For the umpteenth time, stay home for two weeks. Sure, buy your take out. Mask and glove up to get your groceries. Take a walk in the fresh air and avoid people. Just stay home otherwise. Otherwise, plan for this.
Why? At a simple level, this reduces the variables. The fewer people that one contacts, the fewer possible vectors of infection, the easier it is to trace contacts, the easier it is to halt the spread of infection.
Here is a good explainer about how “flattening the curve” looks. As time is passing, and because of isolation, the numbers are looking better than the ones the doctor in this video are using. For example, her premises rely on 40% infection rate but of course, they won’t happen all at once. They’ll happen over time. She also assumes a 20% critically sick rate, but that, too, is likely too high. Finally, she probably overestimates the number of people who will need ventilators. Still, though, the most generous premises are concerning numbers and a slowdown of the spread is critical so that the health care system, government, and companies can catch up to the problem and formulate plans to deal with it.
Katie Porter’s sister, a doctor, is breaking down how staying in can save lives during the COVID-19 crisis pic.twitter.com/9q7MpbpES8
— NowThis (@nowthisnews) March 21, 2020
In addition, since it takes about five days from contact to infection, if one does contact COVID-19, it takes a few days to show, then to get tested, then to quarantine. If everyone takes this time at the same time, and with sufficient testing coming online, cases can be isolated. Most importantly, because the person is already isolated the rate of spread is reduced.
The problem is that people are rebelling after only a couple of days of social distancing. Seriously? Americans can’t suck it up for a week or two? Have we become such soft babies that staying home for two weeks is impossible?
This won’t last forever. First, it can’t. People will just rebel and decide death is preferable to staring at their spouse’s face for another day. Second, testing will be in place and it will be easier to figure out quickly who is sick and not harm as many people. Finally, more data will give people solid confidence to reemerge into society. Read this paper: it is profoundly encouraging. A counter view here.
After two weeks of isolation, then it’s time to decide who to trust to be around. We all have friends who are risk-takers or who travel all over or who ignore their sniffles and will press on anyway. Might want to let those friendships go. In a world where a virus can land one in the hospital with lung crushing pain, steering clear of the risk-takers might be worth it.
One acquaintance said to me, “This is going to go on forever. Why should I stop now? This is stupid.”
First, no, it is most certainly not going to go on forever. In some places, where there’s an overwhelming outbreak, people won’t have to be told to stay inside. They’ll have family or friends at the hospital, and they’ll be scared straight and won’t want to interact with people. In most other places, testing will be available everywhere and so if people practice immaculate hygiene, get tested when feeling ill, and act reasonably, life will get to some semblance of normal rather quickly.
Second, stopping now buys time for the testing to get up to speed. It puts a hard stop on the spread for a couple weeks and buys hospitals and the government time to get on top of efficient responses. This will save lives and resources in the long-run.
Quarantine and social distancing works. It is the only surefire response to a disease that has no treatment and puts so many people in the hospital.
Let’s assume that some communities are doing great. What should they do after the two weeks? Here are my recommendations:
- End public schooling and colleges for the year. Do everything online. Keep the infrastructure for the Fall 2020 session due to possible/probable local flair-ups. The reasons for this are myriad. First, young people will have the guidance of their parents about behavior. Second, it’s nigh to impossible to keep schools hygienic. Kids are just gross. Third, it imposes social distancing.
- Make working from home the default for all workers who can do that. Have team meetings (small groups) as rarely as possible. Employers must change their philosophy about the need for face-time. I’ve worked remotely for three years in a management role and it has been fine. There are some things that are challenging but productivity is higher, not lower, in almost every case.
- Keep all public cleaning hyper-vigilant. That would mean extra time between movies at the theater to wipe down all hand rests and tables with bleach wipes, for example. Restaurants and other public places should hire someone to attend the restrooms full-time. Every public space and surface should be immaculate and well-tended. This goes for stores, malls, etc.
- Resume sports activities thoughtfully. Some sporting events are low contact such as baseball, tennis, golf, badminton, ping-pong, hockey, biking, surfing, skateboarding, skiing, archery, shooting-sports, running, waterskiing, motocross, etc. If crowd sizes are limited, and especially if the venues are outside where people can spread out, why not resume these activities with, again, vigilant cleaning of equipment and personal hygiene.
- Implement staggered scheduling at service providers. You know how hair stylists, dentists, doctors, etc. will have twenty people in the waiting room and be running between patients/clients, etc.? This has to stop. Yes, it will cut into income, but being open and hygienic beats being closed. People should wait in their cars. There should be texting to say the patient/client is there. The previous client should leave and then the space cleaned, and then bring then ext client/patient. Technology will help. If we can use text notifications for table seating in restaurants, it can be used for doctors offices and hair salons. A special note about nail technicians. They’re going to have to do better about hygiene. Most are horrible. Some are great. This is an area where public health officials will have to be more stringent.
- Reduce limits for public spaces. Take out half the tables, maybe more. Upside? Going out to eat becomes a special event because tables are tough to come by. Bars and clubs are trickier. Jam-packed venues make for easy transmission. Outdoor venues, where people are spread out, will be better. This is going to be a tough business to be in, likely.
- Reorient social norms. Make it socially expected to stay home when sick. People should be shunned if they show up sick to anything. This includes allergies. Too often, allergies are not just allergies even during allergy season. Bosses should be fired if they require people to work sick. It should be the expectation that people will self-isolate. Caring for the larger community should be rewarded.
The self-isolation won’t last forever. Once testing gets up-to-snuff and our public health officials have a better handle on the statistics for who is vulnerable, treatment options, care guidelines, hospital preparedness with both staff and equipment, etc., society will open back up. It won’t take long.
There is a pure, driven motivation to open life back up again not only for the economy but for individual mental health and survival.
Isolation can’t last forever. The costs of shutting down will outweigh the deaths or health impacts of COVID-19 because people will commit suicide, have delayed diagnoses for other diseases, plunge into poverty, etc. and more people will die due to the shutdown economy and hospital restrictions than from the virus. Where that balance will be no one knows for sure, and our leaders will have to make their best guesses.
America can self-isolate for two weeks, though. Encourage family members to do this. Check in on grandma and grandpa. Take walks in the fresh air. Enjoy the quieter roads. Find the positive where you can. This too shall pass and there will be a lot of work to do to build back.
Self-isolate now, to save pain in the future.