How one little get-together could undermine everyone else’s efforts

You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”, a playdate, a haircut, or picking up a needless item at the store. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

The above comes from an extract from a letter I received from a friend, who received it from her sister-in-law, who received it from someone who received it from “Mike Redelinghuys, an epidemiologist” (you know how these things ‘spread’). It is essential reading, even if you think you are taking Covid-19 properly seriously.

Add your comments at the end please

(Any info about Mike Redelinghuys  or the letter’s genesis welcome, see comment button below.)

“First, we are in the very infancy of this epidemic’s trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn’t have to.

This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. You will feel discouraged. You should. This is normal in chaos. This enemy that we are facing is very good at what it does; we are not failing.

We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception.

“Critical Mass” by Christoph Niemann. “As a kid, I spent a lot of time building pretty complex chain-reaction projects with wooden blocks. I vividly remember the constant anxiety from knowing that one accidental move could destroy everything in a second …”

We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying around you. You may feel like giving in. Don’t.

Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics.

Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit.

You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbour, your neighbour is now connected to the infected office worker your son’s girlfriend’s mother shook hands with. This sounds silly, it’s not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain.

In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison. These measures also take a long time to see the results. It is hard (even for me) to conceptualise how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise.

You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”, a playdate, a haircut, or picking up a needless item at the store. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

Until we get a viable vaccine this unprecedented outbreak will not be overcome in grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months. This virus is unforgiving to unwise choices.

My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn’t working and become paralysed by fear, or to ‘cheat’ a little bit in the coming weeks.

By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty.”

South African readers/readers in SA: please take 5 minutes to complete this survey about Covid-19/coronavirus in the country. This survey is being run by All-Told, which compiles the respected annual Brand Atlas report about SA. All-Told wants to track how the virus is impacting lives in towns and the countryside, suburbs and settlements. If you complete the survey you will be sent free links to the findings. Click Here

Read more about Critical Mass” by Christoph Niemann. “As a kid, I spent a lot of time building pretty complex chain-reaction projects with wooden blocks. I vividly remember the constant anxiety from knowing that one accidental move could destroy everything in a second ..” more: https://www.newyorker.com/culture/cover-story/2020-03-23

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Siobhan Cassidy

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