Monday, 30th October 2017

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I practiced social distancing before coronavirus. It works.

It should be supported by government… the faster a society can practice it in the face of a pandemic, the less severe the eventual impact for everyone

By Jen Gunter/The New York Times News Service
  • Published 17.03.20, 2:45 PM
  • Updated 18.03.20, 1:29 PM
  • 6 mins read
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Social distancing is a privilege, but it shouldn’t be Shutterstock

Infections and deaths from the new coronavirus continue to spread worldwide, and the World Health Organization has officially declared the outbreak a pandemic.

Many people are starting to talk about social distancing as a strategy to combat the virus, which means limiting activities outside the home to obtaining health care, acquiring food and essential supplies and going to work, if working from home isn’t an option. This approach most likely sounds novel to many, and possibly even draconian to some, but it is very familiar to me.

And it works.

I should know. I am a physician who practiced social distancing for 18 months to protect my premature babies.

The concept is simple: Those practicing social distancing should stay home as much as possible and look to keep a gap of 6 feet or more between themselves and others if they do leave the house. The reasoning: Fewer interactions with people and the added distance when you must interact means less chance of exposure and hence infection with the virus. If you do get infected, social distancing lowers your chance of spreading the infection to someone else.

In 2003, my triplets were born extremely early. Aidan died at birth, and my two surviving boys, Oliver and Victor, born at 26 weeks, were admitted to a neonatal intensive care unit. They weighed 1 pound, 11 ounces and 1 pound, 13 ounces, respectively, and were among the most vulnerable a human can be to lung infections. In addition, Oliver had a severe heart defect unrelated to his premature delivery, further increasing his risk of serious complications from infections.

I was terrified. As a doctor, I’d heard of viral infections, like influenza or respiratory syncytial virus (a virus that can resemble a common cold for most but is often deadly to premature babies), sweeping through NICUs and killing babies. I was pleased with the attention to infection control in my sons’ NICU, which included strict hand hygiene and a no-children-allowed-to-visit policy. Sick parents were asked to stay away, too. I never saw a staff member show up sick.

After almost three months, the boys were ready to come home on oxygen. My husband and I were told to limit their interactions with society — especially with other children. Even a cold could be devastating, never mind influenza. The best medical advice was to do everything possible to keep them from getting an infection in their first year of life.

But how?

It wasn’t as if we could just take them home, barricade the doors and never leave.

I was fortunate to have six months of maternity leave, and it also seemed best to have the doctor at home.

But there were other things to consider: essential food and supplies to restock, medications to pick up, blood work at the hospital, home visits from nurses and physical therapists and doctors’ appointments.

So many appointments, and all at a children’s hospital — the very place where serious infections were most likely to exist. Each visit felt as if I were running a gauntlet of infectious horrors.

No hand shakes, late-night grocery shopping

How did I do it?

I never shook hands; I nodded and smiled.

I used a lot of hand sanitizer — getting a twin stroller laden with oxygen tanks in and out of a public bathroom made hand washing a challenge. Hospitals have plenty of free-standing hand hygiene stations but typically no sinks for hand washing in public areas. (Take note, hospital architects.)

Grocery shopping took place primarily late at night, long after my partner came home. It was my only break from parenting and medical care. It felt like a luxury to walk the quiet aisles and chat — with a little added distance between me and the cashier — at check out.

Everyone who entered the house — whether medical professional, friend or family — was required to be fully vaccinated and to either use hand sanitizer at the door or head straight to the bathroom to wash their hands. If someone was offended, it would not have registered. That was simply the rule.

We declined visits from people with children in day care or school. A few were upset, but if being insulted about their child’s runny nose being a potential cause of death for my children was an issue, frankly, we weren’t meant to be friends.

Some friends drifted away. A few stuck around. And some who couldn’t visit left groceries or cooked meals on the doorstep. These random acts of kindness touched me greatly.

Drives, long walks with oxygen tanks

This was pre-Facebook. Smartphones and home Wi-Fi didn’t exist. There were no video chats. I called friends and family from our landline because my clunky cellphone had limited minutes. In that era, it felt like social isolation.

I coped by going for drives with my boys after medical appointments — they were already loaded in the car with their oxygen tanks, and I had rigged a mirror system so I could make sure the tubes stayed in their noses while I drove around Denver singing show tunes. I took them for long walks in the double stroller.

I had to return to work when the boys were 6 months. Their dad’s work offered no paternity or sick leave, so he was forced to quit. One of us had to stay home with the kids. They were still on oxygen 24 hours a day and at risk for infection.

When the boys came off oxygen at 9 months, we relaxed a little and occasionally went to restaurants. We had enough confidence to throw a party for their first birthday, a milestone we couldn’t have imagined a year earlier. Everyone who came knew what they’d been through, and we trusted our friends and family not to show up sick.

Social distancing is an effective infection-control practice for those at high risk. With the new coronavirus, this primarily means older adults and those with compromised immune systems. And people like my Oliver, with lung or heart conditions. It’s also important to remember that otherwise young and healthy people can still die from this infection.

Dire consequences

And these measures aren’t just for the medically vulnerable like my boys — social distancing slows the spread of a virus in communities. The risk with viruses like the new coronavirus isn’t just that people will get sick and some will die. This coronavirus is transmitted easily — even from people with few or no symptoms — so many may get sick at once, overwhelming the health care system.

The consequences are potentially dire. People who might have recovered from the virus may die because they are unable to get the critical care they need. Those with other noncoronavirus-related illnesses may not get the assistance they need as medical resources are diverted to respond to the coronavirus.

During our 18 months of social distancing, I kept two weeks’ worth of food at home in case one of us got sick. Assuming most illnesses run their course in a week or less, this was enough backup so the sick parent could quarantine in the basement and the other wouldn’t have to take the boys to the grocery store. Since a 14-day quarantine is recommended for those exposed to the coronavirus, a two-week supply of groceries and other supplies should be sufficient.

Panic buying stumps me

I never hoarded toilet paper (honestly, I have no idea what’s up with that). As a gynecologist, I can confidently tell you that if you do run out of toilet paper, a bottle of tap water squeezed on your anus is a fine hygiene hack for a bidet. Just blot dry with a face cloth, which can be laundered for reuse. The panic-buying of hand sanitizer also stumps me, given the effectiveness of a 20-second wash with soap and water.

I will never forget how people helped us when we needed it, so I’m thinking of how I can help others now. I’ve offered to do the grocery shopping for some older friends, and I’m buying gift certificates from local businesses to help them with their cash flow.

It’s important to remember that not everyone can afford two weeks’ worth of groceries or lives in a neighborhood where stores are open late or where it’s safe to shop at night. Some people have to take public transportation to the grocery store, potentially increasing their risk of exposure. Many people can’t take paid time off to look after their young children if schools close. And many workers may not be paid if their businesses close temporarily.

Social distancing is a privilege, but it shouldn’t be. It should be supported by the government as a public health measure. The faster and the more efficiently a society can practice social distancing in the face of a viral pandemic, the less severe the eventual impact for everyone.

What happened when my family finally ended social distancing and took that last big step — interaction with other children?

Within a week, Oliver was in the hospital with pneumonia and back on oxygen. It was devastating to see him so ill, but it made me realize that our strategy of social distancing was effective and worth all the effort.

(Dr. Jen Gunter is an obstetrician and gynecologist in California. She is the author of the “The Vagina Bible” and writes The Cycle, a column on women’s health that appears regularly in the Styles section of The New York Times)