{"id":31104,"date":"2020-04-20T11:37:49","date_gmt":"2020-04-20T17:37:49","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=31104"},"modified":"2024-05-13T09:29:39","modified_gmt":"2024-05-13T15:29:39","slug":"when-will-the-coronavirus-social-distancing-end","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/when-will-the-coronavirus-social-distancing-end\/","title":{"rendered":"When will the coronavirus distancing end? It depends."},"content":{"rendered":"
<\/div>
\"When
When will social distancing end? Not anytime soon. As Colorado officials allow some businesses to reopen, social distancing will be more important than ever. Photo: Getty Images.<\/figcaption><\/figure>\n

Perhaps by the time you read these words, Colorado\u2019s count of COVID-19 cases will, one hopes, have plateaued or even be falling. There will be mounting political pressure to open Colorado and the country back up. With the exceptions of the intrepid health care workers, farm and grocery workers, warehouse workers, delivery people, municipal employees, and staff deemed essential, we will have been cooped up for more than a month.<\/p>\n

It\u2019s been hard. The economy is in lousy shape. We\u2019re restless, anxious, and, even if we\u2019re busy, somehow bored. Who wouldn\u2019t, deep in his or her heart, want to see physical distancing, also known as social distancing end?<\/p>\n

Deep in his heart, Glen Mays<\/a>, chair of the Department of Health Systems, Management and Policy at the Colorado School of Public Health, would love to see social distancing end. So would his colleague Dr. Lisa Miller<\/a>, a professor of Epidemiology and the former State Epidemiologist at the Colorado Department of Public Health and Environment. But both agreed that we still must heed not the heart but the head.<\/p>\n

\u201cWe\u2019re seeing signs of social distancing being effective in slowing the progression of the disease, but given the lag time, it\u2019s important to keep these policies in place for long enough that we can make sure we\u2019re not overwhelming the hospital system and health care workers,\u201d Mays said.<\/p>\n

Added Miller: \u201cI think it\u2019s important for people to understand that it\u2019s not going to get back to the way things used to be for a considerable period of time.\u201d<\/p>\n

Political noise and our own hearts\u2019 desires to the contrary, Mays and Miller\u2019s voices echo the consensus among public health experts all the way to the top. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases put it bluntly<\/a> on April 10: \u201cNow is no time to back off.\u201d<\/p>\n

Okay, then: when?<\/p>\n

Will social distancing end? Not just yet.<\/strong><\/h3>\n

\u201cWhen\u201d will depend. That\u2019s an irksome answer, particularly considering that the coronavirus\u2019s spread is driven by exponential math<\/a>, and math is typically about as concrete as science can get. But in the case of the coronavirus, the unknowns make its math more like wet cement.<\/p>\n

\"Glen
Glen Mays, chair of the Department of Health Systems, Management and Policy at the Colorado School of Public Health, would love to see social distancing end. But he agrees that we still must heed not the heart but the head.<\/figcaption><\/figure>\n

A host of unknowns contribute to that squishiness. How far has the virus spread? What percentage of contagious people show no symptoms at all or symptoms mild enough that the coronavirus doesn\u2019t enter the self-diagnostic equation? How effective has physical distancing been? How is the virus actually transmitted? How will changes in seasons affect transmission? What\u2019s the nature of the immunity of those who have recovered? How long might immunity last? How old is the population? What health problems do they have already?<\/p>\n

These are all inputs to the models that policymakers in Colorado and everywhere outside of Antarctica are relying on to help them make decisions about \u201cwhen.\u201d Uncertainty about the inputs listed above makes those models less useful (technical term: \u201cgarbage in, garbage out\u201d). Both Miller and Mays mentioned George Box\u2019s famous quip: \u201cAll models are wrong, but some are useful.\u201d<\/p>\n

What the useful models are now telling us (this one<\/a> from the Colorado School of Public Health team led by the school\u2019s Dean, Dr. Jonathan Samet<\/a>, being a great example) is that physical distancing works, but that soon after we stop distancing, COVID-19 infections will ramp back up. That\u2019s inevitable once a highly contagious disease unfamiliar to billions of immune systems sinks its hooks into 210 countries and territories<\/a>. The question is, then, how to manage that ramp-up in a way that balances the freedom of movement of the majority against the freedom from critical-care treatment of the minority.<\/p>\n

Selective relaxation on social distancing<\/strong><\/h3>\n
\"Dr.
Dr. Lisa Miller, a professor of Epidemiology and the former State Epidemiologist at the Colorado Department of Public Health and Environment.<\/figcaption><\/figure>\n

In the United States, the answers may differ state-by-state, city-by-city, town-by-town. Miller described each state as its own laboratory, with different demographic makeups, population densities, travel patterns, weather, and so on. Colorado, she says, is unique in that it has a major urban corridor along the Front Range, but also sparsely populated communities in the plains and in the mountains. But then, she adds, those same mountain towns are a global attraction. And so Eagle County\u2014home to Vail and Beaver Creek resorts\u2014now has four times the per capita coronavirus case count as Denver and about the same number of confirmed cases as Boulder and Larimer counties combined.<\/p>\n

\u201cThe diversity of our state and the different regions of our state are things we need to think about,\u201d Miller said.<\/p>\n

