, the process could take much longer. At least one model forecasts that people will need to keep to themselves until a vaccine becomes available, which could take more than a year, reports Nell Greenfieldboyce for NPR.
Its effectiveness depends heavily on just how seriously people take social distancing. But a bevy of other factors could affect the evolution of this pandemic—for instance, whether the virus can reinfect recovered individuals, or if there is any seasonality to its spread. As scientists race to reveal these answers, many are cautioning the world’s residents to be mindful of what has always been in their control: their own behavior, and its role in halting transmission.
For now, the timeline for social distancing is “probably indefinite,” Marrazzo tells the Times. “We’re in uncharted territory.”