Keep your distance

As "pandemic fatigue" grows, scientists encourage one pivotal behavior

"I wish I could suggest a way to help people continue to be careful."

Bernhard Lang

In early 2020, as the spread of Covid-19 took off at a dangerous speed, the dominant reaction was characterized by fear, panic, and anxiety. Now, seven months in, much of that acute and paralyzing stress that led people to stay home and social distance has been replaced by "pandemic fatigue."

From California to the Czech Republic, people are over lockdown — and as their fatigue creeps in, their vigilance to abide by public health measures dwindles. People, in turn, dine-in, gather in groups, travel, and the coronavirus surges. On Friday more than 415,000 cases were recorded globally, an all-time high since Covid-19 first emerged.

To curb an exceedingly catastrophic resurgence, scientists caution that social distancing measures need to be implemented early, fast, and designed with local context in mind.

In a study published Monday in the journal Annals of Internal Medicine, researchers outline why continued social distancing can help thousands of people survive as the pandemic endures.

Co-author Oguzhan Alagoz is a professor of industrial and systems engineering at the University of Wisconsin and finds pandemic fatigue "really concerning."

"We have started seeing this 'fatigue' effect over the summer but due to favorable weather in the northern U.S. and Midwest, people had opportunities to hold activities outside so the impact was not huge," Alagoz tells Inverse.

"I am worried about the impact of shifted behaviors in fall and winter."

That shifted behavior is evidenced by recent cell phone data demonstrating that population movement has already increased — a rise to pre-pandemic levels he describes as a cause for alarm.

Despite these concerns, Alagoz emphasizes that there are still simple tactics we can take to manage Covid-19: wearing a mask, limiting large group gatherings, and social distancing.

"We found that social distancing, which leads to a burden in the economy and social life, indeed contributes to a significant reduction in the number of cases although the effect differs from region to region," he explains.

The study — To determine how effective social distancing measures are, Alagoz and his colleagues created a specialized simulation model that honed in on transmission dynamics in three urban areas: Dane County, Wisconsin; the Milwaukee metropolitan area; and New York City.

The model represents:

  • The social network and interactions among people in these various regions, with and without social distancing measures in place.
  • Local population demographics and density
  • The estimated daily number of contacts
  • Adherence to social distancing measures

The team factored in data from the Centers for Disease Control, local public health authorities, and the growing body of scientific literature.

Mask mandates were left out of the model because the authors focused on early periods of the pandemic before recommendations that the general population wears masks. Importantly, the team also did not account for behavioral changes that happened amid the pandemic and instead estimated people's social interactions pre-pandemic.

Does social distancing work? — Across all three areas, social distancing worked in limiting the community spread — and crucially, when social distancing measures were implemented made a huge difference in the number of Covid-19 cases. Easing up too early on social distancing resulted in higher cases of Covid-19 in each area.

For example, the team found that had social distancing measures been initiated in New York City one week earlier than the actual date, infections could have been reduced by 80 percent by May 31. Meanwhile, waiting a week longer before initiating the measures would have led to a five-fold increase in the number of infections in the same time frame.

"So far these are the only means for us to mitigate the effects of this pandemic."

In Dane County and Milwaukee respectively, implementing social distancing measures one week earlier would have reduced the number of infections by 46 and 52 percent. Waiting a week would have led to more cases in these regions, but not the estimated explosion of cases New York City was estimated to experience.

"This study shows that adhering to social distancing measures by wearing face masks and reducing in-person gatherings in closed environments, etcetera, are working," Alagoz says. "So far these are the only means for us to mitigate the effects of this pandemic."

Whether people followed public health precautions made a significant difference too: The team estimated that 70 percent of the local population in Dane County and Milwaukee would need to adhere to social distancing measures to keep the pandemic in a "steady state." In New York City, 85 percent of people would need to adhere to social distance measures — likely because the population density is high and many people rely on public transportation.

Act fast, act local — The deluge of coronavirus data and misinformation have left many people confused. Some may wonder if public health precautions really work. This study, on top of other research, offers affirmative evidence that social distancing measures are one of our most effective tools to mitigate Covid-19.

The results also show that early, localized interventions save lives, scientists who were not involved in the research wrote in a related editorial.

"Timing, distance, and data are critical during a pandemic," Jeffrey Koplan, the principal investigator of the Emory University Global Health Institute, wrote. "There is no one-size-fits-all community solution. To control the spread of the virus, we must localize our responses."

Partial abstract:
Background: Across the United States, various social distancing measures were implemented to control the spread of coronavirus disease 2019 (COVID-19). However, the effectiveness of such measures for specific regions with varying population demographic characteristics and different levels of adherence to social distancing is uncertain.
Results: The timing of and adherence to social distancing had a major effect on COVID-19 occurrence. In NYC, implementing social distancing measures 1 week earlier would have reduced the total number of confirmed cases from 203 261 to 41 366 as of 31 May 2020, whereas a 1-week delay could have increased the number of confirmed cases to 1 407 600. A delay in implementation had a differential effect on the number of cases in the Milwaukee metro area versus Dane County, indicating that the effect of social distancing measures varies even within the same state.
Limitation: The effect of weather conditions on transmission dynamics was not considered.
Conclusion: The timing of implementing and easing social distancing measures has major effects on the number of COVID-19 cases.

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