Beating COVID-19: It’s up to us

The COVID-19 crisis has become a disease of divisiveness in Israel, germinated by the government’s short-sighted and meandering policies and its failure to effectively communicate what is known about the disease and what we can do until a vaccine becomes available. The new quarantine over the High Holidays announced last night adds to the dizzying confusion.

Against this backdrop, it is not difficult to understand the erosion in the public’s willingness to maintain precautionary practices. The discipline evident during the spring onset of the disease fell victim to inconsistency, illogic and hypocrisy on the part of the authorities.

Nonetheless, despite how infuriating the situation has become, COVID-19 remains a real threat that can wreak untold damage indefinitely. With the swelling number of infected persons and at a time when medical teams and facilities edge toward overload, it is up to us, citizens of all sectors, to block the virus’ advance.

The Best Defense Is Us

While the bio-medical community works valiantly to identify immunological interventions and treatments, citizens are the frontline for threat containment. This is what the WHO special envoy for COVID-19, Dr. David Nabarro, refers to as “holding the virus at bay.” Disease prevention is the only armor we have right now, so the fight against COVID-19 is really about collective self-defense. To internalize this, it is important to reacquaint ourselves with the facts, which have become obscured over time.

The virus, officially known as severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), originated in animals, likely a bat species, and was transmitted to humans, probably indirectly through an intermediate animal carrier. Since it was first identified in Wuhan Province, China in December 2019, the primary mode of transmission has been human-to-human contact, powered by international travel and then diffused domestically.

Respiratory viruses can be propelled by coughs, sneezes, singing, praying, talking, and while eating. It was initially thought that the SARS-CoV-2 virus would fall to the ground a meter or two after being emitted (“shedded”) by a carrier. Subsequently, researchers have simulated the trajectory that the virus can take and found that it can travel further. More recently, mounting evidence suggests that the virus can be transported by tiny droplets called aerosols that can be carried by airborne currents affected by breeze and wind and that they can conceivably be transported further afield.

Nonetheless, it is helpful to think of the virus as having a spatial range that is denser the closer one is to its source, that is, an infected person. The threat dissipates with distance, with one to two meters being considered a reasonably safe length to maintain between carriers and people they might infect.

Managing Risks: Reducing Probabilities

Related to the distance that the viral particle travels is the quantity of particles to which a person is exposed, which when measured in body fluids is referred to as the viral load. Researchers have recently determined that there is a correlation between the viral load and disease severity and mortality.

The danger of contracting COVID-19, then, can be thought of in terms of probabilities: the closer you are to a carrier, even someone who has no symptoms, and the more intense the interaction (as measured by the duration of exposure and the number of viral particles being emitted (singing, praying or cheering are generous providers of the virus), the greater are one’s chances of becoming infected. Increasing that exposure by proximity to numerous other potential carriers (as in crowds), and the probability of infection rises even more.

So, adapting to COVID-19 is really about risk management. That means, adopting practices that lower the chances of becoming infected and, consequently, infecting others. It is important to emphasize another element of risk: While many people have light or moderate symptoms, a good many cases of long-tailed COVID-19 have been documented. These people suffer chronic and often incapacitating symptoms that endure long after the virus is no longer detected in their bodies.

Best Practices

Against this background Dr. Nabarro, who is professor of global health at Imperial College, London and strategic director of the 4SD sustainable development initiative emphasizes the scientific community’s consensus regarding the best practices people can take to protect themselves, their families and their communities. Given the magnitude of the threat, these are relatively simple: (1) wear a face mask in public, (2) maintain a reasonable (1-2 meters) distance from other people, (3) be careful about hand washing and other aspects of personal hygiene, and (4) isolate yourself if you have been near an infected person or have been confirmed to have been infected with the coronavirus.

Obviously, protecting vulnerable populations (the aged, those with chronic diseases, pregnant women) is of prime importance, as is maintaining personal physical and mental fitness. COVID-19 is also a disease that thrives among the disadvantaged: people who live in overcrowded conditions and do not have access to adequate nutrition or sanitation and who cannot afford a day of not going to work are especially vulnerable. It is vital that adequate support be targeted to people in these sectors.

While social distancing, masks and cautiousness are unpleasant and awkward, they are essential parts of the only available strategy to halt the viruses’ advance. The more we protect ourselves, the more we protect each other. Solidarity through careful interaction is key.

That means spreading understanding and reaching out in cooperation across all sectors. We can’t afford the rancor and dissonance of the past few months. Amid the government failure, civil society needs to take the initiative, which begins with each of us and continues by holding the threat at bay — together.