Normally I write about geeky technology topics, but since we are in the midst of a pandemic, I thought I’d deviate from the theme of this blog to share a few analogies related to social distancing which is one of our most effective ways of limiting the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19.
The CDC defines social distancing as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.” Given that a vaccine is still under development and possibly still a year away, social distancing is one of our best bets for limiting viral transmissions (in addition to personal hygiene, isolation, quarantine, and other measures). This article and this article address the concept of “flattening the curve” of the number of cases over time, based on how the cities of Philadelphia, PA and St. Louis, MO responded to the 1918 flu pandemic. While there are several excellent publications on the topic, I’d also recommend reading this article, and this article too.
I’ve shared these publications with many friends and family, and while many have embraced the concept of social distancing and are making significant changes in their daily routines, I feel that some people still do not completely understand its importance or have not yet translated their understanding into making immediate lifestyle changes. Therefore, I’d like to offer 3 analogies in hopes that 1 or more of them help to drive home the point.
Analogy #1: Herd Immunity
Immunizations are given to prevent the spread of infectious diseases for both individuals and populations. While most people understand the benefit of immunizations for themselves (e.g., prevention of influenza, measles, varicella, polio, and many other infectious diseases), it is often necessary to remind people that if a sufficient portion of the population is immunized, it confers protection to those who those who are unable to receive immunizations, often due to a compromised immune system. This phenomenon is known as herd immunity.
When an individual decides not to immunize, it weakens the effect of herd immunity. Therefore, I view it as a social and moral responsibility to get immunizations (and when a SARS-CoV-2 becomes available, we should all get that one too, provided that we don’t have any contraindications). Similarly, I feel that everyone has a social and moral responsibility to practice social distancing. Yet, I continue to hear about people moving forward with previously planned non-essential social gatherings. This article provides one such example, but there are less dramatic examples such as family gatherings with elderly individuals or people with high-risk conditions. The prioritization of one’s individual liberties and personal freedom over that of the public good mitigates the effectiveness of social distancing and weakens our “herd immunity” to COVID-19 which means that more people will get infected, and more people will die.
Analogy #2: The Lottery
If you take the perspective of SARS-CoV-2, the propagation of your genetic heritage is dependent on having as many opportunities as possible to spread to other hosts. In epidemiology, there is a statistic called the “reproduction number” or R0 (pronounced “R naught”) which represents the number of new cases that are infected by one infected individual. Earlier this year, the R0 was estimated in this article, this article, and this article to be somewhere between 2 and 3 (plus or minus), which means that for each person with COVID-19, 2 to 3 additional people had been infected on average. This is a recipe for sustained community transmission.
The lottery analogy comes into play when you look at each opportunity for the virus to shed from one individual and infect another host. On a typical day, most people interact with many individuals at work, running errands, in social gatherings, etc. Most people also touch many things that other people touch such as doorknobs, coffee makers, elevator buttons, money, etc. Some people might also cough or sneeze into the air or perhaps be in close enough proximity to breathe directly into someone else’s personal space. All of these actions are opportunities for a virus to spread to another host. Any one particular action is a low-probability event for transmission, somewhat akin to the virus buying a lottery ticket. However, with enough opportunities, SARS-CoV-2 within a host will win the proverbial lottery 2 to 3 times and jump to additional hosts. Social distancing basically deprives SARS-CoV-2 of lottery tickets and helps drive the R0 to less than 1 so that viral transmissions eventually peter out.
Analogy #3: Game Theory
Game theory is the study of mathematical probabilities and decision-making between individuals or groups. It was initially applied to economic scenarios and extended to military decision-making and other fields. It is perhaps best illustrated through games like chicken and poker, and for a classic example of an application of game theory, read this description of the prisoner’s dilemma.
Let’s imagine a game theory scenario for social distancing. In this case, we have multiple participants consisting of everyone in a community, state, country, or even the entire world for that matter. The number of participants doesn’t really matter, but what does matter is when we look at 1 person who is faced with a choice to ignore or follow recommendations to practice social distancing. If that individual ignores (or is simply unaware of) recommendations to avoid crowds and maintain distance from others, then that individual may achieve some gain (e.g., connectedness with other humans, traveling somewhere new, enjoying a movie) at the expense of giving SARS-CoV-2 more opportunities to spread which translates to a public disadvantage.
Summary
I am certainly not suggesting that we cut off all ties to other human beings in the midst of the COVID-19 pandemic. There are also certain things that we must still do out of necessity such as going to work (if remote work is not an option), shopping for groceries, taking care of friends and loved ones who need assistance, etc. I am also not suggesting that we blame people who take less extensive precautions than we do. We are social animals and thrive on human interactions. We also have our own tolerances for change in different scenarios. Therefore, social distancing is not a binary measure. There are degrees to which we can practice social distancing, and the more strictly we adhere to it, the more we will limit the spread of COVID-19 and save lives. It all boils down to a numbers game. How effectively will we play the game? Time will tell. Be safe everyone!
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