“It’s like a fire… You have to keep suppressing it,” one expert said.
Strips of red tape, six feet apart, line the sidewalk outside the walk-up window at Chocolati Cafe. Business is steady on this sunny Sunday, despite the tables and chairs stacked up inside. Three baristas scramble to keep up with orders from an array of customers that stretches out more than 30 feet.
Geordie Glass has just ordered his eight-ounce latte. He’s on his way to walk a lap of Green Lake across the street. “I do this almost every day now,” Glass, 45, told Viralcocaine. “I’m running out of things to do at home.”
At the lake, a steady stream of walkers, runners, skaters, and bikers share the three-mile path with gaggles of geese. Here, too, most people—if not the congregating geese—are adhering to the international trend toward social distancing.
A reminder is posted by the trail: “Stay 6 feet or at least arm’s length away from others.”
But what was a sort of Northwestern curiosity as recently as a few weeks ago may not only outlast the wishes of GDP-fixated politicians like Donald Trump, but also become a regular—that is, intermittent—fact of American life. Taken together, recent COVID-19 forecasts suggest Americans should be ready not just for a months-long shutdown, but also to potentially return to the practice again.
In other words, some epidemiologists and other scientists closely studying the pandemic increasingly seem to be veering toward a long-term, multilayered approach—including repeated periods of social distancing.
“It’s like a fire. If you don’t completely put it out, it will come back. You have to keep suppressing it,” Michael Osterholm, professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told The Daily Beast.
More than 250 million Americans have been ordered to “shelter in place” or stay at home in hopes of quelling COVID-19. Washington Gov. Jay Inslee (D)—whose initial order in America’s first state with a confirmed case of the disease was set to expire on April 8—said last week that the effort would be extended. He and local authorities have also introduced piecemeal measures: In addition to schools, dine-in restaurants, bars, and other nonessential businesses, closures now include many trailheads, playgrounds, even boat-launch sites.
New data suggest the social-distancing efforts have slightly slowed the rate of increase in new COVID-19 infections across the state—that there’s hope here. “We have to hammer this until we can be assured it will not spring back up,” Inslee said.
But just how hard and how long to hammer remains up for debate. A pair of reports released Monday by the Bellevue-based Institute for Disease Modeling found that social-distancing policies have curtailed the movement of people around King County, Washington, and significantly slowed the spread of COVID-19. Still, the models suggest “evidence of fluctuating adherence” leaves the county in a “precarious position,” according to its authors.
That data followed analyses released Thursday by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine. As of Tuesday, it forecast U.S. deaths to total more than 83,000 by July, even with social-distancing measures in place. “It’s working and it will work even better if we do much more of it,” Ali Mokdad, a scientist at IHME and contributor to the analyses, told The Daily Beast. “In many places, even in Seattle, people are not 100 percent adherent to staying at home. We have to stay vigilant at least through mid-May.”
Even that may not be enough. Still more research released last week by a Harvard team suggested a successful battle against COVID-19 was also unlikely to be waged in a single shot.
The authors of the paper, a preprint posted at medrxiv.org that hasn’t yet been peer-reviewed, determined that one long period of stringent social distancing could potentially backfire in a greater resurgence of infections come fall and winter, unless other interventions are put in place. The finding was consistent with the course of the 1918 influenza pandemic, during which cities that had low peaks during the first wave of infections—thanks in large part to social-distancing measures—were at a greater risk of a higher second wave after those interventions were lifted.
Models detailed in the Harvard paper point to cycled periods of social distancing as a potentially better way to minimize the overall toll on the population, achieve greater “herd immunity,” and take pressure off already-strapped intensive-care units (ICUs).
The approach may also provide a welcome summer respite for Seattleites, New Yorkers, and other Americans who are going stir crazy—or facing economic hardship, large or small. “Any kind of reprieve would be welcome,” said Glass, who works as a physician assistant in radiology—now 30 hours a week due to reductions in elective surgeries in response to the pandemic. Millions of Americans have lost their jobs entirely, and millions more are expected to in the coming days.
Rather than fully releasing the brakes, according to the Harvard models, officials may eventually want to start pumping them—strategically letting up on social distancing as ICU beds empty, and then re-enacting measures as beds fill back up. The idea, in part, would be to steadily build up population immunity while not overwhelming critical-care capacity.
“What we find is that those social-distancing efforts that are relatively successful in flattening the curve end up pushing the peak out,” Yonatan Grad, an infectious-disease expert at the Harvard T.H. Chan School of Public Health and a co-author of the paper, told The Daily Beast. “If there is seasonality, and if the peak gets pushed into the fall, we will see an even higher peak.”