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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsTwo thoughts from an epidemiologist.
I got this in e-mail from a friend who is a friend of an epidemiologist. Underlining is mine.
Excellent and enlightening piece of writing by a Yale Epidemiologist
Much
of what this writer Jonathan Smith says aligns with what Alan Kilian has been telling us. Hey everybody, as an infectious disease epidemiologist (although a lowly one), at this point feel morally obligated to provide some information on what we are seeing
from a transmission dynamic perspective and how they apply to the social distancing measures.
Like any good scientist I have noticed two things that are either not articulated or not present in the "literature" of social media. I am also tagging my much smarter infectious disease epidemiologist friends for peer review of this post. Please correct me if I am wrong (seriously). Specifically, I want to make two aspects of these measures very clear and unambiguous. First, we are in the very infancy of this epidemic'strajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn't have to.
This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren't. You will feel discouraged. You should. This is normal in chaos. But this is also normal epidemic trajectory. Stay calm. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse.
This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying. You may feel like giving in. Don't.
Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn't much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk.
Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son's girlfriend's mother shook hands with. This sounds silly, it's not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain. In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison. These measures also take a long time to see the results.
It is hard (even for me) to conceptualize how 'one quick little get together' can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can't cheat it. People are already itching
to cheat on the social distancing precautions just a "little"- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all
of the work the community has done so far. Until we get a viable vaccine this unprecedented outbreak will not be overcome in grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months.
This virus is unforgiving to unwise choices. My goal in writing this is to prevent communities from getting 'sucker-punched' by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn't working and become paralyzed by fear, or to 'cheat' a little bit in the coming weeks. By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty.
Phoenix61
(17,003 posts)give to teenagers. You are sleeping with every person that person already slept with. The looks on their faces was always priceless.
WinstonSmith4740
(3,056 posts)And yes, that is a fun "A-ha" moment! Almost as good as the look of fear when I tell them that, yes...you absolutely can get pregnant the first time you have sex.
Mike 03
(16,616 posts)There was an article this morning that this is what's beginning to happen in Italy, where people are fed up and believe the restrictions are futile, and it's beginning to lead to incidents of social unrest.
We have to stay strong and focused on the goal.
magicarpet
(14,150 posts)Bernardo de La Paz
(49,001 posts)magicarpet
(14,150 posts)I think it is going to get real crazy before this is over and run its course.
tblue37
(65,340 posts)USALiberal
(10,877 posts)tblue37
(65,340 posts)magicarpet
(14,150 posts)Baitball Blogger
(46,705 posts)BTW, you may have inadvertently invented a new word: "strajectory" A strategic path or route.
LAS14
(13,783 posts)It has possibilities. I'll leave it.
sdfernando
(4,935 posts)I like it as well.
LAS14
(13,783 posts)Laelth
(32,017 posts)-Laelth
uponit7771
(90,336 posts)Arthur_Frain
(1,849 posts)Concise. Not purposely alarmist. Lots of facts and eye opening quit yer bullshit jawbreakers. This is the one that go viral, thank you.
MFGsunny
(2,356 posts)flibbitygiblets
(7,220 posts)The one about going to the store for needless items hit home. So many people seem not to understand that every interaction with the public puts entire households at risk, which negates the benefits of social distancing in the first place.
We are NOT doing this at my house. The only things coming in are being delivered contact-free. And even then, we're aware that humans stocked the shelves, packed the bags/boxes, and delivered the packages and mail. Which is why those items either go into a "quarantine area" for a few days if shelf-stable (time varies depending on the material), otherwise disinfected or washed.
leighbythesea2
(1,200 posts)And disinfecting every package takes time. Puts in perspective what you really need & how exhausting being fastidious is.
That was bulk groceries. Hoping im set for 4 weeks again.
Started voluntarily shelter in place march 1 because of my mother. By april 30, it will feel long for us but i dont care one bit. Stay the course!
flibbitygiblets
(7,220 posts)FailureToCommunicate
(14,014 posts)to watch "Contagion" (made in 2009, with several big name stars, and a killer soundtrack)
Better than any other film I know of, it shows the ease with which virus spreads from things, to surfaces, to persons, to persons, to whole communities. The scene(s) with the daughter and her boyfriend really hit that home. It's not quite like this pandemic (it was referencing a far swifter virus)
Virus don't care.
Virus don't play by the rules.
Virus don't care who you love, or how "careful" you are.
