The COVID-19 pandemic is unlike any other experienced by Americans since
the great 1918 influenza epidemic which killed 675,000 Americans. COVID-19
is a coronavirus similar to viruses that cause not only the common cold but also serious epidemics like SARS (2003) and MERS (2015). Both emerged
from animal coronaviruses that “jumped” into human populations and mutated
to facilitate human-to-human transmission.
COVID-19’s name comes from Corona Virus Disease 20 19 and causes symptoms nearly indistinguishable from seasonal
influenza (the flu). This usually means cough, fever, sore throat, and
shortness of breath. But unlike the flu, COVID-19 is about 10 times more
dangerous (as measured by the proportion of people dying), and perhaps
about 1.5 times more infectious. Those individuals over 70 and with medical
conditions such as cardiovascular disease, diabetes, and whose immune
system is compromised are at much higher risk of dying than other
individuals. Younger healthy persons may just experience mild symptoms and
therefore, as a population, may act as “carriers” of COVID-19 as they feel
well enough to be out and about but will spread the virus.
The major concern of all medical and governmental health experts is that
COVID-19 is not only more infectious and more dangerous than the flu virus but is also a completely new virus to human populations. This means no one
has proper immunity against COVID-19. Even with influenza vaccines, it has
been estimated that 29 million Americans may have been affected by the flu
in 2019 through 2020. Many more would have been affected if we did not have
vaccines. If we assume the same number of infected individuals, we can
calculate that 435,000 Americans may die of COVID-19.
Others, using mathematical models of pandemic spread, have suggested that,
in the worst case, as many as 1.1 million Americans may die. With
approximately 1 in ten infected COVID19 cases requiring hospitalization,
this means that 2.9 million Americans may require hospitalization. Both
numbers are staggering and will have a huge impact on the health care
system.
It is estimated that there are 929,000 staffed hospital beds in all of The U.S. This means that if the pandemic is unchecked, there will be
insufficient acute hospital beds for COVID-19 cases let alone other
diseases. In addition, healthcare professionals are much more likely to be
infected than other people, which will result in a simultaneous reduction
in the medical workforce to care for patients.
This is why the country is finally mobilizing – to prevent a disaster.
Since vaccines and anti-virals are still being developed, we currently have
only one tool to work with: social distancing. The concept of social
distancing is to increase the space between individuals so as to reduce the
probability that the virus can transfer between human beings. This
distancing can be accomplished by physically keeping away from others or,
in the case of COVID-19, to stay greater than 6 feet from the next person.
Distancing can also be accomplished by blocking viral transfer by wearing
gloves, proper handwashing and cleaning surfaces.
Social distancing helps protect
you from getting the virus and becoming sick, but some feel that COVID-19
is not that serious and question the need for any constraints. This
impression is further confused by the fact that mortality rates range from
1-4% depending on the region and the ability to test the virus in
populations. The WHO officially estimated a 3.4% mortality rate as of March
3 ranging from 1.6% in the US to as high as 7.9% in Italy.
Let’s match comparable activities for the risk of death. A 2% mortality rate
for COVID-19 infection is a 1 in 50 chance of dying. Sky diving has a 1 in
101,000 risk of death, boxing has a 1 in 2,200 chance, and airline travel
is barely even registerable. Only climbing mountains in Nepal (1 in 167)
and base jumping (jumping off high rise buildings at 1 in 60) come close.
How many would take a plane ride with a one in fifty chance of dying on
that flight? Even if those odds do not scare you, there is a one in ten
chance of being hospitalized with a serious enough condition to be in an
ICU. This now approaches the odds of Russian roulette for a serious but
non-fatal case.
The impact of social distancing is greater than personal safety alone. It
protects your loved ones and your community. Once someone catches COVID-19,
they are a danger to everyone else. By taking precautions to not catch
COVID-19 and not to spread the virus, you are protecting your friends and
family. Similarly, just as you would refuse to ride with a friend who is
drunk, you should tell your friend who is sick to go home.
Finally, social distancing is a proven means of reducing deaths in a
pandemic. This was shown in the 1918 influenza pandemic. When Philadelphia
experienced the first cases of the disease, the authorities downplayed
their significance and permitted large social gatherings. St. Louis imposed
social distancing by closing schools and theaters. The outcome was that
Philadelphia had a much greater death rate than St. Louis. Social
distancing interventions do work.
Except for individuals with medical conditions, the young (including children)
appear to have much milder symptoms. One could argue that social distancing
is not necessary for this age group. However, because COVID-19 is very
infectious, the young will bring the virus into homes where more vulnerable
family members may live – those with illnesses, and elderly parents or
grandparents. This is the reason why child care facilities and schools are
closed. This is also why large parties and summer breaks to crowded beaches
should be discouraged.
