COVID-19 panic, social distancing and interventions

The coronavirus pandemic is now a major threat to global health and wellbeing. As of March 23, about 339,337 people have been infected and at least 14,703 people have died worldwide. Outside China and South Korea, the number of cases are rising exponentially in many countries like Italy, Spain, Germany, Britain, Australia, Canada and the United States. Nearly all of these countries have declared national emergencies to deal with the invisible enemy. The US is now on a war footing. The numbers are surging by the hour.

While the US and countries in Europe are struggling with the crisis, scientists and medical experts are warning it could kill millions globally unless widespread and prolonged social distancing measures are adopted and strictly enforced. A team of infectious disease experts at Imperial College London predicted that without intervention the disease could lead to an estimated half a million deaths in Britain and over 2.0 million in the US. Dr. Anthony Fauci, the leading public health specialist in the US Federal Task Force on Covid -19, said last week in a CNN interview that it was "possible" that hundreds of thousands of Americans could die; however, he added: "our job ... is to try and make that not happen."

The Imperial College study looked at the effects of two containment methods: (a) mitigation, which seeks to slow down the spread of the virus; and (b) suppression, which aims to reverse epidemic growth and maintaining that indefinitely. The Study concluded that strict mitigation measures would still make the public health care infrastructure overwhelmed in Britain and the USA, leading to hundreds of thousands of deaths. The Team found suppression as the preferred policy option, requiring strategies that include social distancing of the entire population (supplemented by schools/university closures, shut down of businesses etc.), self-protective quarantine, lockdowns of outbreak clusters,  quarantine of families of confirmed cases, and testing. The Chinese and South Korean experiences show that suppression is possible and necessary to rapidly contain the epidemic. This  may reduce the peak healthcare demands by two-thirds. In other words, strategies associated with suppression ultimately help to flatten the curve enabling the healthcare systems to take care of the epidemic.

Needless to say that coronavirus has brought a huge uncertainty and spreading panic globally. We have seen in the media examples of panic-buying from different countries and the length to which people go for rolls of toilet paper, hand sanitizers or face masks. With spike in confirmed cases in many countries, coupled with lockdowns of cities, closure of schools, and businesses/shops to promote social distancing, the panic-buying emptied store shelves faster than they could be restocked. Is panic-buying normal in the face of uncertainty? Social-psychologists are of the opinion that panic-buying results from acute anxiety in the face of disaster or uncertainty.

Dr. Jennifer Horney, a leading expert and director of epidemiology at the University of Delaware, observes that a little more panic that provides a sense of control could be particularly helpful as a coping strategy as long as it does not impact others equally in distress, following public health interventions such as self-isolation or quarantine.

Today, for Covid-19, social distancing is considered the only answer to slow down the spread of coronavirus.  What is social distancing, self-quarantine, or isolation?  We are hearing a lot about social distancing, self-monitoring and/or quarantine to contain the pandemic globally. Social distancing is a measure taken as a public health measure to stop or slow down the spread of highly contagious disease. It requires keeping apart by at least of 2-meter in any public place to avoid any community spread, primarily to reduce the number of people who may potentially need hospital care. A diagnosis of Covid-19 triggers isolation; so isolation is required when a person is sick - either at home or hospital. It is a complete or near complete lack of contact between an infected individual and the family/society. People in isolation must wear mask to protect others - including medical staff - to prevent spreading droplets that might contain the virus.

In case of quarantine, individuals or groups are essentially on lockdown. It means staying home and away from others as a precaution, because of contact with a person found infected with the virus. For example, the Canadian Prime Minister Justin Trudeau is currently on self-quarantine as his wife Sophie Gregoire Trudeau tested positive for the virus after returning from a trip to the UK. Sophie is in isolation while PM Trudeau is completing his 14-day incubation period on self-quarantine. As advised by the public health authority, I completed my own self-quarantine period last week for possible exposure after returning home from a business trip to Asia. I lived in a separate area in our apartment unit, used separate toilet, and did not go out for groceries, socialising and visits to coffee shops. I did not show any symptom over the period; as a result, I was not required any medical attention. In case of symptoms such as fever, cough or shortness of breath, an individual is required to seek medical care.

Self-quarantine is a step up from self-monitoring that involves checking up temperature for any signs of illness. Self-quarantine is required when a person is at risk with higher chance of exposure due to travel or being in contact with infected persons without any known symptoms. In any pandemic, individuals and the public at large are always at various degree of risks. A person who is asymptomatic may still unknowingly pass the infection to others such as friends, family, neighbours, or strangers in public transit systems. Staying home, taking pro-active action, and being compassionate to others are important steps that should benefit all of us to deal with this crisis. So it is wise to avoid any crowd or even socialising. Unfortunately, there may not be any safe ways to socialise now with friends. It is prudent to keep social distance and stay home. The reduced mobility has many socio-economic and financial costs, but failing to do so may ultimately cost everything.

Finally, viruses do not know any boundary or have any nationality. This is why they are call pandemic. The coronavirus has been named Covid-19 by WHO. We should resist any attempt to label this as "Chinese" or "foreign" disease by some quarters in the US to promote hatred against racialised minorities. Any stigmatisation about Covid-19 will make effective public health response much harder in this time of global crisis. Any war of words surrounding the coronavirus may amount to, as one commentator observed, an "infodemic" and can prove very dangerous as the spread of the disease itself. We are all in it together.

Mohammad Zaman, PhD is an international development specialist and advisory professor, National Research Center for Resettlement, Hohai University, Nanjing, China. [email protected]