It’s time for Unity in Distancing
This is not very easy to say.
We, as a country, are outdoors a lot. It is fun, and the weather is (almost) always lovely, or there is just not enough space at home. It is especially fun to hang out with friends. Societal interactions form a massive part of any Indian’s psyche.
That’s why, again, talking about physical distancing (famous as social distancing) is very hard in the context of India and any other country with high population density and massive social connectivity.
We have never faced a threat as insidious as the Coronavirus SARS-CoV2.
Due to multiple factors (high population, high population density, poverty, pollution, high social connectivity), India is at a higher risk than other countries. By the end of the first day of lockdown in India, the number of infected people around the world was 460,000. At the time of writing this article, the number is increasing by about 2 thousand per hour. If SARS-CoV2 finds a foothold in India, it will spread like wildfire.
Medical professionals are well-trained to handle crises, but it is our responsibility to help the health care workers from being overwhelmed.
A simple calculation shows that there is simply not enough space in hospitals if too many people fall sick. The SARS-CoV2 in its aftermath, however, leaves a massive number of people seeking medical help.
So what can we do to dampen the coronavirus juggernaut?
To get an understanding as to why these approaches work, let us have some basic information about SARS-CoV2 and Covid-19.
SARS-CoV2 is a newly discovered virus; that means it didn’t exist before, and we don’t know if immunity against it exists.
As of now, nobody has a vaccine for it, or no one knows how worse it can get. We have already seen how fast it spreads. It took barely two days to infect 100,000 people more after infecting 300,000 people. Imagine if it suddenly turns more virulent after infecting one-fourth of the world’s population.
COVID-19 is the infectious disease caused by SARS-CoV2. The outbreak began in Wuhan, China, in December 2019.
Coronaviruses are a large family of viruses that may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).
COVID-19 is especially dangerous to people with a weak immune system, co-morbid conditions, or respiratory issues.
The SARS-CoV2 virus spreads from person to person. Most studies have shown that the virus spreads through respiratory droplets. This means the droplets that are expelled when someone coughs, sneezes, spits, etc.
The released droplets do not travel further than 2m on their own, but they can stay on certain surfaces before drying out.
So let’s get back to stopping the virus spread!
Wash your hands!
No, we do not mean just after using the toilet.
That is obvious!
The SARS-CoV2, enters a cell, preferably in the lungs, and destroys it from within. This lung damage is often irreversible.
However, to enter the cell, the virus uses a key that is embedded in its coat.
The coat is made of fat, and the virus cannot enter the cell without it.
Now we all know what to do when we have a fatty, greasy pan.
Wash it with water and soap!
So the best way to disarm SARS-CoV2 is to use soap; the detergent effect of soap melts the fat and disintegrates the virus.
Well, if washing with soap works, then why social distancing?
But how will you know when to wash hands: When you touch a contaminated surface? When you come in contact with an infected person?
Viruses are incredibly small, nanometer small you can’t see them, and it might take on an average of 4–5 days before symptoms of Covid-19 show up. There is thus the probability of passing on the virus to others without realizing.
The objective of physical distancing is to reduce the probability of infection. The virus can spread at incredible rates. The spread of the virus follows what is known as an exponential curve. So if it spreads to two people in an hour (the typical number is 2–3 people), then it will infect four in the second hour. Next hour, it infects 8 people, then 16 people and so on. But after 15 hours, it will have infected 32,768! Had even any one of them decided to stay home, the number would be halved.
While the standard measures of killing the virus may not be enough, we can slow the spread.
At this point, the only way to stop it from spreading is by using our behaviour as a vaccine — physical distancing.
What does this mean? It’s an alien concept for a place like India.
When growing up, there wasn’t a day when we did not meet friends; when we did not hang out at each other’s homes, and it was not clear at whose place we had lunch, where we will be having dinner and we shake hands and literally rub shoulders with dozens of people in between.
Social relations are significant not only for our mental well-being but for overall health in general. So when we aim for physical distancing, it will definitely come at a cost to us personally. However, physical distancing has taken up several (mistaken) meanings especially when circulated as “social” distancing.
While most agree that this means physical self-isolation, it does NOT mean
- hanging out at home with a bunch of friends over.
- having dinner parties at home with guests.
- having people over because they feel lonely at home.
- meeting only a few people (but different ones every time).
Anything that involves people getting together who don’t anyways share a home is a bad idea.
Simply put physical distancing is best achieved by Staying Home
and further on
- stay put wherever you are. If you are staying away from your family, that’s ok. Do not travel to get back home as you might be endangering not only yourself but everyone you will get in touch with on the way and your family at home.
- minimize outside contact (go shopping the minimal number of times, preferable one person from the family)
- you can still go on walks and enjoy some exercise as long as you stay away from other people. The WHO still recommends 30 min of physical activity per day for adults and an hour for children
- if you do meet in a group, then it is the responsibility of everyone in the group not to have any other contact outside the group. In this way, if one person gets infected, we know the cohort that needs to be quarantined.
Does this mean you cannot come over for a chat?
Imaging, it is sweltering hot, and I come over for a quick chat.
- I come over to your place; I am offered some water.
- I sit down, wipe my face with my handkerchief, and accept the glass of water.
- You take the glass back to the kitchen.
- Before washing, you wipe the sweat from your face.
If I had the virus, now you have it too.
But meeting in a small group is allowed.
