Dear people who choose not to physically distance
Updated: Apr 15, 2020
Our lives as we know them have been put on hold. Breaking news headlines change by the hour. It is becoming increasingly clear that our world will be forever changed, at least in some way, by COVID-19. For some families, the devastation is more substantial. Every life lost on that world tracker is not just another statistic - it is someone's mother, father, son, daughter, brother, or sister. It is natural with the increased salience of information to forget that these are not just merely data points but instead fatal consequences from a virus that has struck the globe.
Those of us living in Canada have a robust universal healthcare system, and transparent public institutions to protect us. For those of us who do not have to worry about our loved ones living paycheck to paycheck and putting dinner on the table, this period of physical distancing tells a different story. For those of us that are isolating at home in a safe space, free of potential dangers, we are fortunate. And, for those of us that continue to keep learning during this time as our different institutions are able to accommodate online learning, we hold an opportunity many wish for.
We must acknowledge the unique and privileged situation many of us find ourselves in. The best way that we can use this position of privilege is to follow the physical distancing guidelines recommended by experts to help protect our most vulnerable communities. We continue to see, however, examples of our peers disrespecting these efforts, and failing to recognize their responsibilities to our collective society. Being asked to stay home and avoid contact with others contrasts the lifestyle we are accustomed to. Yet, during this unprecedented time, it is one of the crucial strategies to mitigate the rapid growth of COVID-19 (McNeil, 2020).
Contrary to statements made in the media by prominent political leaders, COVID-19 is not like the flu. One way of understanding infectious diseases is to look at their R0 scale (pronounced ‘R-naught’), which refers to the average number of people one sick individual will go on to infect (McFall-Johnsen and Secon, 2020). R0, however, is not fixed; it can change over time with the right preventative measures (McFall-Johnsen and Secon, 2020). This is why you often hear it referred to by scientists and policymakers in the media - it is a key indicator in determining whether the virus is accelerating, plateauing, or diminishing.
Many will remember the fear surrounding the spread of H1N1, and the devastation felt by lower-income countries caused by the Ebola outbreak. H1N1 has an R0 of 1.2 - 1.6, and Ebola 1.6 - 2.0; for every sick person, these diseases would infect somewhere between 1 and 2 others respectively. (McFall-Johnsen and Secon, 2020). Currently, COVID-19 is increasing exponentially, at an estimated R0 of 2.5 (Abedie, 2020).
“I’m young and healthy; why does it matter if I go to the grocery store or spend time with my friends?”; this is a sentiment we have often heard from our peers and in the media. Dr. Robert Signer, Assistant Professor at the University of California, demonstrates the immense impact that even 75% less physical exposure can have on infection rates (Abedie, 2020) (Figure 1). In just 30 days, these measures reduce an individual’s risk of spreading COVID-19 - or contracting it from - 406 people to the basis of it’s R0 - 2.5 (Abedie, 2020).
The trouble with statistics is that they reduce people to numbers. While we are accustomed to reading, absorbing, and repeating these numbers, we are often not well equipped to truly comprehend them, especially when they represent such enormous magnitudes.
It is difficult to grasp, for example, that over 10 million people in the United States filed for unemployment benefits in March due to the economic collapse caused by COVID-19 (Long, 2020) - until we consider that this number represents nearly one-third of the entire Canadian population (Statistics Canada). That nearly 8 out of 10 deaths occur in individuals 65 or older (CDC, 2020) is only a ratio, until we apply these numbers to the most vulnerable members of our communities. The proportion of the homeless population needing shelter services was categorized by age in Canada’s last National Shelter Study, concluded in 2016; nearly 20% of this need resides in individuals 55 or older (Government of Canada, 2019). Individuals experiencing homelessness in tent cities, shelters, and warming centres, however, have no way to socially distance when shelter mats are two feet from one another (Bains, 2020) to accommodate the nearly 235,000 Canadians in need of these services (Purdon and Palleja, 2019). Being asked to stay at home is a small sacrifice compared to what other communities are facing.
While the risk of spreading a disease with an R0 of 2.5 is, clearly, more acute if you are known to be ill, a known or perceived lack of symptoms does not protect you or the people you come into contact with. We must recognize that we are not merely the potential victims of COVID-19, but also it’s carriers. Each time you resist social distancing guidelines, you affect all of us - including the elderly, the homeless, and the unemployed - acting as a vector for the disease.
It is easy to distance ourselves from this vital role, to detach our responsibilities from the scenes that we see on TV and social media. For many, however, this ability is a privilege in and of itself.
One family directly impacted by COVID-19 is 87-year old Allan and his wife, Anne. In 2011, after Allan contracted ventilator-activated pneumonia, Anne was asked to write his obituary; she refused, and nine years later, he has continued to entertain, read, and spend time with family in his Toronto home. As his health declined, however, he was eventually admitted to hospital for palliative care in order to provide him the support he needed in the last stage of his life. This care under COVID-19 looks vastly different, however; with a strain on the healthcare system, hospitals are understaffed and undersupplied as they do everything they can to cope with the needs of not only COVID-19 patients, but others requiring immediate medical care. Allan, not fully understanding where he is or why, often cannot receive full medical attention, as the hospital is strained beyond its capacity. Due to the current R0 of COVID-19, visitors are not allowed into the hospital. His wife Anne must wait, at home, for updates when they are available, hopefully once each day.
Each time someone chooses to flout social distancing guidelines, they make it more difficult for hospital workers to do their jobs and make it more likely that someone like Allan will remain alone, without the comfort of family, or the dignity he is owed in this last phase of his life. Blatantly ignoring the advice of public health officials is selfish and can potentially cost lives for those who contract COVID-19, as well as deny support to others in need of critical medical care. Rejecting and overlooking your responsibility as a member of your community does not make you invincible; rather, it increases the likelihood that these measures stay in place for longer.
As young leaders in the world today, we have a duty to our communities. Although many of us are missing out on some of life’s special occasions, time with friends, and other privileges we are accustomed to, it is vital to put things into perspective. Many of us have an Allan in our lives or a neighbour with an underlying health condition, increasing their risk of complications from COVID-19. Many of us may never contract the virus thanks to the robust measures we as a community are taking, but the impacts for families who lose a loved one will last a lifetime. The frontline healthcare worker who must self-isolate does not have the comfort of returning home to their family each day. The supply chain and grocery workers who supply your food do return home each day, but with the fear that they may infect a loved one. We are doing this for them; we are protecting our most vulnerable populations who may be unable to protect themselves. When you reflect on this historical period, what role will you say you played?
Written by: Quinn Fotheringham and Roya Shidfar
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