Social Distancing: “It’s Not A Snow Day”

As the coronavirus pandemic hits Westport, I’ve tried to maintain a balance. I want to inform readers, but not overwhelm them. I want to be relevant, but not alarmist. And I want to make sure that every story has a local hook. There’s plenty of information about the virus out there, from many sources. This is a local blog, not a national one.

But a number of readers have raised questions about “social distancing.” They wonder what it means for play dates and small gatherings. One expressed concern after seeing a group of teenagers posing tightly for a selfie at the beach.

A dozen readers asked me to post this piece by Dr. Asaf Bitton, executive director of Ariadne Labs in Boston. Originally published on Medium — with the provocative headline “Social Distancing: It’s Not a Snow Day” — it’s gone, um, viral. He writes:

I know there is some confusion about what to do next in the midst of this unprecedented time of a pandemic, school closures, and widespread social disruption. As a primary care physician and public health leader, I have been asked by a lot of people for my opinion, and I will provide it below based on the best information available to me today. These are my personal views, and my take on the necessary steps ahead.

What I can clearly say is that what we do, or don’t do, over the next week will have a massive impact on the local and perhaps national trajectory of coronavirus. We are only about 11 days behind Italy and generally on track to repeat what is unfortunately happening there and throughout much of the rest of Europe very soon.

At this point, containment through contact tracing and increased testing is only part of the necessary strategy. We must move to pandemic mitigation through widespread, uncomfortable, and comprehensive social distancing. That means not only shutting down schools, work (as much as possible), group gatherings, and public events, but also making daily choices to stay away from each other as much as possible to “flatten the curve” (below).

Our health system will not be able to cope with the projected numbers of people who will need acute care should we not muster the fortitude and will to socially distance each other starting now. On a regular day, we have about 45,000 staffed ICU beds nationally, which can be ramped up in a crisis to about 95,000. Even moderate projections suggest that if current infectious trends hold, our capacity (locally and nationally) may be overwhelmed as early as mid-late April. Thus, the only strategies that can get us off this concerning trajectory are those that enable us to work together as a community to maintain public health by staying apart.

The wisdom, and necessity, of this more aggressive, early, and extreme form of social distancing can be found here. I would urge you to take a minute to walk through the interactive graphs — they will drive home the point about what we need to do now to avoid a worse crisis later. Historical lessons and experiences of countries worldwide have shown us that taking these actions early can have a dramatic impact on the magnitude of the outbreak. So what does this enhanced form of social distancing mean on a daily basis, when schools are cancelled?
Here are some steps you can start taking now to keep your family safe and do your part to avoid a worsening crisis:

1. We need to push our local, state, and national leaders to close ALL schools and public spaces and cancel all events and public gatherings now.

A local, town by town response won’t have the adequate needed effect. We need a statewide, nationwide approach in these trying times. Contact your representative and your governor to urge them to enact statewide closures. As of today, six states have already done so. Your state should be one of them. Also urge leaders to increase funds for emergency preparedness and make widening coronavirus testing capacity an immediate and top priority. We also need legislators to enact better paid sick leave and unemployment benefits to help nudge people to make the right call to stay at home right now.

2. No kid play dates, parties, sleepovers, or families/friends visiting each other’s houses and apartments.

This sounds extreme because it is. We are trying to create distance between family units and between individuals. It may be particularly uncomfortable for families with small children, kids with differential abilities or challenges, and for kids who simply love to play with their friends. But even if you choose only one friend to have over, you are creating new links and possibilities for the type of transmission that all of our school/work/public event closures are trying to prevent. The symptoms of coronavirus take four to five days to manifest themselves. Someone who comes over looking well can transmit the virus.

With no school yesterday, some teenagers headed at Compo Beach — and posed tightly together for a photo. Such close proximity is considered potentially dangerous.

Sharing food is particularly risky — I definitely do not recommend that people do so outside of their family.

We have already taken extreme social measures to address this serious disease — let’s not actively co-opt our efforts by having high levels of social interaction at people’s houses instead of at schools or workplaces. Again — the wisdom of early and aggressive social distancing is that it can flatten the curve above, give our health system a chance to not be overwhelmed, and eventually may reduce the length and need for longer periods of extreme social distancing later (see what has transpired in Italy and Wuhan). We need to all do our part during these times, even if it means some discomfort for a while.

