The coronavirus outbreak is getting worse, what’s happening in other countries tells us it will soon get worse still, and public health experts have started asking people to practice social distancing — more isolation from each other, more holing up in your place for days, much less physical contact with the world.
Those measures have some people who are in low-risk groups — young, in good health, not living with anyone more vulnerable — asking an uncomfortable question: Wait, is this all worth it? Maybe I’d rather risk getting the coronavirus and have a bad flu for a couple of weeks instead of dealing with all this disruption to my life?
That’s not a bad question. But one reason so many people are asking it is because of a big failure in communication about the coronavirus. From the White House on down, most communication has been about how to reduce your personal risk of getting the coronavirus. The virus, which is much more dangerous than the flu even for young, healthy people, does warrant strong precautions for your own sake.
But that’s not the whole story. The fact is that social distancing and other preparations that are being recommended aren’t just about protecting yourself. They’re about protecting the people in your community, especially the vulnerable ones.
Here’s another way to think about this: If you are young and healthy, you ought to take precautions because doing so can end up saving someone’s life. In fact, taking precautions like social distancing is likely one of the more important things you can do to protect sick and older people in your community, and to shield our society from the kind of catastrophic effects the virus has had in countries where it has overwhelmed first responders, hospitals, and morgues.
In the US, we’re unaccustomed to framing individual choices in this kind of language. It would be jarring (for many reasons) to hear Trump appear on TV pleading with us to work from home and cancel parties as an act of patriotism, as an act of altruism, as a sacrifice the healthy need to make for the sake of the less healthy and uninsured.
But that’s exactly what taking these precautions is: an act of altruism. As Zeynep Tufekci argued in Scientific American in February, “We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society.”
The crisis in front of us isn’t just one of practical inconveniences; it has a moral dimension we can no longer look away from. Yes, it’s really inconvenient. Yes, it’s not yet mandated by law — and if all goes well, we might improve things before it has to be. And yes, it may get a bit embarrassing and socially awkward to take such precautions if the people around you haven’t realized yet that it’s necessary.
But those inconveniences should pale beside what we stand to lose if we keep spreading coronavirus: our grandparents, our parents, the doctors and nurses who’ll care for them, our friends who are fighting cancer or recovering from surgery or immunosuppressed or dependent on someone who is. If you’re young and healthy, social distancing might be a pain for you. But it’s a chance, in the midst of the one of greatest pandemic crises in a century, to be a hero for other people.
We need to make it easier for vulnerable people to avoid getting sick
One aim of public health experts now that containment is largely out of reach in much of the US should be to ensure that people for whom it is more dangerous to get sick have the ability to stay healthy.
The Centers for Disease Control and Prevention (CDC) has identified persons who are over 60 years old or immunocompromised as a high-risk group. The agency recommends this group largely stay home, but some of them will need to leave the house at some point — for groceries that can’t be delivered in their area, for necessary doctor’s appointments, for jobs they cannot quit.
The more the virus spreads, the riskier these unavoidable activities become. A trip that brings you into contact with 10 people is pretty safe if only a few people in your metropolitan area have the virus — but potentially deadly if many more of them do. On top of that, some people with virus may be asymptomatic, so it’s possible you could spread the virus without knowing you are sick.
At least 20 percent of the population is in an at-risk group for getting coronavirus, which includes older adults, but also people who are undergoing chemotherapy, are living with HIV/AIDS, have preexisting respiratory issues, or are just recovering from another serious illness. That means that if you get coronavirus and spread it to three other people — and statistically, the average person who catches it and doesn’t take any social distancing measures does spread it to two or three people — there’s a scarily decent chance that you will spread it to someone for whom it might be deadly.
That’s a risk you would hopefully never take casually.
But that’s not the only consideration. There’s also the risk that the people you spread it to will then spread it to at-risk people. Overall, one way to think about what happens when you get and spread the coronavirus is that the epidemic’s doubling time in your region shortens. And that faster spread can cost lives.
We need to slow down coronavirus cases
If you get the coronavirus right now, even if you require hospitalization — and evidence suggests as many as 15 percent of infected people might — you will probably survive. From events like the Diamond Princess cruise ship disaster and from reporting from countries that have contained their outbreaks well (see Taiwan and Singapore), we have reason to believe the mortality rate from coronavirus may be below 1 percent when there’s adequate health care available.
But what about when there isn’t? In Wuhan, China, when the crisis got severe, patients were turned away from hospitals because there were no beds for them. In Iran, scenes of hundreds of people desperately trying to reach the hospital were shared online. In Italy, doctors are warning that they’re setting up critical care services in hallways and that ICUs are so overwhelmed that many patients are dying needlessly.
Could problems like these happen in the US? Yes. A paper released last month by the Center for Health Security examined the burden on hospitals should the coronavirus spread widely here.
Even if you aren’t among the 38 million Americans who will need medical care if the virus spreads undisrupted throughout our population, you likely know someone who will. And if things get this bad, the pace at which the virus spreads through the population will determine whether our medical system is overloaded.
“It’s impossible to avoid an epidemic here in the US,” former Food and Drug Administration Commissioner Scott Gottlieb told USA Today on Monday in an interview where he called for much more comprehensive social distancing measures nationwide. “We do have the potential to limit the scope of the epidemic, but we need to be taking more aggressive steps. If you implement mitigation steps, you slow the rate at which people get the virus. You end up extending the epidemic, it lasts longer, but it doesn’t peak as high. You want to slow the rate of infection here so that you can manage it with the health care system.”
That point is illustrated in this adaptation of a chart from the CDC:
Taking steps to make the outbreak happen slower — like taking precautions yourself as a healthy person — will reduce the odds that we overwhelm our hospital system, which increases the likelihood that everyone who needs hospitalization gets it. Delaying the peak of the epidemic by even a few weeks can save lives by ensuring that a greater percentage of the cases have access to medical care.
There’s historical data to back up this graph. In 2018, researchers compared the effects of the 1918 influenza in St. Louis, which implemented social distancing measures, and Philadelphia, which didn’t.
You can see that the measures taken in St Louis saved lives, and also delayed and smoothed the peak of the outbreak. That’s what we’re aiming for, and it’s something you can personally help achieve by taking precautions.
We aren’t often asked to help other people
Many public health announcements about the virus have assured people that their personal risk is likely low. This is, of course, true — if you are young and healthy. But this may be interpreted by some people that because their personal risk might be low, they don’t need to take any precautions.
Here’s a better message: Coronavirus is a high-risk threat to too many of our family members, friends, and neighbors. The risk to our country and to our communities is high. The risk to our parents and grandparents is high. The risk to those of us undergoing chemotherapy or immunocompromised for other reasons or with underlying health conditions is high.
And the rest of us can help. Rarely does the normal person have the opportunity to, with small sacrifices, save the lives of their friends, neighbors, and relatives. But right now, we do have that opportunity. By taking strong social distancing measures before they’re mandated in your community — by canceling or not attending parties and large events; by changing religious services to reduce disease-transmitting activities; by, if you are lucky enough to be in a job that permits it, working from home or letting your employees work from home — you can save people’s lives.
If you don’t have reason to be scared individually, that’s great, but our fellow citizens who are vulnerable matter too, and we can help save them. Take measures for people who are sick or weak or old and build a country that’ll be there for you when you’re sick or weak or old, because someday you will be.