What is social distancing?

Simply put, social distancing is putting physical distance between yourself and other people. This helps to slow down the rate of transmission of the infectious disease, thereby "flattening the curve": as fewer people fall sick at the same time, the load on hospitals and medical professionals goes down and their ability to handle the cases on hand increases.

Here’s how much distance you need to maintain, especially during the COVID-19 pandemic:

• The World Health Organization (WHO) has recommended that people maintain at least three feet (or one meter) of distance from others. Experts like the doctors at Johns Hopkins Medicine in the US recommend six feet or two meters of minimum distance from others, if possible, during the COVID-19 pandemic.
• A minimum of six feet of distance is also recommended for people over 60 years of age and for those who have chronic health conditions like diabetes or kidney disease that put them at greater risk of severe illness due to COVID-19.

Social distancing is, of course, not new. Public health officials have noted the usefulness of limiting the size of gatherings during an epidemic since the mid-20th century, when the influenza virus was seen to spread more quickly during festivals and conferences.

COVID-19 is a new infection. Which means that there is no cure or vaccine for it yet - according to the WHO, the pneumonia vaccine does not protect you against coronaviruses. Our bodies, too, haven’t had time to develop immunity to it (that said, a study done with COVID-19 patients aged one day to 18 years found that children are likely to have less severe symptoms than grown-ups).

COVID-19 infection is also a highly contagious infection that has spread to 176 countries and regions of the world - making more than half a million people sick - in under four months. Add to this the early estimates of its mortality rate of 3-4% of patients globally (this rate is as high as 9% in places like Italy), and it becomes imperative that we do everything we can to stop its transmission. Social distancing is one way to slow down the transmission of the disease.

Social distancing is effective because of how the SARS-CoV-2 virus spreads. COVID-19 is a zoonotic infection - it is thought to have been transmitted from an animal to humans at the Huanan live animal and seafood market in China in December 2019. Since then human to human transmission of the virus has been noted. This occurs when:

• A healthy person comes in contact with a patient: they may do this unknowingly as the symptoms can take two to 14 days to appear. In many cases, there are no symptoms at all.
• When a sick person sneezes or coughs without covering their mouth properly, their cough droplets can stay in the air for 3 hours. These droplets can also survive on surfaces like plastic and steel for two or three days. If a healthy person unwittingly touches a contaminated surface, their risk of getting the infection increases. (This is the reason why high-touch surfaces like doorknobs and lift buttons should be especially disinfected regularly during any epidemic.)
• COVID-19 can also spread through having sex with a patient and by sharing utensils with them. These common-use things are called fomites.

Social distancing reduces the chances of coming in contact with sick people, and with contaminated surfaces.

Social distancing can limit the rate of transmission until scientists can figure out a way to treat the infection. Some of the tried-and-tested methods for achieving social distancing are:

• Stay at home as much as possible.
• Prevent children from going out to play during this time.
• Try to minimise trips to the market - see if you can get the essentials like food and medicines delivered to your home.
• If you think you may have come in contact with someone who has the infection, take proactive steps to self-quarantine.
• Work from home, if possible.
• Avoid large and small gatherings.
• Avoid all non-essential use of public transport.
• Call your doctor for a consultation rather than visiting their clinic, if possible. If you must visit the doctor’s office or a hospital, wear a mask.
• Postpone any elective surgeries or procedures.

The message of social distancing as a “defensive measure” against COVID-19 needs to be emphasised clearly and repeatedly in India for at least two reasons:

• On average, 464 people live on each square kilometre in India. This means India’s population density is higher than that of China (145 people per square kilometre), Italy (206), Spain (91.4) and France (117). (Italy, Spain, China and France had reported the highest number of deaths by COVID-19 infection as of 31 March 2020.)
  Research has shown that population density is an important factor in the spread of infectious diseases. This is because people who live in close confines are more likely to bump into each other and share resources - this increases the chances of spreading the infection from one person to another. This is especially true in the case of a highly infectious disease like COVID-19, which has an even higher rate of transmission than the flu.
• Large gatherings are part and parcel of life across Indian cities, towns, peri-urban areas and villages. It is naturally difficult for us to give up on routines we’ve been habituated to for decades - that is why the importance of social distancing in this time needs to be emphasised clearly and repeatedly in our country.
• COVID-19 took hold of China at a time when many Chinese origin people had flown there for the Chinese New Year. When these people flew back to their resident countries, some of them took the infection back with them. India is faced with a similar predicament, with festivals like the Holi of 2020 and Ram Navami of 2020 falling during the rise of COVID-19 in India.

People may feel cut off from the world at this time. This can be remedied to an extent by staying in touch with friends and family over the phone.

Negative news about coronavirus infection may cause anxiety in some people. You can deal with this by only looking at reliable sources of information and shunning unvetted WhatsApp messages and social media chatter.

Cabin fever may also affect some people who may get anxious, irritable or even upset at being confined indoors with the same set of people, albeit loved ones. Staying busy, exercising, going out into the balcony for air and sunlight can help to alleviate the symptoms of cabin fever to some extent.

Performing necessary functions, like getting groceries, medications, etc., from stores becomes difficult during social distancing. However, most state health departments and government bodies minimise the anxiety associated with these necessities by either providing relief, or - like in India’s case - making contact-free home deliveries possible. Stores also try to maintain the recommended distance by allowing shoppers to enter the premises one at a time.

In India, educational boards have also postponed exams that are typically held in March to avoid bringing hundreds of students - and their parents - in close proximity during a pandemic. While this may have come as a relief to some students who wished for more time to prepare, others may feel the exam stress building up again. It's important for students and parents to stay relaxed by meditating, exercising or establishing any other routine that helps them to focus even as they practise social distancing from friends and family. The important thing now is, of course, to stay safe, stay happy.