By Dr. Majid Sadigh, Director of Global Health, Nuvance Health
How can we contain the spread of COVID-19?
The message of hope in containing the spread of COVID-19 remains in staying calm, focused, united, and following Centers for Disease Control and Prevention (CDC) and state public health department guidelines for preparedness and prevention. For example, social distancing continues to be a pillar in these guidelines and must be followed.
We must believe in the power of science and data. We must find trusted platforms to educate ourselves and others in our communities. We should ground our actions, interventions and words on what is true, and to be collegial, adaptable, and innovative as knowledge grows and situations change. Transparency and level-headedness are as much a responsibility of each branch of government as they are of each individual. We must ask ourselves, “How can I protect myself, my family and my neighbor? How can I help my students, my patient population, my citizens, and the nation?”
Can we predict how long COVID-19 will be in our communities?
The length of the epidemic in each country, in each state, will be different. It all depends on the epidemic phase and virus prevention measures taken. Other key factors are people’s level of trust and compliance in their communities as well as their engagement and active participation in preventive actions, such as staying home and limiting interactions with others.
Some people are speculating that the potential seasonality of this virus will lead to its decline as spring approaches. However, there is simply too much we still do not know about this virus and cannot rely on its seasonality. Generally, it is not the temperature outside of the body that defines viral spread but the change in human behavior in different climates. When it is warm, we are outdoors with more natural social distancing. When it is cold, we are indoors in close quarters.
Non-essential businesses, community programs, and schools are temporarily closing and moving to remote operations when possible. What else might be impacted by COVID-19?
I have a great deal of respect for the CDC. The CDC has been a leader in many of the most complex humanitarian and public health endeavors both nationally and internationally — and have subsequently built respect and credibility all over the world. We have to follow the organization’s advice line-by-line. While social distancing is the guideline for the time being, more aggressive public health measures may be needed if the virus is not contained.
Is there a way to predict a minimum number of people that may be impacted before the spread of COVID-19 slows?
Such predictions require more data, and more data is only possible through a combination of widespread testing, tracing, and isolation of contacts. We need to pay close attention to the growth curve of the pandemic. It usually takes a few weeks to peak and a few additional weeks to stay constant before falling steadily. If we carefully follow the recommendations from the CDC and the state public health departments, we can effectively alter the course of this virus.
Based on the current trajectory of the COVID-19 virus, is it possible to estimate how many people in the United States may be infected with COVID-19?
There are several reasons why this is not possible. We can only speculate based on how long the virus has been in this country. The number of infected people will vary depending on the specific steps taken towards preventative public health measures, both at national and state levels. Also, the pattern of spread differs in various geographic locations.
Fortunately, seroprevalence testing (the number of people in a population who test positive for a specific disease based on blood serum specimens) is available here in the United States, which will allow us to uncover a great deal more information about the scope of this disease. These data are building out of Wuhan and other parts of China, and have already taught us about asymptomatic versus symptomatic cases as well as the pattern of spread. For example, we see that the majority of cases in China acquired the virus from someone at home. Of all people with proven COVID-19 infection, two to 10 percent of family members acquired the disease. On the other hand, 90 to 98 percent did not acquire the disease. This finding indicates there are many other players involved in the spread of the virus, including gender, age, intimacy of the contact, and underlying comorbidities. There may be a group of people who are simply more contagious. We are finding out more information every day.
Dr. Majid Sadigh is the director of global health at Nuvance Health, the director of Global Health Program at University of Vermont Larner College of Medicine, and the Trefz Family Endowed Chair in Global Health at Nuvance Health.
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