covid19

Ending Social Distancing will Lead to More Deaths

Deaths will increase if we end social distancing early- this chart shows it

President Donald Trump wants to pull back social distancing policies and guidelines regarding the coronavirus outbreak. However, according to past history on outbreaks in the United States, if we do this too early people will die.

A horrific flu pandemic outbreak in 1918 caused as many as 100 million deaths across the globe and around 675,000 deaths in the United States. Cities all over America used social distancing measures to combat the outbreak, and these measures largely worked to lessen the death count.

However, when cities pulled back social distancing efforts in order to return to normal life and the economy, flu cases and deaths rose again. For example- St. Louis. This city is a prize example of how doing social distancing aggressively helped right as the flu hit. A 2007 study found that when the city pulled back its efforts too early, deaths rose rapidly.

Consider this chart, where the largest peak shows after social distancing was lifted, and the peak then falls again once social distancing started up again.

Of course, this pattern happened in more cities than just St. Louis. Across 43 cities, this pattern repeated across the country. Howard Markel, an author of the study and director of the University of Michigan’s Center for the History of Medicine, said the results are a clump of “double-humped epi curves.” Social distancing caused flu cases to fall, and then when social distancing was lessened cases rose again.

The second rise in deaths appeared as cities lessened social distancing policies. “Among the 43 cities, we found no example of a city that had a second peak of influenza while the first set of nonpharmaceutical interventions were still in effect,” according to the study.

In another study, 17 cities across the US followed the same trend: “[N]o city in our analysis experienced a second wave while its main battery of [nonpharmaceutical interventions] was in place. Second waves occurred only after the relaxation of interventions.”

We’ve come far in medicine since 1918, of course, but that doesn’t mean we don’t still need nonpharmaceutical interventions like social distancing to lessen the effects of pandemics when we don’t yet have a vaccine. We’ll likely need social distancing for months more, as a vaccine is still far away.

The PNAS study concluded: “In practice, and until emergency vaccine production capacity increases, this means that in the event of a severe pandemic, cities will likely need to maintain [nonpharmaceutical interventions] for longer than the 2–8 weeks that was the norm in 1918.”

This is why experts in public health are against lifting social distancing measures even though Trump is for it. Coronavirus cases are still rising in the United States, and models suggest that they will continue to rise if social distancing is lifted.

Successful public health measures are largely invisible, as it can take months and years to have the hindsight knowledge needed to know that these measures have worked. Tara Smith, an epidemiologist at Kent State University, says, “It’s the paradox of public health: When you do it right, nothing happens.” We won’t visibly see each death prevented, but they will be prevented nonetheless with the right measures.

The economy is flailing as businesses of all kinds close. Trump is worried about this, but we must remember the alternative is thousands upon thousands of deaths.

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