3. Take care of yourself and your family, but maintain social distance.
Exercise, take walks/runs outside, and stay connected through phone, video, and other social media. But when you go outside, do your best to maintain at least six feet between you and non-family members. If you have kids, try not to use public facilities like playground structures, as coronavirus can live on plastic and metal for up to nine days, and these structures aren’t getting regularly cleaned.

Compo Beach has been a popular place the past couple of days, with most people keeping their distance … (Photo/Jo Shields Sherman)

Going outside will be important during these strange times, and the weather is improving. Go outside every day if you are able, but stay physically away from people outside your family or roommates. If you have kids, try playing a family soccer game instead of having your kids play with other kids, since sports often mean direct physical contact with others. And though we may wish to visit elders in our community in person, I would not visit nursing homes or other areas where large numbers of the elderly reside, as they are at highest risk for complications and mortality from coronavirus.

… and Earthplace is popular too. (Photo/Frank Rosen)

Social distancing can take a toll (after all, most of us are social creatures). The CDC offers tips and resources to reduce this burden, and other resources offer strategies to cope with the added stress during this time.

We need to find alternate ways to reduce social isolation within our communities through virtual means instead of in-person visits.

4. Reduce the frequency of going to stores, restaurants, and coffee shops for the time being.

Of course trips to the grocery store will be necessary, but try to limit them and go at times when they are less busy. Consider asking grocery stores to queue people at the door in order to limit the number of people inside a store at any one time. Remember to wash your hands thoroughly before and after your trip. And leave the medical masks and gloves for the medical professionals — we need them to care for those who are sick.

Maintain distance from others while shopping — and remember that hoarding supplies negatively impacts others so buy what you need and leave some for everyone else. Take-out meals and food are riskier than making food at home given the links between the people who prepare food, transport the food, and you. It is hard to know how much that risk is, but it is certainly higher than making it at home. But you can and should continue to support your local small businesses (especially restaurants and other retailers) during this difficult time by buying gift certificates online that you can use later.

5. If you are sick, isolate yourself, stay home, and contact a medical professional.

If you are sick, you should try to isolate yourself from the rest of your family within your residence as best as you can. If you have questions about whether you qualify or should get a coronavirus test, you can call your primary care team and/or consider calling the Massachusetts Department of Public Health at 617.983.6800 (or your state’s department of health if you are outside of Massachusetts). Don’t just walk into an ambulatory clinic — call first so that they can give you the best advice — which might be to go to a drive-through testing center or a virtual visit on video or phone. Of course, if it is an emergency call 911.

I realize there is a lot built into these suggestions, and that they represent a real burden for many individuals, families, businesses, and communities. Social distancing is hard and may negatively impact many people, especially those who face vulnerabilities in our society. I recognize that there is structural and social inequity built in and around social distancing recommendations. We can and must take steps to bolster our community response to people who face food insecurity, domestic violence, and housing challenges, along with the many other social disadvantages.

I also realize that not everyone can do everything. But we have to try our absolute best as a community, starting today. Enhancing social distancing, even by one day, can make a large difference.

We have a preemptive opportunity to save lives through the actions we take right now that we will not have in a few weeks. It is a public health imperative. It is also our responsibility as a community to act while we still have a choice and while our actions can have the greatest impact.

We cannot wait.

43 responses to “Social Distancing: “It’s Not A Snow Day”

  1. Tell that to all the people acting like it’s a vacation at Compo Beach. The NIMBY force is strong here.

    • I was at the beach. I had a different impression: Nearly everyone was aware of social distancing. If you were at the beach and saw differently — well, you were at the beach too, right? Readers, what did you see and think?

      • We were there yesterday for a walk and saw a great representation of our community. Everyone was enjoying the fresh air, dogs were getting exercise, and kids were playing on the playground. We didn’t see any big clusters of people and in any case they were all outside. Every person we encountered was super-friendly. Let’s continue to support each other; we’re all in this together!

  2. Celeste Champagne

    This is an excellent summation of the situation. Thanks for sharing & posting.

    • Michelle Benner

      Thank you Dan! We must all follow these guidelines. It is our collective social obligation. Stay well, stay safe!

  3. Hi Dan, I’ve just been made aware that there are five preschools in Westport that are still open and functioning. This makes no sense and seems extremely unsafe. Wondering if you were aware of this?

    Sent from my I-phone

    >

  4. I am not aware of that.

    • In Maryland, all public schools are closed. My grandson is in first grade, in a public school, and will stay home. My granddaughter is in a private preschool and that is still opened. Government would need to order it closed. That hasn’t been done yet. I would think it should be. My daughter is obligated to pay $2,200 a month whether or not my granddaughter goes due to the contract. I guess the private preschool doesn’t want to give up that kind of money unless they’re forced to. My daughter is thinking of keeping her home though since she is working from home now.

