To Know Why Social Distancing is so Important, Do the Math
The Covid-19 pandemic has been contemplated for many years, especially when we faced the H1N1 flu in 2009 and the Ebola outbreak in 2013. The societal impact has been imagined in movies from “Outbreak” to “Contagion”. However, now that we are living in a real pandemic movie, the reality is overwhelmingly jarring. Nothing can prepare you for the level of personal anxiety, confusion, retracing of steps, paranoia, and fear that a pandemic causes. Any job insecurity, stress, anxiety, depression, and/or financial issues are now on steroids. The additional irony is that the solution is isolation, just when you need your family, friends and support systems the most. The escape of sports, going to a movie, going out for a drink or to a restaurant is part of the problem. In the midst of all of these disorienting emotions and impactful life changes, there is the sudden burden of the responsibility to be apart. In some cases, it truly is a life or death responsibility as shown by the horrible and gut-wrenching tragedy of 4 members of one family dying due to Covid-19.
Covid-19 by definition is a new, novel mutation of a coronavirus. Because it is new, there is much that we do not know about it. However, what we do know makes it one of the most dangerous viral pathogens we have faced in at least a century. The symptoms mimic a common cold or the flu. So it flies under the concern radar. How many times have we gone to work or gone out with a cold or mild flu symptoms? What is different about Covid-19 is that it is much more contagious than the flu and appears to be 10 times more deadly. There is no vaccine or treatment. And since it is new, none of us have immunity to it. If exposed, we will likely get infected. The good news is that studies show 80% will recover with no problems and can be treated at home. The bad news is that 20% will need to be admitted to the hospital and about 20% of those will require an Intensive Care Unit (ICU) admission. Around 2–3%, on average, will die, with a lower rate for younger patients and a much higher rate for older patients and those with chronic conditions. The fact that only 2–3% will die doesn’t sound too bad until you do the math. There are sophisticated simulations that portend the danger, but with just simple math you can get a sense of the risk. With around 209 million adults in America, if 60% become infected there would be over 25 million hospital admissions, 5 million ICU admissions, and 2.5 million deaths due to Covid-19. In the terrible pandemic flu of 1918, 675,000 Americans died. These Covid-19 numbers, in addition to the normally expected hospital demand, would overwhelm our healthcare system, as we are tragically seeing occur in real-time in Italy.
With no medical or preventive treatment, the only vaccine we have is social distancing and staying at home. The critical number to appreciate is the Covid-19 basic reproduction number R0 — (“R-naught”) which is the average number of new cases caused by an infected individual. Because epidemics grow exponentially if left unchecked, the difference between an R0 of 4 is exponentially worse than one of 2.5 as the diagram below illustrates. The virus lives on surfaces for some period of time but the predominant mode of transmission is human to human. The need for close contact for transmission is the Achilles heel of Covid-19. R0 is a function of being contagious and being in close contact (generally within 6 feet) with others who are not immune. It is estimated that the R0 of Covid-19 is 2–3, each person spreads it to 2 or 3 other people, and so on, and so on. The goal is to reduce R0 to 1 or below. At 1 or less, the transmission of infections will die out.
Therefore the best way to defeat the Covid-19 virus and reduce its R0 is to create distance between each other and most importantly, isolate yourself completely if you have symptoms of a cold or flu. Do not go around anyone if you feel sick, even if you just have the sniffles. Assume you have Covid-19 and act accordingly. Quiet as it is kept, you should do the same for the cold and flu anyway because they are also contagious. But they have treatments and/or the risk of death is small. Covid-19 is a Russian Roulette gun and every exponential spread is a threat personally, to the community and to the country. We all now have the burden of this responsibility. We have some of the best minds in the world working on solutions and sooner or later, a solution will be found. But until then let’s try to reduce R0 below 1. Stay apart and stay home!
Source: “Here’s How Computer Models Simulate the Future Spread of New Coronavirus”. https://www.scientificamerican.com/article/heres-how-computer-models-simulate-the-future-spread-of-new-coronavirus/
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