Virus don't f-ing care.
KY_EnviroGuy
(14,490 posts)we must spread those reminders within our isolation groups. Post-it notes should be selling better that toilet paper, LOL.
With Covid-19, complacency and carelessness kills.
rocktivity
(44,576 posts)Last edited Tue Aug 16, 2022, 01:17 PM - Edit history (28)
In the absence of a vaccine, an antidote, mass testing, and a more robust healthcare infrastructure, there's not much left to do except "hunker down" and "ride out" the "inevitably worse." The real issue is that "the line" we're trying to hold against the virus should have been drawn four months ago when border closing, comprehensive testing, professional-grade masking, contact tracing, and actual quarantining could have combined to "flatten the curve." I think that's why people have started "rebelling" against social distancing -- not out of boredom, ignorance, or defiance, but from subliminally realizing that curve flattening was a fantasy, and that staying home now does too little, too late.
This could have happened in the U.S. -- but it can't now because U.S. leadership didn't see the smoke on the horizon and/or pull the alarm in time.
rocktivity
usaf-vet
(6,186 posts)...inside. You can't ignore it all. For example, medical supplies are often mailed to you.
Has anyone addressed the impact of direct sunlight on, for example, a bill in a white business envelope?
How about UV light?
The bills still have to be paid.
Nasruddin
(754 posts)ALL of them.
Some of them are difficult but it's a lot less work in the long run, & less paper garbage in the house.
Laura PourMeADrink
(42,770 posts)Seemingly bright people are thinking and acting like just because they know and love someone they are safe.
yaesu
(8,020 posts)sustain civilized life & that people are able to obtain these items. Really, people must not leave their house for any reason in this is going to work. There isn't any way to get deliveries in most areas so people must go out, mingle. I went out today for food, first trip in 2 weeks, places were just as busy as any normal day the only difference is most things I needed to bake weren't available & mainly just junk type food was plentiful. I went to 3 stores, I will be living off the most unhealthy food in my life once my meat & frozen veg stash is gone.
It depends on what you mean by "work".
If you wanted to kill the epidemic by starving the virus of hosts completely, you are right.
I don't think that's what we are doing. We are going to reduce the peak impact of the virus so the medical system and other systems can hold up. We do that by getting off the exponential growth and getting into a linear growth of cases. That is bad, but less bad than a civilization ending catastrophe.
Sugarcoated
(7,724 posts)go to the store, worker puts them in the cab of our truck. I carefully disinfect everything with clorox wipes, I have a system to not cross contaminate. I also wear an N95 mask.
Stuart G
(38,421 posts)..This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren't. You will feel discouraged. You should. This is normal in chaos. But this is also normal epidemic trajectory. Stay calm. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse.
...This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying. You may feel like giving in. Don't.
WinstonSmith4740
(3,056 posts)I teach Health in high school, and we're doing it all with Google classrooms right now. Do you mind if I send this to them? It is reassuring without pulling punches.
bronxiteforever
(9,287 posts)Historic NY
(37,449 posts)I said do you have a mask, nope. But your going out to physical therapy, yes. Is anyone wearing masks there no. Wait no mask, and you don't have one. What part of this virus don't you understand? She says she is the last patient, oh great I tell her. Oh but they clean, really how do you know. She says they wipe down the equipment and they do a deep clean. How do you know? A thousand questions and she oblivious. What part of social distancing don't you understand. I realize she has been cooped up since Dec after surgery and a injury, she doesn't get it. She goes out shopping now its her hobby, after telling me she has a freezer full of stuff. Apparently listening to the news hasn't sunk in.
dhill926
(16,337 posts)BobTheSubgenius
(11,563 posts)A very close friend of mine was quite miffed when her husband put his foot down and said, in no uncertain terms, that they would NOT be doing even a small gathering for her sister's birthday.
I couldn't believe that someone that aware (usually) and sensible (often) would even dream of going along with that plan, especially since she has been suffering and asthma flare-up lately.
infullview
(981 posts)Let's say optimistically that only about 40% of the US population of 328 million gets exposed to the virus, and that the average death rate for the combined demographic is 1.7%, that's more like 2.2 million dead. This assumes that no vaccine is available for the next 12 months. Who's coming up with these numbers? 100,000 sounds way too optimistic.
smirkymonkey
(63,221 posts)Very good advice.
SammyWinstonJack
(44,130 posts)😰