  5. Thanks for the great info Dan. Stay safe.

  6. Thank you for forwarding this info from Dr. Bitton. He very clearly states what we must do to lessen the number of people who will get Covid 19, and to keep ourselves and our lived obes safe, Nina Marino

  7. We drove down to Compo Beach today. I saw many young people together and some playing catch with a ball. The parking lots looked like they do on a great summer day. It is hard to believe that some parents allow their children to get together when it is so dangerous. I also saw many people with their dogs in close knit groups.Your blog is so vital to our community and I will be contributing to your efforts. I work at Bedford Middle School.

    • Thanks, Paula. I think part of the issue is that the weather is nice. Every year at this time, people want to just get outside. Add to that the stress of the past few days, and everyone heads to the place they always congregate. I did too. I was careful to not get close to anyone — but I did chat, from a few feet away. The playground was not as crowded as usual (and, as someone pointed out, playgrounds are places that NEVER get cleaned). I did see a few kids in groups (and adults), but to my mind, the vast majority were being safe.

      Will you be going back to the beach, having seen what you saw? If not, where will you go? These are questions not just for you, but everyone. And I have no idea what the “right” (or “most realistic” answers are — if indeed there are any.

    • Dr. Madison Ryan

      Chill out and educate yourself on the facts. They are young kids not nursing home patients.

  8. Francoise Jaffe

    Thank you for your continued excellent and useful work, Dan

    I unfortunately deleted an email in which I seem to remember that a health department official explained that “contact tracing” on people who attended the party in which people got exposed would be too onerous and unproductive, and therefore, was not done. Am I mistaken?

    If that indeed were the case, I think it would be a very problematic decision given that we know (and it is reiterated in the article that you published) that contact tracing is key.

    We need to identify who has been exposed and could potentially have exposed others, so that they, in turn, can monitor themselves and take more precautions than they otherwise might have. This is not an issue of confidentiality or hysteria. It is simply the best way we have to “flatten the curve” which we have been told is one of the most potent tools we have at our disposal.

    It is useful to remember that we are in the very early stages of understanding this virus. We have recently learned that it is communicable even before symptoms become apparent, but the mechanisms of transmission are not yet elucidated. But we do know what works–isolation and contact tracing.

    It also appears that not taking these recommendations seriously is what has led Italy down the very scary and radical path on which they now are. It did not happen in either Taiwan or Singapore, because in both these places, directions were heeded.

    Counter intuitively, being more vigilant does not increase anxiety. It increases agency, which counteracts anxiety. In my communications with my own patients, I have found out that the most anxious among them were actually faring better when they took these recommendations to heart. It makes them feel safer. And we are all safer for it.

    So please… encourage the people who were exposed and are showing symptoms to trace their whereabouts and self report to the people with whom they came into contact. It is the safest and the most responsible step to take. Information is the best antidote to fear.

    • I understand – from the Westport Weston Health District AND what I’ve seen on MSNBC, in their very strong and thorough coverage of this – is that no one has the resources to do contact tracing. For one thing, there are already too many contacts; for another, the limited number of people who could do that are needed to do other tasks related to the virus. That’s not to minimize contact tracing; it’s just to say that apparently there are other priorities, according to health officials. One more example of the perilous times in which we live.

      • I think it might be helpful to learn which country the guest of honor at the Bon Voyage party was leaving for. I recently attended a Memorial Service where there were a number of foreigners. I’m truly hoping that the previously-mentioned guest of honor was not one of them. It would relieve my mind to know that. I see no reason why that should remain secret.

        Also, to keep from getting cabin fever, I thought I’d clean up my garden as the daffodils are coming up. It seemed warm enough, but it really wasn’t. Maybe in a few more days.

    • Francoise, we do have resources – our individual voices. If those at the party, themselves contact those they’ve come in contact with (since the schools/WWHD won’t do it and they could have done it anonymously for a broad set) then the next level could in turn do the same. It’s not too late, especially since we have the two-week watch period. Unfortunately, we have to can not relying on the gov’t to do everything for us. We have to take social responsibility. In the meantime, everyone has to quarantine (and they’re not) since they don’t know how directly they’ve been exposed and that halts businesses.

