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Juliana’s thoughts on public health

Should I...?

I’ve received a lot of questions over the last few days. Here are my short answers to some of those and a more detailed discussion for folks who are interested.

Should I…

  • go to the gym? Probably yes but it depends.

  • cancel my trip to visit family in Virginia? It depends.

  • go see the play I’ve been planning for all year? It depends.

  • keep going to work? Definitely yes.

  • send my kids to school? Definitely yes.

  • stop all work travel even if it means losing clients? Probably not.

  • cancel the quilting or video game conference I’m organizing for late March? Maybe.

Community transmission is the term we use when there are people getting COVID-19 who haven’t traveled in an area with COVID-19 and haven’t knowingly had contact with someone who did travel. Community transmission is happening in a few places in the U.S., most notably in Washington state, but it is not happening broadly. This means that for the vast majority of people in the U.S., the likelihood of getting COVID-19 is pretty darn close to zero as of today.

So why do I suggest teleworking and canceling unnecessary travel now rather than waiting until there is broad community transmission? I think we’re on the cusp of COVID-19 getting very big, very quickly in North America and there is evidence that implementing social distancing early is more effective than waiting. Social distancing is the idea that we decrease the amount of contact people have with others by doing things like closing schools, encouraging teleworking, avoiding large gatherings, and so on. This is what many countries are doing already (China, Japan, France, Italy).

While we don’t have tons of robust studies to prove it, there is a fair amount of evidence showing that social distancing can slow down flu transmission which decreases the severity of an outbreak. We don’t know for sure if these same measures will have a similar impact on COVID-19, but at this time it’s reasonable to assume they can.

Since social distancing would likely slow the spread of the virus, I think it’s reasonable for folks who are able to start implementing it now. Many don’t have this option: if you’re a bus driver, work at a grocery store, or teach elementary school, you can’t work from home. But it’s important to realize that social distancing protects the people around you, not just you. If you can afford the privilege of having your groceries delivered, you are helping to protect everyone who does need to go to the grocery store and the people who work there. When you work from home, you help protect everyone in your office. And by keeping yourself healthy, you reduce the strain on hospitals so that they are better able to care for people who do get sick.

So how do you answer the question “Should I…?” Consider the following:

  • How necessary is it for you to go, what are the consequences of canceling, and what are the alternatives?

  • Are you currently sick or is someone in your household sick?

  • Are you older or do you have chronic health conditions? Are you coming into contact with lots of people who are older or have chronic health conditions?

  • Can you wait a few days to decide or even decide on a daily basis? When would you need to decide and what can you do to prepare?

The situation is evolving rapidly and each person’s situation is different. The right choices for you may be different from the right choices for someone else, and the right choice today may be different from the right choice next week.

Juliana Grant