Examining The Trade-Offs To Social Distancing

Mar 20, 2020
Originally published on March 20, 2020 9:09 am
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DAVID GREENE, HOST:

Of course, we keep hearing this term social distancing. Wherever we live in the United States, we've been told that if we do leave our homes, we should practice that. It means maintaining 6 feet between you and other people. Use those elbow bumps, not handshakes. Don't sit at bars. Avoid eating at restaurants. And if you can meet up remotely, well, do it. This is all raising questions about how long we are going to have to keep this up and what the costs of it might be. Joining me in the studio here in Washington, NPR global health correspondent Nurith Aizenman. Hi, Nurith.

NURITH AIZENMAN, BYLINE: Hi.

GREENE: So you've been talking to people who actually research this kind of thing, social distancing. I mean, what are they thinking about here when it comes to the trade-offs we're all making?

AIZENMAN: Yeah. There is a lively discussion underway. Earlier this week, one influential researcher of disease prevention, Dr. John Ioannidis of Stanford University, published a provocative editorial. His take is that, OK, these social-distancing measures might be warranted in the very short term, given that we're in an emergency. We've seen what happened in China and Italy - the spike in infections, their hospitals overwhelmed. So we're trying to move fast to avoid that. But Ioannidis says the world also needs to start thinking very soon about the cost of these preventive measures.

GREENE: I mean, so you're saying, like, these preventative measures have caused businesses to shut down. And that means people unemployed. And that means the unemployment rate going up. I mean, there are real impacts here.

AIZENMAN: Exactly. And that then leads to all sorts of other health problems - suicides, diseases that are related to poverty. Here's Ioannidis.

JOHN IOANNIDIS: I'm not saying that we should not do everything that we can, but we should be very careful and measure very carefully what we're doing and what we are achieving with that because we are risking billions of lives while what is at stake may be, at the worst scenario, millions of lives.

GREENE: So he's actually saying that these strict measures could end up harming more people than we save from coronavirus.

AIZENMAN: Right - worldwide. But then other people who study this point out that, look. Some models suggest that if we don't take the strict action, as many as 2 million Americans could die, and the ramifications of that many deaths to our economy, to our health care system will extend way beyond just the COVID-19 casualties. One of the thinkers in that camp is Danielle Allen. She directs the Edmond J. Safra Center for Ethics at Harvard University.

DANIELLE ALLEN: If your health system collapses, a lot of other problems of social collapse follow. This pandemic is so significant that it is much better to analogize decision-making to what you would have in the context of a war.

GREENE: I mean, I've heard this analogy that this is - we need to be on a wartime footing, but what - does that really change anything?

AIZENMAN: Yeah. Allen says that it means that you ditch the usual method that we use for deciding what public policies to pursue - you know, the way of tallying up costs against benefits. She argues that instead, when you're on a war footing, you get into this triage mode. You identify your top priority, which - in this case, it really is the preservation of our health care system. She says if it collapses, our society is in peril. And so you keep that as your focus while you find creative but, you know, maybe less-than-ideal workarounds for keeping up all the other services that we need - education, business.

GREENE: So I want to ask you the question that - I feel like it's the impossible question, but everyone seems to be asking it right now. How long will this last? I mean, when it comes to the social distancing, how long might this go on?

AIZENMAN: You know, I'm hearing a range of opinions. On the more optimistic side is Dr. Ashish Jha. He's professor of global health at Harvard Medical School. He says right now, the U.S. is playing catch-up. There still aren't enough tests. Hospitals are going to have to really ramp up their capacity to provide intensive care. But he says once the U.S. gets to that point - let's have a listen.

ASHISH JHA: I don't see the need for nationwide lockdowns for any extended period of time. You can imagine short periods where, if it starts circulating at high levels, we may have to intervene. But my guess is we can - once we get ahead of it with testing, isolating people who are sick, we have a lot more tools at our disposal.

AIZENMAN: But other people I spoke to were less confident, including Marc Lipsitch, who is also at Harvard, and he's part of a team who run models that suggest as soon as officials lift the social distancing, the virus flares up again, and they'll need to impose social distancing all over again.

MARC LIPSITCH: I think we're really in a big dilemma, and I don't think anybody has a good answer to what to do.

GREENE: No good answers. All right. Nurith Aizenman is NPR's global health correspondent. Thanks so much, Nurith.

AIZENMAN: You're welcome. Transcript provided by NPR, Copyright NPR.