      If we had extensive testing quarantining could be targeted and then certain aspects of life could go on. I really hope they notify us when testing is more available so that that next layer of contacts could get tested even if their symptoms are weak.

  9. Amy Pietresanta

    Hi — thanks so much Dan, you’re the best! 🙂 I did have one question though… I’ve been hearing on NPR that social distancing really doesn’t mean isolation. This is an example of what I heard yesterday quoting health officals in WA state — which seems contradictory?

    https://www.npr.org/2020/03/13/814615866/coronavirus-and-parenting-what-you-need-to-know-now

    “Many are wondering: What exactly is “social distancing?” Can my children still go on play dates? Or is it screen time, all the time?

    The idea with closing schools is to limit the number of social contacts. That is what is going to be most effective in slowing the spread of this disease. But we want to acknowledge that staying with immediate family only might be hard to enforce for more than a few days.

    Luckily, public health officials in King County, Washington, offer this helpful guidance:

    “Social distancing doesn’t mean you have to stay stuck in your house. … The current recommendation is to avoid large groups. That mostly means groups over 50 people but conservatively means anything more than 10 people. However, if you don’t fall into the high risk group, you can still certainly visit each other.”

    Think of it as a good opportunity for one-on-one hangouts.

    Also, be extra mindful of grandparents, neighbors, friends and people with compromised immune systems. They are the most vulnerable in this outbreak. Instead of a face-to-face visit next week with Nana and Papa, try starting a video-chat habit: Try coloring together, cooking or reading aloud.”

    • Thanks, Amy. I sure don’t have an answer either. I think everyone is flying blind, but doing the best they can. There seem to be “absolute best practices,” and “practices that acknowledge reality.” Even in places like Wuhan, which locked down the city, what did that mean? How did people get food? How did people produce food? What happened when a pipe broke, and a plumber was needed? How did essential healthcare workers get to and from work, and who took care of the transportation system so they could get back and forth? Who pumped gas? Etc., etc., etc.

      I’m trying to provide as much information as I can, without overwhelming people. I did hear on TV that even 70% compliance makes a huge difference in slowing the spread. Obviously, that can’t be the general message, because a lot more than 30% of the population may then place themselves in that 30%.

      Bottom line: Who knows? Sorry for the non-answer, but the more people who ask, the more we might figure all this out together.

  10. Frannie Southworth

    Dan, thanks so much for always keeping us informed! I agree that we have an obligation to one another to adhere to social distancing. Unfortunately until it hits Westport hard, many people don’t get it. I don’t understand that since we have been given guidelines on how other countries are helping to slow down the cases. My friend just called very upset that her neighbor was having a party with their kids today. Flattening the curve is crucial and we must follow the medical expert’s advice on how to do that!!!!! From what I’ve read, this virus apparently remains in the air for 30 minutes and is very contagious. You don’t just get it from droplets. Jeff & I are staying home, taking a walk in the neighborhood and fortunately we have lots of things we love to do at home. Some ideas:This morning I facilitated a meditation & music class on Zoom. My friend and I have a reading club together that we did on FaceTime. I also skyped with a friend I normally get together with 3X a week that I stopped gathering with a week and a half ago and we had a great time chatting. I know it must be so hard not to gather, especially when the kids are off from school, but there are many ways to stay connected and this is a life and death situation. Please take it seriously. .Be creative about how you can do things in a new way for the time being. How great that we can read books, watch movies, play music, paint, do crosswords, and play family games. Jeff is 70 and I’m 64 and we are part of many longtime older Westporters who are doing all we can to remain healthy since it could be very dangerous for us to get this virus. This pandemic has made me even more grateful for what is good in my life. I am praying for the well being of people everywhere, and my hope is that our whole community will be smart about this health crisis and remain kind to one another! ❤️ Wishing everyone health and peace.

  11. Dan wrote: “it’s gone, um, viral.”

    You’ve been waiting two weeks to post that. :^)

  12. Well written article. Thanks for sharing.
    This would be tough to do quote from article: “Consider asking grocery stores to queue people at the door in order to limit the number of people inside a store at any one time.”
    Unless you have fire and police helping with crowd control, customers will not listen to store employees or managers. Also store owners wouldn’t want to deter people from coming inside. They want the sales. If people have to wait in line to get in they will (might) leave.
    I don’t see that suggestion (recommendation) happening anytime soon.
    Learn something new like knitting, crocheting or weaving they’re are instructions on how to on you tube and websites with tons of patterns.
    On a side note, to the person who deleted the a certain email by accident. Look in your trash folder you can move it back into your inbox.

