As I was driving to work early this morning, I have to admit that I was a little annoyed at Mayor Lightfoot and Governor Pritzker. It’s St. Patrick’s Day… and it’s Chicago. For the 35 years I have lived in Chicago, St. Patty’s day has meant the parade, dying the river green and gathering in my favorite pub to drink green beer. So, full disclosure: I’m not Irish for 364 days of the year but on March 17th, I am.
In my ‘one day Irish’ mode, you need a really good reason to cancel the parade, dying the river and close the pubs. And all of this because of ‘social distancing’? I’m a physician but still, I thought we were supposed to be getting closer together- not farther apart! Isn’t that the gripe about the isolation of the internet?
OK, I can give up the green beer (I’ll make my own in the comfort of my living room…reach out if you want the recipe!) if it means saving lives , but exactly how does social distancing save lives?
As of March 16th, there were 167,502 confirmed cases of COVID-19 and over 6000 deaths and it’s getting worse. That certainly gets my attention, how about yours?
Let’s get down to basics to properly explain this and knock down any false information or theories coaxed from Google docs worldwide.
COVID-19 is an infection and infections have been around a while, right? Why can’t we just take an antibiotic and be done with it? Well antibiotics only work on bacteria and COVD-19 is a virus. Yes, there are antiviral drugs, but they don’t work very well so forget taking a pill and “POOF!” COVID-19 goes away.
OK so pills are out but what about a vaccine? I for one don’t worry about polio anymore because as a kid I got vaccinated and polio – a virus causing disease- went almost into extinction in the US. Great idea right? Hold up there. There is no vaccine currently available because COVID-19 is new and even fast tracking this, it takes one year to eighteen months to develop a vaccine. So next year, if COVID-19 starts up again, we may be in business.
So that leaves us with social distancing since that seems one of the only methods left to contain the virus and save lives. The concept goes to the heart of how an infection spreads. After all, if only one person got the virus and then it died, none of this would be an issue. But COVIDF-19 has proven to be quite good a spreading from persons to person. Two concepts are important here: how does it spread and how many people can one infected person infect.
COVID-19 had two major ways to spread. Most spreading of the virus is in respiratory droplets released when a person coughs. Somehow that makes sense since COVID-19 affects the respiratory system. A secondary form of spread is from surfaces where the virus can stay infectious for anywhere from three hours to over a day. One issue with COVID-19 is that people can be spreading the virus and yet be without symptoms. Furthermore, the incubation period (the time before actual illness can start after exposure) of the infection can be up to 14 days so the time during which a person is infectious can be significant. Fortunately, once a person has the disease and has healed form the disease, they are likely immunized and no longer infectious.
If you could identify everyone who has the virus, even if they are not having symptoms, you could just quarantine them for 14 days and the virus would die out and problem solved. Not so easy. First of all, it would impossible to test every person on the planet to see if they have the disease. So, you have to test targeted groups of people. If someone is symptomatic, that would be a good place to start. But we know some people will be spreading the virus and yet not be symptomatic. So, another way to screen is to see if someone has possible recent contact with someone who did have the virus. Been to northern Italy lately? Bam! You are quarantined. And if you don’t mind, stay out of my neighborhood too!
In this context, social distancing begins to make, well, a lot of sense. If I never come into contact with someone who is infectious, I never get infected. Clever! And if this could be done universally, the virus would die out quickly as those who were infected can heal without further spread.
So now we come to the second important concept- how many people can one person infect? Well, standing for 4 hours in line at TSA to enter the US would be a great way to spread the virus. Drinking at a pub would also be a good way to spread the virus. How about a parade with a million people in attendance. We don’t have to like it, but we have to get it.
That having been said, I still need to function, and I have a job that does not allow me to sit in my living room, watching reruns of Poirot, and drinking my self-colored beer. Well, keeping at least 6 feet from my fellow human would limit the ability of those nasty droplets to enter my system. Vigorously cleaning all surfaces where they may be would also reduce the transmission. So by putting all of this information into play, the goal is to reduce the number of people an infected person can infect. This would slow down the spread of the virus, giving the healthcare industry the resources to treat those who are most seriously affected and hopefully saving their lives. It would also reduce the number of people infected.
Voila! Lives saved and all because I need to drink my beer in isolation.
You go Mayor Lightfoot! Good on you Governor Pritzker! And because of these difficult decisions on your part and what appears to some as draconian measures, more people will be around next year to drink that green beer. I’ll even but you one if you like.
John S. Rinehart MD, PhD, JD is the author of the recently released Getting Pregnant for Dummies (Wiley Publishing 2020), available in bookstores and online at Amazon and BN.com.
Dr. Rinehart has maintained an exclusive practice in infertility and reproductive endocrinology for the past thirty-five years. He serves as a Senior Attending Physician with North Shore University HealthSystem and as a Senior Clinic Educator for the Pritzker School of Medicine for The University of Chicago.