The news cycle calls the COVID-19 crisis a rapidly developing story. It unfortunately also has been one with a lot of voices and one for which we have no precedent. I will not add my voice this week, but I offer a couple of trustworthy voices from the last 24 hour cycle.
Please consider this counsel from Dr. Asaf Bitton, MD, MPH, a healthcare leader from the Harvard University School of Public Health.
“So what does this enhanced form of social distancing mean on a daily basis, when schools are cancelled?
I can suggest the following:
1. No playdates, parties, sleepovers, or families visiting each other’s houses. This sounds extreme because it is. We are trying to create distance between family units and between individuals across those family units. It is uncomfortable, especially for families with small children or for kids who 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 4-5 days to manifest themselves. Someone who comes over looking well can transmit the virus. 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 the schools. 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 overwhlemed, 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.
2. Take walks/runs outside, but maintain distance (ideally 6 feet between people outside your family). Try not to use public facilities like playground structures as coronavirus can live on plastic and metal for up to 3 days, and these structures aren’t getting regularly cleaned. Try not to have physical contact with people outside of your family. Going outside will be important during these strange times, and the weather is improving. Go outside every day if you can but stay physically away from others. Try not to have kids play with each other (even outside) if that means direct physical contact. Even basketball or soccer involve direct contact and cannot be recommended. If people wish to go outside and have a picnic with other families, I strongly recommend keeping distance of at least 6 feet, not sharing any food at all, and not having direct physical contact. Invariably, that is hard with kids, so these shared, “distant” picnics may be tricky. Do 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. We need to find alternate ways to reduce social isolation in these communities through virtual means instead of physical in-person visits.
3. Reduce the frequency of going to stores/restaurants/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 less busy. Consider wearing gloves (not medical – but perhaps washable) and of course washing hands before and after really well. Leave the medical masks and gloves for the medical professionals – we need them. Maintain social distance from folks. 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 is certainly higher than making it at home.
4. If you are sick, definitely stay home and contact a medical professional. If you are sick, you should try isolate yourself from the rest of your family within your house as best as you can. If you have questions about whether you qualify or should get a coronavirus test, you can call you primary care team and/or consider calling the Partners Health Care hotline staffed 8AM-8PM every day – 617 724 7000, or the Massachusettes department of public health at 617 983 6800. Don’t just walk in to an ambulatory clinic – call first. Obviously if it is an emergency call 911.
5. We need to push our local, state, and national leaders to close ALL schools, events, gatherings, and public spaces now. A local, town by town response won’t have the needed effect. We need a statewide, nationwide approach in these trying times. Contact your representative and the governor to urge them to enact statewide closures. As of today, 6 states had already done so. We should be one of them. Also urge them to fund emergency preparedness and make increasing coronavirus testing capacity an immediate and top priority.
I realize there is a lot built into these suggestions, and that they represent a real burden for many people, businesses, and communities. Social distancing is hard and may negatively impact others, especially those who face vulnerablities 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 inequities.
I also realize that not everyone can do everything. But we have to try our absolute best as a community, starting today. It is a public health imperative. If we don’t do this now voluntarily, it will become necessary later involuntarily, when the potential benefits will be much less than doing so right now.”
Please also let me add some good news from FDA:
“Aimed at ramping up testing capacity in the U.S., the FDA will now allow individual states to authorize the use of laboratory-developed tests by qualified in-state labs for the coronavirus causing the current outbreak. The labs do not have to engage with the FDA nor will they need to apply for Emergency Use Authorization (EUA).
- Although states are not required to follow New York’s lead, the Empire State’s system may serve as a useful guide for others.
- The FDA will also allow the distribution of commercially developed tests prior to Emergency Use Authorization under certain circumstances and only after the tests have been validated. The agency believes that a 15-period should be sufficient to prepare an EUA filing.
- The agency will also allow the distribution of serology tests (tests that detect SARS-CoV-2 antibodies in the blood) contingent on the tests being validated, the FDA being notified and the inclusion of warnings that the tests have not been reviewed by the FDA and results should not be the sole basis for diagnosing or excluding COVID-19.
- The FDA says more than 90 test developers have sought its assistance thus far.”
Back to Charlotte here…
A lot of you who read my posts are caregivers…if not to an older loved one, then to others within your orbits. My longstanding advice is perhaps more relevant than ever in a crisis. You will do a better job of caring for others if you also are taking good care of yourself!
Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.