  13. Social distancing can take a toll (after the Earthplace picture) … [Insert anti-toll comment here]

  14. Vanessa Bradford

    Awe Dan! I apologize as last week before the social distancing I sent you a check and thank you note for all you do and 06880. Now I realize I need to update my methods to say thanks via pay pal or visa. You don’t need to be opening mail! So everyone in the 06880 Woog world, if you appreciate the daily work Dan does, send your donation ASAP!

  15. Werner Liepolt

    I’m very appreciative of the constant flow of information and feedback about our dire straits.

    I walk a couple of miles at Sherwood Island everyday and had been having a daily workout at Saugatuck Rowing Club.

    At Sherwood Island today I saw individual and family groups walking, riding bikes, flying drones, and playing frisbee golf in the large park-wide course. Great place for socially distanced recreation.

    I’ve stopped going to workouts until we get some traction.

    Keep up the good work of keeping Westport honest

  16. I just remembered something….
    I found out a couple are families are heading north to New Hampshire, Vermont and possibly other destinations north of us for the weekend or extended period.
    Just be careful. The virus is up their too.

    • Barbara Wiederecht

      Wendy you are correct. Vail corporate just announced all 40 resorts were closing tomorrow until the end of net week to assess the situation further. So lots of people will be coming home.

  17. David J. Loffredo

    Dan – love the biog – but so many of your readers chime in when you post about stuff that’s been gone for more than 20 years….

    If you have kids – actual school age kids right now – this mass quarantine and social distancing thing is a losing battle.

    So post pictures and tell everyone without school age children who may be home for the next COUPLE OF MONTHS how easy this is – and those of us who are dealing with this will do our best to figure it out.

    I feel for the working parents who now scramble to find child care, and for the restaurant and retail workers who may not get paid, I worry WAY more about the long term if not permanent economic impact of this mess way more than the temporary health effects.

  18. Wise words. Thanks for posting.

    Sent from my iPhone

    >

  19. People were letting their kids use the playground?! Shame on them. Im glad we opted to avoid compo today. If we went we planned to keep our normally off leash dog on leash and stay away from everyone. I was actually concerned about other dogs interacting with my dog because it’s unknown if they are carriers of the virus. Instead we picked a more desolate beach in a neighboring town.

  20. Reading this made me cancel the one social plan I had scheduled. However, I see that the schools are scheduled to reopen March 26! David Abbey needs to read this article!

  21. There is only ONE state that doesn’t have a Caronavirus case yet, and that state is West Virginia. Anyone have any idea why that is?

    • Jack The population is rather spread out because of the mountains and valleys. They don’t have huge cities. Quite a bit of land is owned by farmers (food and cattle, trees etc) or just landowners ranchers.

    • Jack: America very likely has a large number of people with the virus well beyond the confirmed cases simply so relatively few have been tested due to the shortage of test kits. So, yes, West Virginia likely has multiple cases—they just have not been confirmed.

  22. That should read “simply because…”

  23. As background: We used to live in Lausanne, Switzerland before we moved here 5 years ago.
    My daughter age 29 received this yesterday from her best friend in Switzerland.
    The CHUV is Lausanne’s University Hospital.

    “Hello everyone, I would like to use this channel to send you important information that I have from my doctor friends who are on the front line at the CHUV: there are currently 4 young people who are at CHUV with corona who were in good health and who are currently in serious condition and intubated with severe breathing difficulties. The reason for this is that they took anti-inflammatory ibuprofen style drugs ((NSAID) to bring down the fever and this is believed to have caused these complications. This is new information and doctors in Italy are also starting to notice this problem.
    So message to everyone: if you get sick do not take anti-inflammatories but take Paracetamol (Tylenol) instead.
    If you have a group with your class, please transmit the info.”

    Information of Tylenol:
    https://www.health.harvard.edu/pain/12-things-you-should-know-about-pain-relievers
    “Is Tylenol an NSAID?

    No, Tylenol is not an NSAID – it is acetaminophen. The two main categories of commonly used pain relievers (analgesics) are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin and drugs known as COX-2 inhibitors. Many are available over the counter; some are available by prescription only.”

    Here is another corroboration to the story.
    Anti-inflammatories may aggravate Covid-19, France advises https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

  24. well done presenting a piece of invaluable information.

    Sent from my iPhone

    >

  25. Thanks now that is valuable info, Christina!

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