Let’s face it: social distancing is boring, and difficult. While people in my generation understand its necessity, we still possess a sense of invincibility. And among high school seniors, there’s righteous anger at COVID-19 for everything we’ve lost: prom, the last few months of school with our friends, possibly the honor of walking across the stage at graduation in front of everyone who supported us through our years of education. Unknowns regarding the future spark anxiety too. Much information surrounding COVID-19 is available through mainstream media, but there are gaps. Here, I’m going to do my best to fill them in.
To this end, I reached out for guidance to Dr. Wan Yang, an environmental engineer and infectious disease modeler in the Department of Epidemiology of Columbia University’s Mailman School of Public Health. My first question: why can’t we quarantine only the people most vulnerable to this disease (the elderly and those with preexisting conditions)? The answer is more complicated than it might seem.
Initially, it seems like a good idea. Let everyone else go on with their everyday lives, build herd immunity to prevent future outbreaks, and keep businesses running. But a deeper look reveals major problems with this plan. For starters, it’s not just the elderly and those with preexisting conditions who are affected. The CDC is recording a large proportion of severe cases among young adults without preexisting conditions. Of course, gathering accurate data to prove this point is difficult as our nation’s testing capacity is vastly insufficient, but as of March 26th, up to 23% of people hospitalized in the US were under the age of 44. Severe cases occur more commonly in people over the age of 65 or with underlying health conditions, yes. Still, no one is safe.
COVID-19 is a tricky disease. There’s still debate over how it spreads: respiratory droplets, or even finer particles of virus-laden air called aerosols? Respiratory droplets are the more likely answer, but especially in healthcare settings, aerosols haven’t been completely ruled out as a transmission method. Plus, according to Dr. Yang, “when there is widespread disease, with high prevalence of asymptomatic infections… there are chances they can pass the virus to the vulnerable individuals.” So even if you feel perfectly fine, you may still carry the virus to more vulnerable individuals in your social circles.
I also wanted to know what other countries have done correctly (and incorrectly) in their handling of COVID-19, and what the United States can learn from when formulating our response. “Early on widespread testing to thoroughly identify infections including those with mild symptoms or no symptoms at all so as to isolate and stop the spread is critical,” Dr. Yang told me. In an article from the Canadian Broadcast Corporation, infectious disease expert Andrea Crisanti, currently on the ground in Vò, Italy stated that because the large majority of cases present no symptoms, ubiquitous testing provides the possibility of catching all possible cases, isolating them, and preventing rapid spread through communities. This worked in South Korea too. China’s primary tactic was to institute a strict lockdown in Wuhan, which is finally beginning to reopen. A combination of these two methods seems to yield the best results in terms of containment. And if these measures aren’t enacted quickly and completely? “[A] sudden and large surge in the number of people needing care would likely overwhelm our healthcare system, leading to a large number of deaths, like what is happening in Italy now,” warned Dr. Yang.
I’ve also been hearing in the news that younger people are more severely impacted in Europe and America than in China and South Korea. I asked Dr. Yang why this seems to be happening. Disconcertingly, this is one question nobody appears to know the answer to. “We don’t know for the time being,” Dr. Yang said. “We cannot accurately assess how severe it is for different age groups and if there are really differences in Europe and America vs. China and South Korea.” So best practice is to assume you’re vulnerable and stay home.
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-346. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2
Doremalen, N. V., Bushmaker, T., Morris, D. H., Holbrook, M. G., Gamble, A., Williamson, B. N., … Munster, V. J. (2020). Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. New England Journal of Medicine. DOI: 10.1056/nejmc2004973
Geggel, L. (2020, March 5). Can wearing a face mask protect you from the new coronavirus? Retrieved from https://www.livescience.com/face-mask-new-coronavirus.html
Pelley, L., & Miller, A. (2020, March 21). ‘They were completely unaware’: Why mass COVID-19 testing is key to stopping spread | CBC News. Retrieved April 5, 2020, from https://www.cbc.ca/news/health/coronavirus-canada-testing-symptoms-italy-1.5504780