Infectious diseases spread though contacts, either through the physical or airborne routes. The speed of the spread is measured by what is known as ‘doubling time‘, the time it takes for the number of persons infected to double. For example, with a doubling time of 2 days, the number of infected would swell by 16 times every week while with just three days doubling time it would only increase four times! In simple terms, in a three day doubling time scenario, every infected person interacts socially an uninfected one once in three days to infect! The effectiveness of different interventions are assessed by comparing the doubling time, the more effective an intervention is if the doubling time is more.
‘Social distancing‘ is one such measure for viruses that spread by contact and are carried through particles in air. Reduce the contact and allow sufficient distance for the particle not to contaminate. The idea is not new; it has been known and deployed successfully for centuries in the ancient eastern cultures, for improving cleanliness in normal times and reduce community spread during afflictions. Isn’t it surprising that it is such a difficult option in modern day to day life, be it public transport, restaurants, shopping malls, concert halls, and so on, is unthinkable to live without them!
The 1918 flu, also known as the Spanish flu, that lasted until 1920, is considered the deadliest of the pandemics in recorded modern history. Today, as the world has come to a grinding halt in response to the corona virus, scientists and historians are studying the 1918 outbreak for clues to the most effective way to stop a similar global pandemic. The efforts implemented then to stem the flu’s spread in cities across America—and the outcomes—may offer lessons for battling today’s crisis. Studies found, one of the keys to flattening the curve was social distancing. And that likely remains true a century later, in the current battle. Compare typically two states of US Philadelphia and St. Louis:
The total number of deaths in Philadelphia is twice as much higher than St. Louis which has put in place social distancing measures. For example, It didn’t cancel a World War I victory celebration parade as the 1918 flu picked up, which most likely would have led to thousands of infections. But, the other fact that the impact of the virus reduced quicker, that is within 4 weeks compared to 12 weeks in St. Louis.
As the non medical interventions such as social distancing, was lifted up, St Louis showed a jump in the mortality rates: The flat curve just shot up for a few weeks, nevertheless the second peak was not astounding.



The lessons of 1918, if well heeded, might help in avoiding repeating the same history today.
But it is not an ‘open and shut‘ case: as since then, lot of water has flown under the bridge, decades of advances, by the pharmaceutical companies — finding treatments or vaccines for major illnesses, including H.I.V. and smallpox — the developed countries such as US, had a built-in expectation that no matter what the ailment, there must be some kind of available fix. Locking your family inside your home and advising not to socialise, seemed a retrograde measure. Encouraging or forcing people not to go to work appeared economically disastrous.
How to assess the pros and cons? Let us assign an economic value to human life by estimating the implicit value that people in a given society place on continuing to live based on their willingness to pay for services that reduce their risk of dying. It is then possible to compare the gain of estimated person death-value with the loss of GDP before enforcing any non-pharmaceutical interventions, such as social distancing. The statistical models, however inaccurate they may be, are available to guide the policy makers in choosing such extreme measures as options during pandemics especially when the medical interventions are not available.
Nearly two decades back, The Bush administration, concerned with bioterrorism after the Sept. 11, 2001, encouraged scientific exploration of alternate (unconventional) strategies to handle such national disasters arising out of natural or manmade. Bush’s concern was accentuated by a string of new outbreaks caused by infectious diseases transferring from birds and other animals to humans, including an avian flu, that year in Vietnam. Because there was no vaccine for these new threats, they could spread rapidly.
The concept of ‘social distancing’ as a tact was first whispered as a policy and later made its way through the US federal bureaucracy in 2006; it was viewed as impractical, unnecessary and politically infeasible. It required the key proponents — Dr. Mecher, a Department of Veterans Affairs physician, and Dr. Hatchett, an oncologist turned White House adviser — to overcome intense initial opposition. In February 2007, the C.D.C. made their approach — bureaucratically called Non-Pharmaceutical Interventions, or NPIs — official U.S. policy. Following a five-year review by the Obama administration, the strategy was updated in a document published in 2017. A rough road indeed for the ‘social distancing’ to find a place as a government policy! But strangely, no other country has any such public ‘policy’!
Dr. Mecher was a key voice on the “Red Dawn” email chain of public health experts in raising early warnings this year about the coronavirus outbreak. A week after the first coronavirus case had been identified in the United States, and six long weeks before President Trump finally took aggressive action to confront the danger the nation was facing — a pandemic that is now forecast to take tens of thousands of American lives — Dr. Mecher was urging the upper ranks of the nation’s public health bureaucracy to wake up and prepare for the possibility of far more drastic action. “You guys made fun of me screaming to close the schools,” he wrote to the group, which called itself Red Dawn, to an inside joke based on the 1984 movie about a band of Americans trying to save the country after a foreign invasion.
Throughout January, as Mr. Trump repeatedly played down the seriousness of the virus and focused on other issues, an array of figures inside his government — from top White House advisers to experts deep in the cabinet departments and intelligence agencies — identified the threat, sounded alarms and made clear the need for aggressive action. The president, though, was slow to absorb the scale of the risk and to act accordingly, focusing instead on controlling the message, protecting gains in the economy and batting away warnings from senior officials. At last, ‘social distancing‘ became one of the mitigating state enforcement strategy in US. In hindsight, US might be paying dearly for Mr. Trump’s dilly dallying in embracing shutdowns and social distancing!
Social distancing measures in simple terms are steps you can take to reduce social interaction between people. This will help reduce the transmission of viral diseases such as coronavirus (COVID-19), that gets transmitted from affected persons.
This seemingly simple strategy of intervention advices nothing more than to
- Stay at least 6 feet (about 2 arms’ length) from other people
- Do not gather in groups
- Stay out of crowded places and avoid mass gatherings
Looks simple panacea; healthy practices to follow even in ‘non-corona‘ times, isn’t it? Now Social distancing and lock downs are the buzz words of all countries for retarding the rapid spread Covid-19, that has no known and proven therapy for cure! That will be the order of the days to come till a viable vaccine arrives!
See how life has changed in the course of a couple of months since the beginning of the year! You don’t have an option to pursue your wish for free life, enjoy liberty and pursue happiness, the buzzwords of a free society! Life is strange, indeed. So learn to ‘stand apart‘ in modern times to allow the invisible monster to ‘pass through‘!

Photo: The Indian state of Kerala has found unique way to promote social distancing: Use umbrellas; Since two opened umbrellas, not touching each other, will ensure minimum distance of 1 meter from one another meeting the safe distancing requirement!
Credits:
1. https://www.nytimes.com/2020/04/22/us/politics/social-distancing-coronavirus.html


