Physical distancing the ‘new normal’?

Persons may have to accept a “new normal” with physical distancing measures remaining in place until a vaccine for COVID-19 is developed.

Contributing to the virtual symposium “The Impact of COVID-19 on Health Systems” on the topic “The Future – Physical Distancing and Socialisation”, Dr. Sandra Reid explained, “We would have heard that it would take at least a year before we get a vaccine for the COVID-19 illness.

In the absence of any effective pharmacological therapy and/or vaccine against the virus, physical distancing is one of several non-pharmaceutical inter-ventions or community mitigation strategies that are the mainstay management of the pandemic.”

Dr. Reid, who is the Deputy Dean (Clinical) and Senior Lecturer in Psychiatry in the Faculty of Medical Sciences of The University of the West Indies, St. Augustine, said that there is quite a bit of evidence to support the effectiveness of physical distancing measures in controlling the influenza virus.

“And there is evidence from systemic reviews and expert opinions of the effectiveness of physical distancing. But, there is little scientific evidence to guide pandemic planning decisions, such as when to go back,” she told the event, which was hosted by the Faculty of Medical Sciences and the Caribbean Centre for Health Systems Research and Development.

“The question then is, ‘Will physical distancing become the new norm...?’ I believe that decision is country specific and informed by evidence. Every country is challenged to make a decision balancing healthcare capacity against the economy. The decision must also take into consideration social, economic, political and mental health considerations, and it should consider those whose quality of life would be significantly compromised by such a policy.”

Dr. Reid therefore suggested that continued physical distancing is recommended, and highlighted that the World Health Organization’s (WHO) recommendation is for physical distancing measures and frequent hand washing to remain in place even after lockdowns have been lifted.

She went on to point out that the London Imperial College COVID-19 Response Team advised that the pandemic is best controlled through suppression of spread using a combination of physical distancing of the entire population, home isolation of cases and household quarantine of their family. Moreover, intermittent physical distancing with resumption of more measures if or when case numbers rebound.

She further observed, “Even now with COVID-19, we are seeing the risk of new spikes in infections. For example, Singapore after widespread testing and comprehensive tracing of close contacts, neglected to address their migrant workers who lived in overcrowding dormitories and after reopening schools on March 23rd, Singapore saw a 250 per cent increase in infected persons after just one week. The story is the same in a few other countries.”

“Intermittent physical distancing is when persons are allowed periods of normal social interactions and when infections begin to rise in the community, community physical distancing is put in place again.

“The advantage of this approach if successful, is that it allows the community to build immunity without overwhelming the health services. The big draw-back, however, is that it assumes that infections with SARS-CoV-2 confers immunity and for a long enough period that when social distancing measures are relaxed, there will not be massive numbers of persons falling ill,” Dr. Reid said. (TL)