COVID-19 Pandemic The Urgent Need For Social Distancing

COVID-19 Pandemic: The Urgent Need For Social Distancing

Coronavirus disease (COVID-19) is a respiratory illness that results from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (Parodi, JAMA, 2020). It is highly infectious and can transmit through direct contact: hand shaking; hugging; touching items such as handrails, door knobs, remote controls, elevator buttons, credit cards, money .. . indeed any hard surface. The virus can survives on such surfaces for up to several days. “It can spread through asymptomatic or minimally symptomatic individuals who would not normally seek medical care”. (Parodi, JAMA, 2020)

The NSW chief medical officer, Dr Kerry Chant, has warned that up to 1.5 million people in NSW alone could, become infected with COVID-19 in the coming months, as there is no herd immunity. Follow this link to an essay by Tomas Pueyo that has been viewed 7 million times explaining the growth of infections. There is no vaccine at this stage.

The primary concern at this moment, is that if  too many people will become infected in too very short a period of time. This would overwhelm health services and hospitals. The focus must be to ensure that our hospital system is able to meet the demands of this health emergency. Health experts warn  that we will not have the capacity to care for the most vulnerable and in most in need. Therefore the aim is to slow down the spread as much as possible so as to “flatten the curve”.  This is the situation right now. (Fig1).

What does “flatten the curve” mean? The term refers to the aim to slow down the spread of the virus and prevent too many people catching it now or within the next 3 months. If you catch it later, your chance of getting help in a hospital are much greater, as there will be fewer sick people presenting at the same time.

“The next two weeks is (sic) absolutely critical to the direction of this curve. Total social isolation, complete interpersonal distancing, combined with massively increased testing (which we have just built capacity for this week in our labs) will flatten this curve and save countless Australian lives”, according to Dan Suan, Staff Specialist Immunologist, Westmead Hospital. He emphasises “we can do this with no vaccine and no effective antivirals. Each individual simply has to make it their personal responsibility to have minimal contact with all other people. Cancel all unnecessary things. I am running my clinics by phone so patients don’t have to come to hospital. We have a narrow window of opportunity to do this, this could not be more urgent. I hope you understand I would not say this if I was not absolutely sure of how critical this is”. See Fig 2

Bill Bowtell, adjunct professor of the Kirby Institute [Interview on ABC on link] for Infection and Immunity, University of New South Wales, also highlights the importance of immediate action.

  1. What to do if you think you are showing symptoms

Symptoms range from fever; a cough; a sore throat or shortness of breath.  The virus can cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against influenza and AIDS have not been effective. Recovery depends on the strength of the immune system.

NSW Health Department website: “If you develop a fever, a cough, sore throat or shortness of breath ….  seek medical attention as soon as possible by calling your GP or nearest emergency department or Health Direct on 1800 022 222. It is important to phone ahead so that the practice or emergency department can make appropriate preparations and protect others.”

 2 What to do if you are a senior citizen or living with one – precautions

Isolate yourself! Do not get in touch or contact with anyone outside. Get food delivered but avoid close contact.

If you live with elderly – anyone over 70 yrs  – stay at least 2 meters away at all times, wear gloves and mask for their protection.  If you have any reason to believe you might have caught the virus or have a respiratory infection keep in contact with your family through social media or telephone.

  1. What to do if you have a family with infants

Children, should they catch the virus, have shown little to no major symptoms. Consider young children at this stage at being at low risk – BUT they can carry the virus and transmit it, even if they do not show any symptoms themselves. Children with respiratory infections, common in those that attend child care, can be a threat to the elderly, so suggest keeping them at a distance from their grandparents.

  1. What to do if you are an international student or have recently arrived from overseas

As of Monday all travellers arriving from overseas need to self-isolate for 14 days , announced by the Federal Government today. Recommend that they keep away from others and maintain a healthy diet and fitness.

  1. What to do as you travel to work

Seek work-from-home conditions if at all possible. Avoid public transport or try to keep a distance. Wearing a mask may be useful and ensure you wash hands when you reach your workplace or home. If your work requires you to meet with other people, get your employer to apply protective measures. By law [OHS] your employer has to ensure your health and wellbeing.

  1. Why minimising contact is important and not to be disregarded – Practical advice like that?

Any direct contact with people or environments including public transport, handrails, shared utensils, even mobile phones and keyboards carry the virus. Distance to people, relentless and obsessive cleaning of hands and all items in use is strongly advised. Do not mingle in meetings, crowds, gatherings, be this at work, church, party, wedding, …. Do not go there. Decline any invitations. Mass gatherings need to be postponed, including dinner with friends.

Dr Smita Shah

AIMGA Vice President

Clinical Associate Professor, Faculty of Medicine and Health, The University of Sydney

Director, Primary Health Care Education and Research Unit  Western Sydney Local Health District

 Acknowledgements: Dr Ralf Itzwerth and Professor Raina McIntyre, Professor of Global Biosecurity, Kirby Institute, Karoline Baird

Fig 1

The news on 15.3. has announced 300 infected, 3 deaths

Fig 2

Pueyo shows the impact of just one day delay leading to 40% more infected. This is where we go unmitigated: “the cost of waiting”. (Coronavirus: Why You Must Act Now, Tomas Pueyo)

updated on 16 March 2020