(Disclaimer – my work experience is in chronic disease versus infectious disease epidemiology)

 

Move Fast

The growth of coronavirus in the U.S. is presently exponential.( https://www.nytimes.com/interactive/2020/03/13/opinion/coronavirus-trump-response.html;

) Preventing cases now will prevent far, far more in the future.

Coronavirus appears to be spread primarily person to person; very large proportions of infection on cruise ships and in families. Some models claim near a majority of infections are spread by asymptomatic carriers. Spreaders may not know they are infected.

Translation – the less you contact other people, the less the spread.

Yes, social support is crucial to surviving anything in life. But the less you’re around other people, you less you will unintentionally spread the virus.

 

 

Age

Rather unlike flu, much of coronavirus transmission occurs through adults. And there is a dose response curve with age.

The older you are, the more fatal the illness. In the South Korean data, probably more accurate than others we have due to greater community testing (a quarter million so far in a nation of 50 million), mortality rates for those over 80 were over 8%; for 60-69, 1.4%; for youth, pretty darn low.

Why this dose response curve is so sharp is not clear. Is it due to the burden of disease with age? That youngters’ immunity to coronavirus fatality is because they have seen more recent similar infections? Because their overall viral immunity is better?

The answers will come later. The British have called for “self isolation” for over 70s due to the dose response numbers.

Bottom line – the sicker you are overall, and the older you are, the more susceptible to coronavirus mortality. This is The time for great community support of the elderly and the sick.

 

Travel bans

The WHO does not advocate travel indiscriminate travel bans. The South Koreans are appearing to arrest the exponential growth of virus by targeted measures for each entry into the country.

Travel bans hurt international cooperation, necessary for dealing with pandemics. When you stop passengers, you also stop the cargo in the passenger planes, which may carry needed medical equipment. The people making the masks and drugs you need may not be willing to play if you ban their goods and planes.  You play havoc with national economies.

But they are great political theater. They give the appearance of something “really important” being done, though they work best if instituted very early, not late.

The virus is established in the population. We will have travel bans, but they will by no means make us safe.

 

Learn to Bow

It may give you a sense of social connections, but now is the time to stop shaking hands. You can try elbow bumps, but a safer strategy to show fellowship and social engagement is to bow.

As the Japanese and Chinese can tell you, bowing has many meanings. It can be done informally, formally, gravely or humorously. You can get across a lot of meaning with a bow. And it’s a low safer than shaking hands.

 

Thank People

Crises and disasters should tell us that humans are social animals, and dependent on many, many others who keep us alive. I mean far more than the firemen and police, doctors and nurses cited after 9/11. Thank the truck driver who brings food to your supermarket. Thank the municipal worker who keeps your water safe. Thank the linemen who keep your power running. Thank the cleaners who sanitize our workplaces and homes. And many, many others.

We’re dependent on a whole lot of people we never meet. When you meet them, thank them.

 

Wash Hands

Stores will run out of hand sanitizer, but we probably won’t run out of soap. Washing your hands may be a better deal anyway, as it’s behaviorally more common for people to soap their whole hand rather than with sanitizer. There are good ways to do it that make washrooms more safe for who comes next (https://www.bbc.com/news/av/health-51754472/coronavirus-how-to-wash-your-hands-in-20-seconds

). And though it will be hell on folks with OCD, you can definitely use hand creams to treat the dryness of your skin – if they’re available.