When Will Social Distancing End?

President Trump extended federal social distancing guidelines until at least April 30th. But will social distancing end then, or later?

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On Sunday, President Trump announced that he would extend the Coronavirus social distancing guidelines, which suggest Americans avoid gatherings of groups of 10 or more, to stay away from restaurants and bars, and to avoid unnecessary travel, and increase hand hygiene, until the end of April. This represents a retreat from what he said last week when he said he’d like to see guidelines eased by Easter Sunday, and wanted to see churches packed to the gills with worshippers. Now, having perhaps taken the advice of health experts, he plans to keep the current federal guidelines active until the end of April. In that press conference, he also suggested that the crisis would be largely over by June 1. But when will social distancing really end? And is it helping?

The Current State of Social Distancing

The evidence so far in the United States has shown that aggressive social distancing in the hot zones of infections has been working, especially in states that go further than the federal guidelines outlined by Trump. Last week in Washington State, Governor Jay Inslee said that the rate of infection in the state, which has already had 200 deaths due to the Coronavirus, has been slowing at least slightly. And hospitalizations due to COVID-19-like illnesses in the state have dropped by nearly 20 percent, suggesting that fewer people are becoming seriously ill from the dangerous virus.

And in New York City, evidence suggests that a turning point in the rate of infection occurred on March 16, the first day that schools were closed. The day after, all bars and restaurants were ordered closed, and by March 23, three days after the stay-at-home order took effect, newly reported fevers were below the levels seen on March 1, according to the New York Times.

Right now, one in five people around the planet are under lockdown. There have been almost 400,000 cases confirmed globally, and at least 16,500 people have died of the virus, while about 101,000 have recovered. But according to the World Health Organization, while it took 67 days for the first 100,000 cases to appear, the most recent 100,000 confirmed cases have happened in the last four days. Part of this is because of scaling up testing capacities across the globe — but it also suggests that the worst is far from over when it comes to Coronavirus, as cases can exponentially spike in areas. This reality, especially in lieu of appropriate testing measures, increases the need for social distance and flatten the curve to lower the burden on hospitals, ICUs, and health care workers.

But just because social distancing appears to have worked to slow the rate of infection and hospitalization in some major hot spots so far doesn’t mean that the efforts will end on April 30. After all, some models suggest that some forms of social distancing may be needed for the next 18 months — or until a vaccine is developed. So, when will social distancing end?

First, Look to China

Two months ago, China took aggressive measures to shut down the spread of the infection in the country. They stopped moving in and out of Wuhan, where the pandemic was first reported, and 15 other cities in the province, functionally shutting down the movement of 60 million people. Very shortly after travel was limited in and out of Hubei Province, the Chinese government ordered a shelter-in-place and told people only to leave their homes for medication or food. That amounted to a lockdown of 760 million Chinese citizens. China also will start mass testing asymptomatic citizens on Wednesday, April 1, a necessary step to ending lockdown conditions and quarantining fewer Chinese citizens.

Two days after Wuhan was locked down, the daily infection rate peaked, and the rate of infection today has slowed significantly. Since March 18, only six locally transmitted cases of COVID-19 have been reported.

As of last week, a reported 75 percent of China’s workforce was back on the job. While the Hubei Province is still on lockdown, the lockdown is expected to lift on April 8th, suggesting that the United States could see itself operating under the social distancing guidelines for at least two months before some things return to normal, if not much longer.

However, China’s guidelines and enforcement of social distancing guidelines were — as still are — much more stringent than those in the U.S. So, using their progress as a model works, but only to a point.

The U.S. Will Be Different Than Other Countries. Here’s Why.

The United States, which has a population of over 325 million, and, as of yesterday, about 248 million Americans in at least 29 states have been ordered to stay at home except for essential trips for groceries and medicine and outdoor exercise.

None of the measures put in place so far have been as strict as in China, and some states have not enacted shelter-in-place designations at all, meaning that the combination of testing shortages, which limit our information about the virus’s spread, and social distancing measures could lead to a slower and longer spread of the Coronavirus, enacting later waves of social distancing measures in different states.

If, for example, the United States aggressively ramped up testing, which has, so far, been inadequate, those who have already had the virus, whether or not they are asymptomatic, could return to work or help in the public efforts to stop the virus’s spread. But, without testing, everyone must act like they have the virus, whether or not they do, meaning that social distancing will drag on longer.

New York’s peak, for example, is on the horizon in likely April, whereas other states that announced their first infection weeks later, like those that haven’t yet enacted shelter-in-place guidelines, will likely see their infection peaks occur later on, in about 30 days, per Governor Cuomo.

What Do Models Suggest Could Happen?

For the most part, there are two realistic paths for life returning to normal. One of which is, of course, the development of a vaccine that could be administered globally. The other is to socially distance until the disease works its way through the population, which will kill many but could leave many immune. Whether or not immunity is a given is still uncertain.

But the timelines for these two paths both look like they’ll take one to two years, and for many, the prospect of working from home for the next 12 months feels untenable. While most epidemiologists have refrained from speculating when, exactly, social distancing and shelter-in-place guidelines will end, there are some ways this could play out.

There’s also a fairly recent study published by a medical journal called the Lancet. According to CNN, Professor Joseph T Wu from the University of Hong Kong said: “While these control measures appear to have reduced the number of infections to very low levels, without herd immunity against Covid-19, cases could easily resurge as businesses, factory operations, and schools gradually resume and increase social mixing, particularly given the increasing risk of imported cases from overseas as Covid-19 continues to spread globally.” This study basically suggests that easing up social distancing too soon could create a second wave of infections.

We Learn More, And Can Treat It Better

Some timelines suggest that within three to four months, after public health experts learn more about the virus, including how to effectively treat it, some aspects of life could return to normal. In this timeline, the need for social distancing would still be in place, but with the effective, quick treatment of COVID-19, hospitals might not be as overburdened as they will be under current treatment times.

That timeline is also dependent on widespread testing for people who have symptoms and those who don’t — like South Korea has done, testing some 10,000 citizens per day — and could mean that in some cities where the peak of infection has passed, some restaurants could open with limited capacity.

Without Widespread Testing or a Vaccine, Some Uncertainty Remains

Even if some life can return to some normalcy in the next year — restaurants, and small businesses returning to work, but major events like music festivals and sports games remain canceled, it’s unreasonable to expect that all would be back to completely normal until a widely available vaccine has been developed, tested, and produced on a mass scale. Most experts suggest that the absolute earliest this could be the case is Spring 2021 — meaning that globally, the world can expect to be under some form of social distancing or lockdown for at least a year.

This story is developing. Fatherly will update it frequently as new information becomes available.

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