Learning to keep our distance

NICK EICHER, HOST: Coming up next on The World and Everything in It: social distancing. We’re hearing that phrase a lot. But what does it mean in practical terms? What distance is far enough? What works and what doesn’t work?

Joining us now to explain is Dr. Charles Horton. He’s a physician in Pittsburgh.

MARY REICHARD, HOST: Good morning, Dr. Horton, now this new term describes something so serious that it can be a matter of life and death. So can you define social distancing and give us some examples of the best way to practice it?

CHARLES HORTON, GUEST: Sure. Social distancing means putting space between you and other people to slow down the spread of disease. Now, normally people are very social; it’s how God made us. I like eating out with my friends more than I enjoy eating out by myself. But now we’re being asked to consciously avoid group events or even prevent them for awhile, to slow down the spread of disease.

One excellent example of leadership in this area is actually what the sports leagues have done. They’ve decided to put the public’s health ahead of ticket sales and not have crowds sitting close together. That’s social distancing. Closing schools, closing restaurants, canceling or delaying cultural events until after things settle down. And working from home whenever possible.

REICHARD:  I’m wondering: can you go too far with this? I mean, maybe some people are doing things they believe are social distancing, but maybe they really aren’t. 

HORTON: I’ll give a lawyer’s answer: It depends. If you completely isolate yourself from the world, you won’t get coronavirus. Now Gunnison, Colorado, actually did this with the Spanish flu in 1918. Officials there barricaded the roads for two months, and nobody in Gunnison died from Spanish flu.

For certain vulnerable people, trying to have the absolute lowest chance of exposure makes sense. The danger goes up sharply with age. Ditto if you’re in generally poor health. Your average teenager is going to shrug this off. But your patient with iffy lungs from smoking a pack a day won’t.

That’s the main idea behind social distancing: make it harder for the virus to spread person to person, and keep it from infecting people who’d be hard hit. Grandma visiting the grandkids who aren’t in school because the school was closed? That could well protect Grandma because the children don’t have coronavirus. 

As far as things that don’t help: I was reading about people going to crowded bars for St. Patrick’s Day festivities, but occasionally using hand sanitizer. If anyone in the bar is sick that’s not enough. 

REICHARD:  We’re hearing a lot about “flattening the curve.” Can you explain that in simple terms? 

HORTON: When we talk about a curve, an epidemic curve, or sometimes we say “epi-curve,” we mean how many new cases show up per day. Lots of factors feed into that. There’s some we can control and some we can’t. Because some bugs are just more contagious than others. They all do have one thing in common, which is they all have to get from one person to another, or they won’t spread. So, the faster a bug spreads, the steeper the curve. The slower it spreads, the flatter the curve. The curve always tails off after a while, even if people don’t do anything at all, because the bug runs out of people to infect.

If you want to think about something happier than actual viruses, think of something “going viral” on the internet, like that video where the guy’s two-year-old barges into the room while he’s giving a live video interview on TV. If you looked at how many people had watched the video, at first it’s going up really quickly, everyone’s forwarding it to their friends. Nobody’s seen it before. Hey, you’ve gotta check this out. After awhile, it tails off because more and more people have already seen it. Real viruses act the same way.

Right now, we’re trying to keep the curve flat as possible, to make the disease spread as slowly as possible. The goal is to keep our hospitals from being overrun like they had been in Wuhan, like they are now in Italy, like we’re starting to see in Seattle.

REICHARD: You know last night, Dr. Horton, I was at the grocery store when I heard a young woman expressing exasperation that people were panicking, and that she wasn’t going to die, so what’s the big deal. What do you say to that kind of naïveté? 

HORTON: I would remind her that even if she isn’t in much danger, she could carry the virus to people who are. And the situation we’re really concerned about getting into is simply running out of ventilators. What if people would survive with the help of a ventilator and ICU care, but there’s no ventilator, or there’s no ICU bed? That’s the situation we’re trying to avoid. And that’s the reason for the kind of extreme seeming measures. They’re worth it. This is not a dress rehearsal. 

REICHARD: Any final tips for us, Dr. Horton? 

HORTON: Again, social distancing. Do clean things that we touch a lot, like refrigerator doors, doorknobs, cash, cellphones. Do cough and sneeze into your sleeve. If you’ve ever seen one of those pictures where someone takes a flash photograph of a sneeze or a cough, it’s amazing how far the respiratory droplets go. It’s about six feet, then gravity takes over. So if you have to be out and about, then keep that six foot mark in mind. 

REICHARD: Anybody’s who’s seen that picture would never forget it. Dr. Charles Horton is a practicing physician in Pittsburgh, Pennsylvania. Doctor Horton, thanks for spending some time with us today. 

HORTON:  My pleasure. Stay calm, stay well.

(Smiley N. Pool/The Dallas Morning News via AP) Physician assistant Paige Lehrer takes samples for flu and streptococcal infections testing from a patient as cars line up for drive-through coronavirus testing at Neighborhood Medical Center on Belt Line Road, Monday, March 16, 2020, in Dallas. 

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