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  • Lisa Reynolds, MD

Social Distancing and Coronavirus

3/14/2020, 8 pm

UPDATE

Worldwide: 154K cases, 5,700 deaths (126 countries)

US: 2.7K cases, 58 deaths (49 states)

Oregon: 36 cases, first death.

Save Lives: Flatten the curve

We are in a coronavirus pandemic (pandemic: an outbreak of disease that spreads across several countries and is then spread through community contact (not just from outside travellers)). This novel virus (never before seen and so there is no inherent human immunity against it) will likely go on to infect 70% of the world’s citizens. If we see a rapid increase in infected patients, including an increase in high risk patients, we will outstrip our medical capacity and the fatality rate will be high. If we can spread out the pace of infection, we can better take care of the sickest patients and save their lives. This is what we call “flatten the curve”.

How to flatten the curve: Implement the protective measure of Social Distancing

The only tool that has effectively slowed the spread of coronavirus has been social distancing. This is because the disease is spread from person to person through droplets expelled by an infected person by coughing or sneezing. These droplets then enter another human through eyes, nose or mouth. The droplets are often transferred via hands (the hands of the sick person touching the well person or vice versa or the well person picks up droplets from a surface and infects themself by then transferring droplets to their own eye/nose/mouth).

What is social distancing?

It’s just what it sounds like. Keeping people apart from each other:

Stay out of congregate settings: school, church, workplace, museum

Avoid mass gatherings: concerts, parades, conventions, theaters

Maintain a 6 foot distance from others, especially if one of them is ill

It is important to institute these measures BEFORE there is widespread illness, otherwise it’s too late.

How to achieve social distancing?

Community and government interventions

Governments: close schools (3/14/20: 13 states + Washington DC have ordered statewide K-12 school closures, including Oregon; many regional closures: Seattle area, LA, San Diego). Cancel school events

Governments: Ban large gatherings (OR and WA have banned gatherings > 250 people)

Governments: Encourage employers to allow telecommuting.

Leagues: cancel/postpone sporting events (NBA, NCAA, MLB, MLS)

Individual changes may be even more important

Work from home

Stay home when sick

STAY HOME even when well

Keep your kids home including home from daycare (in Oregon, schools K-12 and many universities are closed, but daycares are open). I’m particularly concerned about plans to increase the number of kids in a given daycare center. We need to think creatively - do staggered work shifts and therefore have staggered daycare shifts? Miss work. Delay the software project. Close down the coffee shop where we probably shouldn’t be congregating anyway. (See MONEY below - I know we need to help folks do these hard things.)

Social Isolation

Social Isolation is recommended for those at highest risk of severe and fatal cases of coronavirus.

Those older than 60 years old

Those with co-morbid conditions such as heart disease, lung disease, diabetes and suppressed immune systems.

These folks need to stay home. Order food and groceries in. Have very few visitors, if any. This includes people in nursing homes.

This is very disruptive!

Yes it is, but it’s our best chance to slow the spread and be able to adequately take care of and save the lives of those at highest risk.

How can we make this less disruptive?

Technology can be a second best substitute for in-person classes, church services, singing groups, business meetings, dinner dates.

Money. All of us will feel some financial hit, whether it’s a decrease in our savings and retirement due to the stockmarket downturn or decreased pay due to missing work. Some of us will not have the same access to food provided by our schools. The most vulnerable are at risk of losing their jobs and their homes.

AND This is where we see the best of people and the best of government. Neighbors are stepping up to help each other. The US House passed temporary paid sick and family medical leave and as well as monies for health care, food security and unemployment insurance (and guess what? The US Senate is expected to pass this.) Furthermore, the government has promised that coronavirus testing will be free. There is also talk of a stimulus package to stop or dampen the effects of the recession. Remember when we bailed out banks? LFG.

IN SHORT

STAY HOME WHENEVER POSSIBLE

WHEN OUT - STAY 6 FT FROM OTHERS

KEEP YOUR KIDS HOME

CHECK ON YOUR AT RISK NEIGHBORS AND FAMILY MEMBERS

THE LIVES YOU SAVE MAY BE YOUR OWN and those you love.

And remember - if you are about 75% good on this, it’s much much better than doing none of this.

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This website is written by Lisa Reynolds, MD, Portland, Oregon Pediatrician on the front lines of the coronavirus epidemic. Mom and daughter. Candidate for Oregon HD36.

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