So­cial Dis­tanc­ing is a key prac­tice that can pre­vent the spread of the Nov­el Coro­n­avirus in T&T. Since the pan­dem­ic of the Nov­el Coro­n­avirus (Covid-19) has stolen the in­ter­na­tion­al news head­lines, the term so­cial dis­tanc­ing has be­come the buzz­word.

We have even been ad­vised on some prac­tices that are con­sid­ered so­cial dis­tanc­ing, like avoid­ing crowds and any gath­er­ing of peo­ple. The Prime Min­is­ter even an­nounced at his press con­fer­ence to lim­it gath­er­ings to a max­i­mum of ten peo­ple. Many may have been stay­ing at home be­cause of the clo­sure of schools, uni­ver­si­ties and busi­ness­es. It may be ob­vi­ous that the ob­jec­tive of these mea­sures is to re­duce the prob­a­bil­i­ty of con­tact be­tween per­sons car­ry­ing an in­fec­tion, and oth­ers who are not in­fect­ed, in or­der to min­i­mize dis­ease trans­mis­sion. How­ev­er, what are oth­er prac­tices of so­cial dis­tanc­ing we can prac­tice to re­duce the spread of in­fec­tion?

So­cial dis­tanc­ing is a set of non phar­ma­ceu­ti­cal in­fec­tion con­trol ac­tions in­tend­ed to stop or slow down the spread of a con­ta­gious dis­ease, like Covid-19. It is most ef­fec­tive against in­fec­tions that can be trans­mit­ted via droplet con­tact (cough­ing or sneez­ing); di­rect phys­i­cal con­tact, in­clud­ing sex­u­al con­tact; in­di­rect phys­i­cal con­tact (e.g. by touch­ing a con­t­a­m­i­nat­ed sur­face such as a fomite); or air­borne trans­mis­sion (if the mi­croor­gan­ism can sur­vive in the air for long pe­ri­ods). It may be less ef­fec­tive in cas­es where an in­fec­tion is trans­mit­ted pri­mar­i­ly via con­t­a­m­i­nat­ed wa­ter or food or by vec­tors such as mos­qui­toes or oth­er in­sects, and less fre­quent­ly from per­son to per­son.

This pub­lic health mea­sure to pre­vent the spread of dis­ease has been prac­ticed for ages. His­tor­i­cal­ly, lep­er colonies and lazaret­tos were es­tab­lished as a means of pre­vent­ing the spread of lep­rosy and oth­er con­ta­gious dis­eases through so­cial dis­tanc­ing, un­til trans­mis­sion was un­der­stood and ef­fec­tive treat­ments were in­vent­ed. This was al­so em­ployed dur­ing ma­jor epi­demics and pan­demics in the past such as; the Span­ish Flu of 1918, the SARS (Se­vere Acute Res­pi­ra­to­ry Syn­drome) in 2003, the Swine Flu in 2009 and now in 2020 with Covid-19. By prac­tic­ing so­cial dis­tanc­ing and re­duc­ing spread through per­son-per­son con­tact, we pre­vent a sharp peak of in­fec­tion and re­duce the in­ci­dence to a lev­el that will not over­whelm the health­care sys­tem ca­pac­i­ty. This ef­fect is what is called ‘flat­ten­ing the curve’), a pop­u­lar term that was used by the Pub­lic Re­la­tions Of­fi­cer of the T&T Med­ical As­so­ci­a­tion (T&TMA), Dr. M.I.O. Rah­man and lat­er by our Min­is­ter of Health.

Here are mea­sures of so­cial dis­tanc­ing we can em­ploy to pre­vent the spread of Covid-19:

Avoid: Group gath­er­ings, con­certs, ath­let­ic events, malls, crowd­ed re­tail stores , the­ater out­ings, work-out at the gym, sleep overs, play dates, vis­i­tors in your home , non-es­sen­tial work­ers at your house

Use Cau­tion when: Vis­it­ing gro­cery store, pick­ing up med­ica­tion, vis­it­ing lo­cal restau­rants (get take out), go­ing out for ex­er­cise, trav­el­ing

Safe to: Take a walk, go on a hike, play in your yard , read a good book, lis­ten to mu­sic , have fam­i­ly game night, go for a dri­ve, have video chats, stream your favourite movie.

It is true that the ma­jor­i­ty of cas­es of Covid-19 present with mild to mod­er­ate symp­toms and re­cov­er ful­ly. So why in­sist on so­cial dis­tanc­ing? We must re­mem­ber the vul­ner­a­ble, those who suc­cumb to the com­pli­ca­tions and have a high risk of dy­ing from Covid-19 in­fec­tion. These in­clude the very old, the very young, those with co­mor­bidi­ties such as; Di­a­betes Mel­li­tus, heart dis­ease, lung dis­eases (Asth­ma and Chron­ic Ob­struc­tive Lung Dis­ease), liv­er dis­ease, kid­ney dis­ease, and preg­nant women (see Fig3 for more). If some­one con­tracts Covid-19, it is not like­ly they may die from it, but con­tract­ing the dis­ease means you can spread it to these more vul­ner­a­ble in­di­vid­u­als, putting their lives at risk. Yes, you may sur­vive, but you may be­come the cause of the death of an­oth­er be­cause you spread it to them.

Even though so­cial dis­tanc­ing can be very ef­fec­tive in re­duc­ing the spread and not put a toll on our health­care sys­tems, it does have its draw­backs. We are a high-tech so­ci­ety, but al­so a high- ‘touch’ species. So, lim­it­ing our phys­i­cal in­ter­ac­tion can lead to feel­ings of lone­li­ness, re­duced pro­duc­tiv­i­ty and loss of the ben­e­fits as­so­ci­at­ed with hu­man in­ter­ac­tion. This is be­cause so­cial dis­tanc­ing mea­sures can make peo­ple like­ly to iso­late them­selves and more prone to anx­i­ety. It is im­por­tant to note that, while work­ing from home, phys­i­cal ac­tiv­i­ty will be re­duced lead­ing to added feel­ings of sad­ness, frus­tra­tion or anger. The el­der­ly may be hit the hard­est by the neg­a­tive im­pacts of so­cial dis­tanc­ing. A sit­u­a­tion such as the Covid-19 pan­dem­ic is one where many feel they may not be in con­trol. Such a sit­u­a­tion is a risk fac­tor to de­vel­op anx­i­ety, or ag­gra­vate symp­toms if you al­ready have a pre­ex­ist­ing mood dis­or­der like anx­i­ety or de­pres­sion. Al­though so­cial dis­tanc­ing may be an op­por­tu­ni­ty to tune in­to your own well-be­ing, it may be a good time to fo­cus on a healthy di­et, sleep/rest or tak­ing walks more than you nor­mal­ly would.

Us­ing tech­nol­o­gy, keep in touch via tele­phone or video con­fer­enc­ing with loved ones, fam­i­ly and friends. Whether or not you are prac­tic­ing so­cial dis­tanc­ing, make sure you are not ig­nor­ing your men­tal health. Let’s be each oth­er’s keep­er and stand unit­ed against Covid-19 by be­ing apart. Prac­tice so­cial dis­tanc­ing.

Dr. Visham Bhimull

Pri­ma­ry Care Physi­cian

MBBS (UWI)

Diplo­ma in Fam­i­ly Med­i­cine (UWI)