Yes! It is, but the group should stay constant over time. If one member of the group gets infected, then the whole group can be quarantined, and the infection will not spread further. However, then everyone in the group needs to make sure that there is absolutely no external contact. Given the uncertainty of interactions with others, and the level of risk, then it is wise to abstain from even small groups and self-isolate.
ok! but we are very healthy!
Sure, so healthy individuals might not be adversely affected by the virus, just suffer a minor inconvenience.
But you may be in contact with a lot more vulnerable people than you think. The number of individuals you know in the hospital, with respiratory issues, weak immune systems, friends with old parents and grandparents at home; you might be putting everyone at risk just because you thought that the interacting individual is healthy.
Healthy individuals, the ones who might be infected but do not show any symptoms, are the most dangerous. If these individuals decide to physically mingle in society, then they can spread the virus without knowing.
Hence, especially if you are healthy, stay in!
Sure! but it is not possible for everyone to self-isolate
The biggest enemy of health in the developing world is poverty.
- Kofi Annan
While the population density of India is about 420 individuals per square kilometre, in some of its densest regions it rises up to approximately 29,000 per square kilometer (Mumbai). The ability to distance oneself physically is a luxury.
People move to the cities for a chance at a better life. This means making compromises on a lot of fronts, sometimes including health. Going to work every day is the only means of putting food on the table (this phrase generously assumes a table). Slums form where the sanitation and space are, no doubt, less than optimum.
Looking at the distribution of slums over the world, almost all of them are in the so-called developing countries.
The availability of water for drinking is often not a given. Washing comes after. With a high density and massive social and economic inequality comes further issues of health. The individuals most vulnerable to falling prey to Covid-19 are the ones with respiratory problems and weakened immune systems. Air pollution is one of the contributors to increased respiratory problems. In India, it is the second biggest death risk after high blood pressure.
The people living in such cramped conditions are one of the most vulnerable in the case of infectious diseases. Besides the obvious immense value of human life this vast community forms the backbone of the burgeoning economy of the country. It is essential for the day to day running of the society.
For the privileged, who can afford to stay at home, and enjoy a better quality of life and access to healthcare, it is an added responsibility to take care of the ones who cannot. The only way to do this in the current scenario is to stay put and avoid any chance of infecting others.
The impact of social media on the way of life and thinking of the masses is impressive.
However, most of the social media is chaff and bit of grain. The trick lies in identifying the truth from fake news.
Calling out bullshit is scientifically possible. It is hard, but possible. It would be better to focus on the facts for now.
According to the latest data by the ECDC, the cases in India are on the rise.
For comparison, observe the rapid increase of cases in Germany and the United States. At the same time, South Korea seems to have successfully managed to level off the total number of cases, and the new instances are dropping in number.
By tracking a massive number of people and targeted testing, what South Korea managed would be difficult in India given the large population size.
Here we could go into numerous details about the appropriateness of strategies being implemented by different countries (autocracy, public privacy). However, honestly, we do not have the time to debate it. If you agree with a philosophy that is helping you stay at home right now, no need to argue as we have the same purpose. Let us sort out the belief structure later after a few months, but that will be possible only if we all make it till after.
In the meantime, coronavirus is no reason for bad behaviour.
Make sure that you are
- not spreading rumours. Fact check before forwarding that funny but untrue story
- not being a racist, the virus owes no allegiance to any nationality, custom, creed, religion or ethic but itself
- not being a bad neighbour. If someone is quarantined, bring groceries to their door, run errands for them etc.
- not hoarding. We live in a land of plenty, only if everyone takes their share leaving the rest for others
- not going on protests, social movements, religious gatherings or any events that require physical congregations. This is not the time.
- make use of social media to spread the right information about how to combat coronavirus. Remember this is physical distancing, not cutting yourself off socially from society.
- use social media to check up on relatives and friends whom you cannot see physically.
- check up on your neighbours (online, across the balconies, call), a caring neighbourhood is a healthy neighbourhood. Be social, from a distance.
- boasting of high moral values, this is the right time to accept people as they are irrespective of their cultural background, again the virus couldn’t care less.
- pay extra attention to personal and public hygiene. Sneezing and coughing in the elbow and NO SPITTING.
- if possible try to maintain a balanced lifestyle with a solo or a fixed small group exercise regime, else exercise at home
- provide “paid leave” to domestic workers
- be a responsible citizen, the country and the world needs us to do our part
Look, this isn't a movie. You are not Will Smith in I Am Legend. Go home. - Giuseppe Falcomatá, Mayor of Calabria, Italy
This is not the common cold. If you were planning on showing off your machismo against “just a cold”, then this is the time to put it on display.
Show that you are brave enough to care about your friends and family. Currently, the only way to do this is to stay physically isolated. Are you brave enough to do this? We have done great things by coming together, now is the time to do this again, by staying apart.
It’s tough , but we can do this!
Where do we go from here?
The lockdown will take a toll on the economy. That is the superficial way of saying that people will be gravely affected. What is the economy but an instance of the cooperative output of millions of individuals.
Rebooting the society ought to be slow and done in a controlled fashion. The whole of society is not a well-mixed pot of khichdi but more like a finely layered dum biryani. The virus, like the flavour, spreads at different speeds through the different layers. Thus there will be some pockets where the disease is already gone from while others where it is still at the peak. Mixing up the layers too fast could spread the virus to hitherto uninfected populations. However, if we gradually release the lockdown, then it will be possible to track possible resurgence and conquer it before it can ever spread!