COVID-19: Are you ready for the next normal?


Coronavirus (COVID-19): Social distancing – it’s no joke!


We continue to receive questions about social distancing and the “why” behind this important public health practice and its effectiveness in containing the spread of COVID-19.

Go to any media outlet and you will be bombarded with talk of COVID-19 and social distancing. You may even have seen a few jokes and memes. But what is social distancing, and why is it so important to the control of the spread of COVID-19?

Although the term social distancing, also known as non-pharmaceutical intervention (NPI), may be new to many of us, the concept has been around for centuries. A form of NPI/social distancing was referenced in the bible with the development of leper colonies to decrease the spread of leprosy. In more recent history, we only need to look at the tale of two cities to see that NPI measures are effective ways to decrease the spread of disease. During 1918, the city of Philadelphia did not heed warnings about the spread of the so-called “Spanish” flu and held a parade for WWI soldiers. The crowd was estimated at over 200,000 people. Three days later every bed in Philadelphia’s 31 hospitals was filled with patients infected with the  flu and 2,600 were dead within a week. At approximately the same time, St. Louis officials heeded warnings about the flu and instituted school closures and banned public gatherings, both forms of NPI. Philadelphia instituted NPI measures nearly two weeks later. These social distancing practices kept per capita flu-related deaths in St. Louis to less than half of those in Philadelphia, according to a 2007 paper in the Proceedings of the National Academy of Sciences.

NPI/ social distancing is based on a set of commonplace, commonsense actions with infection control benefits. The goal is to reduce the probability of contact between people who are ill or carrying an infection, and others who are not infected. Reducing contact among people will minimize disease transmission, illnesses and deaths. The transmission of COVID-19, which is spread by droplet contact, from sneezing or coughing, or by direct and indirect contact with a person or a contaminated surface, like a door handle, is directly impacted by NPI/social distancing measures.

Social distancing starts with maintaining a personal space of six (6) feet between individuals. Yes, this means no hugs, no handshakes and avoidance of large gatherings where maintaining this distance is impossible. Recommendations have been made for school and business closures, working from home, and the cancellation of large scale sporting events, amusement/ entertainment parks and religious services. There are other commonsense practices that are equally as beneficial, such as frequent disinfection of surfaces, staying home when you feel ill, cough and sneeze into the crook of your elbow and do not touch your face, to name a few.

And let’s not forget the importance of frequent handwashing. Experts recommend washing your hands with soap and hot water, for at least 20 seconds, often throughout the day. In

addition, you should also wash your hands whenever you come indoors, before you eat, before you touch your face, and before spending time with those who are vulnerable to the effects of COVID-19, including older adults and those with serious chronic medical conditions.

Additionally, if you must be in a public place, you should use antibacterial wipes to decontaminate surfaces that could be contaminated, such as grocery cart or a door knob.

With COVID-19, the goal of NPI/social distancing is to slow down the outbreak and reduce the chance of infection among high-risk populations which will reduce the burden on our health care systems and workers. Experts call this “flattening of the curve” which refers to the benefits of NPI/social distancing practices which will prevent a surge of illnesses which could overwhelm healthcare systems. There is early, although not yet substantiated information suggesting that the implementation of NPI/social distancing practices very early in the outbreak of COVID-19 in the city of Guangzhou, China had significantly lower numbers of hospitalizations from COVID-19 on its peak day than the city of Wuhan, which put measures in place a month into the outbreak.

The CDC’s Morbidity and Mortality Weekly Report (MMWR) published April 17, 2020 sheds light on the impact of NPI/social distancing mitigation efforts in New York City, New Orleans, San Francisco, and Seattle. These 4 cities instituted similar NPI/social distancing measures at approximately the same time and early data showed a subsequent decrease in new cases. While the report noted limitations, the authors state “this analysis suggests that policies to increase social distancing when case counts are increasing can be an important tool for communities as changes in behavior result in decreased spread of COVID-19.”

As individuals, we can help to slow the transmission of this virus to at risk populations through simple, commonsense practices. NPI/social distancing isn’t a joke, it can save lives.

This world-wide Coronavirus outbreak is fluid and evolving. Cogency will strive to stay on top of this situation to keep you informed. For more information about this Coronavirus outbreak and how to characterize your risk and reduce risk to those you are charged to protect, contact the experts at Cogency at

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