Physical Distancing

The term social distancing has been used frequently throughout the last few weeks. Let’s use a better term, physical distancing. You may consider this a moot point, but words are important as they have implications beyond their direct interpretation.

80% of the people infected with SARS-CoV-2 will have mild symptoms. This number has been fairly static since the beginning of the outbreak and seems reliable as more data comes in. However we should define the word “mild” and make sure we understand what that entails. Essentially in these studies, “mild” simply means the patient was not hospitalized. So that qualifies a wide range of possibilities from those who are asymptomatic to those experiencing something like several days of the worst flu they have ever had. In many ways the 80% mild cases are a source for optimism, as the majority of people will not end up in the hospital. However, this is also what has made this virus so potentially dangerous. And this feature is what requires physical distancing.

As everyone is well aware at this point, we are all making significant sacrifices to create this physically distanced society. So thank you to those making a difference, hopefully this will show you why your efforts are critically important.

The mild and asymptomatic cases make this virus extremely hard to track and isolate. These are the cases that allow the virus to slowly spread throughout a community without raising an alarm. The more time the virus can spread without detection, the larger percentage of the population it comes into contact with. Let us assume that our population fits the general population of the communities already infected, in the sense that 20% of the infected people will require hospitalization and 4-5% of those patients will likely need an ICU bed. Now we have to venture from abstract percentages to real numbers.

Let’s start with the hypothetical situation that 10% of our population of 100,000 people contracted the virus. That gives us 10,000 people infected, 8,000 “mild” cases, 2,000 people requiring hospitalization, and 400-500 of those hospitalized requiring ICU. As soon as you take percentages to concrete numbers, the problems become obvious. We certainly do not have anywhere near the capacity to treat that volume of patients in a short window of time. As one more example, let’s say only 1% of the population contracted the virus. 1,000 people infected, 800 “mild” cases, 200 people requiring hospital beds, and 40-50 needing ICU placement. Now this scenario seems somewhat more manageable, but there is still a glaring problem. We do not have the required ICU beds to treat the most severe patients.

This is why we GET to physically distance ourselves. We have the opportunity to make a difference. A difference that is well beyond the capability of any drug, physician, or modern healthcare facility. We have the power to force the infection rate much lower than 1%, and the best strategy to accomplish this is physical distancing. The short term (1-2 months) outcome of this pandemic is squarely in the hands of the public. Embrace the responsibility, and help make this a manageable fight for our healthcare workers and our community in general.

In closing, we have replaced the term social distancing with physical distancing. This is not a time to socially isolate ourselves, but to come together as friends, families, and communities. Leverage technology to stay in touch with those important to you, even if you cannot physically be near them. Realize that we are all making sacrifices and be respectful of that. Show sympathy, support, and shoulder the responsibility. This is the ethos of America, and we will undoubtedly come through this stronger.

-Ryan

2; 4/2/2020

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