Sunday, March 15, 2020

Social Distancing is Kindness: #FlattenTheCurve

I've been a global health advocate working on infectious diseases for over 10 years now. But this Sunday morning (instead of going to church) I'm writing to you as a science-loving mom to encourage a shift in attitude about how we view a world-wide and national plea for social distancing. 

I'm well aware that a policy of social distancing goes directly against a core American ideal of individualism ("I have the right to do what I want and you can't stop me!"). But Americans are compassionate, too. Together, we can turn an attitude of forced isolation to one of solidarity in kindness.

The Science of #FlattenTheCurve
It's now too late to stop the spread of the corona virus, so we need to take every precaution to SLOW the spread. That's what people mean when they use the phrase "Flatten the Curve." They're talking about a graph representing the number of daily cases over time. This graph from the CDC shows what we are trying to achieve with social distancing: a reduction in the outbreak's peak. We want to slow the spread of the virus so that everyone doesn't get sick simultaneously, which would overwhelm our ability to care for everyone.

Source: CDC and distributed by Vox
The most important part of the "Flatten the Curve" graph is the location of the peak in relation to the dotted line. The line shows the limits of our health care system. That's the point where we reach the maximum care that our doctors, nurses, clinics, and hospitals can provide. The worst case of a big spike in COVID-19 would be health care rationing! 

Source: Washington Post
If you really want to geek out with more detail, The Washington Post put out an article today with several excellent simulation models showing how social distancing works.  

The Need for Kindness
Crossing that health care line would be especially alarming because we all know who gets access to anything in the US when a resource is scarce...the wealthy. High-risk medical populations and people experiencing poverty would be most in danger. The virus would spread quickly through populations unable to self-isolate (hourly employees needing money to survive, homeless populations, etc).

Isn't it the most noble thing we can use our personal actions to protect the most vulnerable people? Isn't it an exercise in kindness and compassion to protect the lives of our elders, our neighbors in ill health, and people struggling through this crisis in poverty?

Stephen and April
Folks are worried. They're scared and asking for our help. But don't take it just from me. Read two stories from my friends who depend on our actions to keep them safe.

Steven lives in Syracuse, NY, and is in a life and death struggle with kidney failure every day. I follow him on Twitter because of the way he daily expresses his love of his family, Disney, video games, Huey Lewis & the News, and other things we have in common. But he also tweets about what life is like waiting every day for a kidney.
Source: China Centre for Disease Control & Prevention

Steven says:
"I'm sure this pandemic with COVID-19 is scary for everyone. We have decent protocols in place, but I think things are going to be different for everyone in the next few weeks. Schools closed, events cancelled...some people have lost jobs. It's rough. For me, I worry about being able to get dialysis as well as my increased potential for infection due to being immunocompromised. In all those articles where they talk about the people most at risk...well, that's me. 

And I've fought for so long to survive for my family. I don't want to get sick and have to try and fight this...and if I have to go to the hospital, can I get dialysis? Will they be too overwhelmed? See, I can't put off dialysis. It's not something I can stop doing for a while. I HAVE to do it. Or I die. So, I worry about that. Then I worry about being able to pay our bills. We're stretched as thin as butter over too much bread as it is. We're not sure if my wife can work the next few weeks, either. We're still waiting on word for that. And my "safety cushion" savings got used up long ago. It's an adventure down this road, for sure."

April of St Louis, MO is one of the strongest women I know because of her spirit, and not just because she's one of my TaeKwoDo instructors who carries a sword! She's not a complainer. When injured, she has an incredible tendency to push through all kinds of pain as she performs jump kicks and other physically demanding feats in our workouts. Most people would not think she'd be medically at risk just to look at her.

April says:
"I'm really tired of how little concern some people are showing for those of us who would contract a serious case of COVID-19 and could die from this. Your jokes about the flu also are not comforting or funny. I end up in the hospital every flu season. I won't be one of the "mild" cases, so when you make fun of those of us who are showing concern and taking caution, you're showing me you really don't care about my well-being. Please stop. I am scared and if you can't be a decent human being and empathize with those of us who aren't as lucky and healthy as you are, please just do us all a favor and don't say anything at all."

So what can we do? Author Cindy Wang Brant posted this brainstorming exercise a family did with "Family Quarantine of Love" written right at the top of it to remind them all that these sacrifices are acts of love. 

My last note is that none of us will get banners or balloons if we do a great job with this. A successful social distancing policy will look to critics as if there was never an emergency and we over-reacted. As with most acts of kindness, we must be willing to do the unpopular thing. We have to do the right thing when we know no one is looking. Do it for the Stevens, the Aprils, your grandparents, and people relying on soup kitchens. Do it because you care.