People stand apart as they try to adhere to social distancing measures
while waiting near an electronic sign thanking NHS workers for their
efforts, at a bus stop in Leeds, northern England, on March 30, 2020.
PHOTO | AFP
The World Health Organisation (WHO) has recommended social
distancing as a key strategy in halting the spread of the coronavirus
disease. This calls for maintaining physical distance or staying far
away from each other by at least a metre or three feet so as to prevent
the transmission of the disease from person to person.
The
strategy is extremely significant in the campaign against Covid-19 as
the disease can also be spread through respiratory droplets.
When
infected people cough or sneeze, they spray small liquid droplets from
their nose or mouth, which contain the Covid-19 virus. Those that are
too close to them are at risk of breathing in the droplets and end up
getting the disease.
Social distancing also limits the
number of people an infected person can interact with — and spread the
virus to — especially before they realise that they have the disease.
This is because those with Covid-19 can spread the ailment at least five days before they develop symptoms.
Even though social distancing cannot totally prevent the spread
of coronavirus, it plays a significant role in slowing down the spread
of the ailment which had infected close to 800,000 people by yesterday.
Most
importantly, the strategy ensures that arising cases are kept within
manageable levels that a country’s healthcare system can handle. This is
called ‘flattening the curve’.
If transmission occurs
rapidly and Covid-19 cases peak, the cases end up becoming overwhelming,
hence making it impossible for hospitals and health workers to offer
adequate medical care to patients.
This leads to
unnecessary deaths and suffering, as is the case in Italy, whose death
toll of over 11,500 is now the highest in the world.
In
Kenya, the government has initiated a raft of measures aimed at
enhancing social distancing, such as closure of schools, banning public
gatherings and limiting the number of passengers that public transport
vehicles can carry.
Most significantly, it has initiated a daily curfew starting from 7pm to 5am.
During
this period, all Kenyans — save from those offering critical services —
are required to be indoors (preferably at home) so as to further
enhance effectiveness of social distancing. However, enforcing these new
restrictions has not been easy.
Many Kenyans have
complained and described the measures as a either draconian, especially
due to the way police enforce them, or a bother to their lives.
But
history offers proof that even though social distancing may appear to
inconvenience people, it holds the key to saving mankind from the
devastating effects of contagious disease outbreaks.
An
article published in the Journal of the American Society of
Cytopathology offers a stark historical reminder that during disease
pandemics such as Covid-19, individuals can only ignore social
distancing recommendations at their own peril.
The
article’s author, Dr Stefan Pambuccian, reviewed multiple published
data and research dating back to the infamous Spanish Flu (also known as
the 1918 flu pandemic) that lasted from January 1918 to December 1920.
It is estimated that about 500 million people — or one-third of the
world’s population (at the time) — became infected with this virus. The
number of deaths was estimated to be at least 50 million worldwide with
about 675,000 occurring in the US alone.
Just like
Covid-19, the Spanish Flu (caused by the H1N1 virus with genes of avian
origin) had neither a cure nor a vaccine to prevent it.
The
flu’s impact was more devastating than coronavirus because it killed
both the young and old, including those of otherwise good health.
Despite
this bleak outlook, the findings of the study revealed that US cities
which adopted early, broad isolation and prevention measures – such as
closing of schools and churches, banning of mass gatherings, case
isolation and disinfection or hygiene measures — had lower disease
occurrence and death rates from the flu.
These cities
included San Francisco, St. Louis, Milwaukee and Kansas City, which
collectively had between 30 and 50 percent lower disease and mortality
rates than cities that enacted fewer and later restrictions.
“The
stricter the isolation policies, the lower the mortality rate,” says Dr
Pambuccian, a pathologist and vice-chair of the Department of Pathology
and Laboratory Medicine at Loyola University Chicago Stritch School of
Medicine
He studied the Spanish Flu, including
prevention measures and outcomes, to help develop standards for staffing
and safety in the cytology lab, where infectious diseases like Covid-19
are diagnosed and studied at the cellular level.
“Like
today, not everyone in 1918 and 1919 thought the strict measures were
appropriate or effective at the time. An estimated 675,000 people died
in the US from the Spanish flu. And there was scepticism that these
policies were actually working. But they obviously did make a
difference,” writes Dr Pambuccian.
He notes that
although the world is a much different place than it was hundred years
ago, the efficacy of the measures instituted during the 1918 to1919
pandemic “gives us hope that the current measures will also limit the
impact of the Covid-19 pandemic”.
Past studies have also offered useful lessons from the Spanish Flu pandemic.
A
2007 study published in the Proceedings of the National Academy of
Sciences (PNAS) journal indicated that US cities which put in place
social distancing strategies and went a step further to make it
difficult for people to ignore the recommendations – just as Kenya is
doing now – had a reduced disease burden.
For these
cities, it wasn’t just enough to tell people to stay at home. They made
it harder for people to break the rules by prohibiting just about every
aspect of public life — from attending schools and eating in
restaurants, as well as patronising entertainment venues.
Aside
from initiating social distancing measures early, these countries also
ensured that the restrictions were sustained, lasting until the virus
really seemed to go away. And if the virus came back, the measures were
quickly redeployed.
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