That said, public health experts agree on the big picture of how we\u2019ll open our doors and our economy back up again. It will happen slowly and carefully, through what Mays called \u201cselective relaxation\u201d of physical-distancing rules. Among the ideas: friends and families may get together in small groups. Small businesses restart with limitations, with telework remaining a mainstay. Lots of shift work. Restaurants and bars open with tables far apart. Gyms could open but limit client numbers. There will be tough calls, such as with hair salons and barber shops. How do you maintain your distance when you\u2019re cutting someone\u2019s hair?<\/p>\n

Mass gatherings \u2013 concerts, shows, megachurch services, sporting events, festivals \u2013 are probably out of the question in the near-term.<\/p>\n

\u201cI think, considering the risk-benefit tradeoff, it\u2019s going to preclude moving forward with those kinds of events until we\u2019ve got a major breakthrough in prevention, treatment, or vaccination or some combination of them,\u201d said Mays, who is not alone<\/a> with that take.<\/p>\n

Even such a limited opening will demand continued, extraordinary precautions. \u201cNo masks\u201d may be added, tacitly or explicitly, to those \u201cno shirts, no shoes, no service\u201d signs, and the people providing the services will wear them, too. Compulsive handwashing and frequent deep cleans will be de rigueur. Those at higher risk may need to continue to physically distance: in Colorado<\/a>, those confirmed to have coronavirus over the age of 70 are at least 22 times more likely to end up hospitalized than those younger than 30. Those with COPD<\/a>, cardiovascular disease, hypertension, and diabetes look to be at greater risk<\/a>. If reopening indeed hinges on balancing hospital resources and economic reopening, how will policymakers take such demographic facts into account?<\/p>\n

Tools of the trade<\/strong><\/h3>\n

More importantly, opening back up in any real way will depend on public-health action of unprecedented scale. That action will include the three prongs of testing, contact tracing, and, based on those findings, testing of contacts and limited isolation.<\/p>\n

\u201cIncreased testing linked with more targeted contact tracing is going to be an incredibly important part of the long-term strategy for managing this pandemic,\u201d Mays said.<\/p>\n

This is a proven combination for taking the bite out of epidemics, Miller says. Contact tracing could be augmented by cell-phone location technology<\/a> and the mass-hiring<\/a> of people to help with contact tracing.<\/p>\n

For contact tracing to work, though, we will need much more testing. Yet testing will have its limits. South Korea, considered the gold standard as far as COVID-19 testing, has tested less than 1% of its population, Mays says.<\/p>\n

\u201cThey\u2019re still doing risk-based testing \u2013 testing the people who are likely to have been exposed. That\u2019s probably the most realistic path for us,\u201d he said. \u201cI don\u2019t think it\u2019s feasible to get to a situation where we\u2019re testing 25% or 50% of the population, over and over.\u201d<\/p>\n

Another factor that will play into the answer to the question of \u201cwhen\u201d will be antibody testing, Mays says. Such blood tests, which are just now being rolled out, can establish whether someone has antibodies related to a COVID-19 infection he or she has recovered from \u2013 and thus can be assumed to have at least some immunity for some period of time.<\/p>\n

Taken together, the answer to \u201cwhen,\u201d in Colorado and elsewhere, will depend on what we learn \u2013 and how fast we learn it \u2013 about many other questions related to COVID-19 and the SARS-CoV-2 virus that causes it. Miller and Mays are optimistic that \u2013 given the global scope of the disease, the extreme motivation to beat it back, and the legions of smart people focusing on various aspects of the virus and the disease and then sharing what they\u2019ve learned \u2013 we should know more about the coronavirus and how to control it, faster, than we have about any pathogen, ever.<\/p>\n

\u201cWe\u2019re learning every single day,\u201d Miller said.<\/p>\n

\n

For all updates and to read more articles about the new coronavirus, please visit uchealth.org\/covid19<\/a><\/h4>\n

For updated information on COVID-19 testing at UCHealth locations, please click here<\/a>. For information on community testing sites throughout Colorado, please click here<\/a>.<\/h4>\n<\/div>\n

She is hopeful that a vaccine will come, and that therapies to keep the disease from progressing as aggressively \u2013 many of them are already being tested<\/a> \u2013 will come before vaccines. Such therapies should reduce the number of and length of hospitalizations, take pressure off the health care system, and enable the acceptance of more societal opening.<\/p>\n

And don\u2019t forgot, a proven approach in combatting the coronavirus is the one we\u2019re living with now. The curve is indeed flattening; physcial distancing works. That\u2019s good news, because we may need to do it again.<\/p>\n

\u201cOur collective actions \u2013 and our collective pain \u2013 is having a tangible effect on this virus,\u201d Mays said. \u201cWe may have to selective put the brakes back on. It\u2019s good to know that the brakes work so we can reapply them as needed, hopefully on a more precise basis going forward.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Perhaps by the time you read these words, Colorado\u2019s count of COVID-19 cases will, one hopes, have plateaued or even be falling. There will be mounting political pressure to open Colorado and the country back up. With the exceptions of the intrepid health care workers, farm and grocery workers, warehouse workers, delivery people, municipal employees, […]<\/p>\n","protected":false},"author":23,"featured_media":31215,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[4859,4860,392],"class_list":["post-31104","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-coronavirus","tag-covid-19","tag-infection-prevention"],"acf":[],"yoast_head":"\nWhen will the coronavirus social distancing end? - UCHealth Today<\/title>\n<meta name=\"description\" content=\"When will physical (also known as social) distancing end? 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