What is social distancing?

Social distancing is the concept that individuals refrain from the usual activities in which they encounter other people, for example, work, school, the gym, public transportation, shopping, sporting events, worship, theaters, bars and restaurants. When people with the coronavirus come into contact with others there is the possibility of transmitting the virus. The other possibility is that healthy people become infected by someone who is carrying it. This coronavirus is so new that not everything is understood yet about how contagious it is, particularly when there are no symptoms or if the virus is brewing but not yet apparent.  However, one thing is clear, as evidenced by the growing numbers: the virus is most definitely being spread from person to person in the community — as opposed to direct contacts or the travel origin we saw at the beginning of the epidemic. Scientists, doctors and epidemiologists have created mathematical models to understand the virus’s spread and how to limit it.  There is strong agreement among all the experts that social distancing is the most successful method to slow down the contagion. There has been the suggestion that instead of social distancing, these measures should be called “physical” distancing since there is concern that social isolation will create strain on mental health.   Experts recommend keeping approximately 6 feet away from others; of course this is somewhat arbitrary but it is felt that droplets from sneezing and coughing have a 6 foot trajectory limit. Since it is impossible in most group situations to remain outside of 6 feet, the advice from the CDC is to forego situations where there are crowds or gatherings.  We have seen this number of people to avoid move from 50 to 10 as concerns about spread are growing.

Do young, healthy individuals need to practice social distancing?

Social Distancing in a Computer Lab

Social Distancing in a Computer Lab at BGSU. Photo by Mbrickn. CC-BY-4.0.

Emphatically YES! Although the risk of having serious disease from COVID-19 is much lower in younger, healthy individuals, they pose similar if not greater risk of spreading the virus since they may manifest fewer symptoms and be unaware of being actively ill.  In this manner, people unknowingly become the “vectors’ of disease.  During the early stages of the outbreak it seemed as though many young people brushed off the health risks of acquiring the virus, figuring they would “get it anyway” and best  just “to get it over with”.   As the timeline of the outbreak — now a pandemic — progressed, it has become evident that there will be significant loss of life if the spread is not curtailed very soon. One of the greatest concerns in the impact on hospitals and health systems; at the current rate of growth of COVID-19, there will not be sufficient beds, ventilators (breathing machines) and health care workers to take care of seriously ill people, let alone the normal heart attacks, strokes and accident victims.  We can think of this in global terms or personal terms.  If a young adult were to contract COVID-19 and spread it by not observing social distancing, they may be infecting others, who in turn, would further the spread.  In this manner, we may think of social distancing as civic responsibility. If a young person considers the potential lethality of COVID-19 on parents or grandparents, it may drive the point home that the coronvirus is not be taken casually. 

What places and activities should you avoid doing when you are practicing social distancing (and which ones are considered”safe”)?

In the face of this pandemic, in practice, social distancing means avoiding interacting with other people other than at home or outdoors.  Period.   This is very stringent and may be impossible for some people to do.   As local and federal governments impose shut downs, many of these options will disappear.  Further, some workers are essential to keep the fabric of society intact, others may not have the possibility of working from home.  At this point in the pandemic, there is no such thing as “safe”.

How long should individuals practice social distancing? 

As people recover, and as testing availability improves, it will, as far as we know now, be safe for people who have already had COVID-19 to be among other people.   The CDC defines recovery after a positive test, as two negative swabs 24 hours apart in combination with other factors.  

From the CDC site: CDC guidelines

  • People with COVID-19 who have stayed home (home isolated) can stop home isolation under the following conditions:
    • If you will not have a test to determine if you are still contagious, you can leave home after these three things have happened:
      • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)AND
      • other symptoms have improved (for example, when your cough or shortness of breath have improved)AND
      • at least 7 days have passed since your symptoms first appeared
    • If you will be tested to determine if you are still contagious, you can leave home after these three things have happened:
      • You no longer have a fever (without the use medicine that reduces fevers)AND
      • other symptoms have improved (for example, when your cough or shortness of breath have improved)AND
      • you received two negative tests in a row, 24 hours apart.

What should you do if your job and/or life situation does not allow you to practice social distancing?

The guidelines are very clear about mitigating risk for people who must be out in the world, on the job or in other public places: 

    • Maintain a distance of at least 6 feet from others,
    • Wash hands often with soap and water for 20 seconds (if soap and water is not available, use of hand sanitizers with at least 60% alcohol content is advised). 
    • Do not touch the face.
    • Stay away from older people and those with underlying health conditions.

Are there other steps you can take to protect yourself and others?

Experts advise boosting immune system with healthy eating, exercise and reducing stress, in other words, all the typical health behaviors that are encouraged under normal circumstances, but which become more important during this unprecedented era.  It will be important to maintain contact with friends and family and to remain socially connected, preferably by remote means.

Dr. Howard Baucher, Editor in Chief of  The Journal of the American Medical Association (JAMA) makes the following recommendations:

  • Check in with the CDC website for daily updates since both the virus and restrictions are occurring at a breakneck speed. 
  • Protect the frail and the elderly.
  • Protect health care workers.  We need them to take  care of us.

Finally, remember that Dr. Anthony Fauci, our nation’s foremost authority on COVID-19 says “If it looks like you’re overreacting, you’re probably doing the right thing”.

About the Author

Author, Speaker, Hospitalization Expert, Researcher

Author and speaker Sara L. Merwin MPH received her Master of Public Health degree in epidemiology from the Columbia Mailman School of Public Health and has worked as a clinical researcher at Northwell Health System and Montefiore Medical Center. She has held faculty appointments at Zucker Hofstra School of Medicine and Albert Einstein College of Medicine. Her career and research focus includes patient and professional education and communication.