New Study: Why Social Distancing May Need To Continue Until 2022

How long will social distancing go on? Perhaps intermittently until 2022, new research shows.

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According to a recent Harvard Chan School of Public Health analysis, the best strategy to ease the critical care burden and loss of life might be on-again, off-again social distancing. That’s the best course of action, researchers say, barring the development of other interventions, like a vaccine.

The reason is that while social distancing immediately alleviates the critical care burden and lessens loss of life, it prolongs the amount of time required for herd immunity to develop, allowing for infection spikes that fluctuate with the changing seasons, researchers say.

“In the absence of such interventions, surveillance and intermittent distancing may need to be maintained into 2022, which would present a substantial social and economic burden,” researchers wrote. “To shorten the SARS-CoV-2 epidemic and ensure adequate care for the critically ill, increasing critical care capacity and developing additional interventions are urgent priorities.”

The research team’s findings, which were released as an academic preprint awaiting peer review, differ from those of other health experts. For example, a recent New York Times op-ed, published by Dr. Ezekiel J. Emmanuel, vice provost of global initiatives and a professor at the University of Pennsylvania, outlines a plan to reopen the American economy by June. Emmanuel’s approach calls for 8-10 weeks of sheltering in place.

For context, the White House-cited Institute for Health Metrics and Evaluation‘s COVID-19 projections currently predict a flattened curve by June 1 with about 60,000 deaths. Peak hospital demand is expected to occur on April 14.

Also for comparison, former FDA commissioner Scott Gottlieb recently authored a 4-phase plan to reopen the country. Right now, it appears we’re at Phase 1: Slow the Spread. Gottlieb’s plan doesn’t offer a firm reopening date, or end to social distancing.

One-and-done distancing

In the eyes of the Harvard team, the problem with a one-and-done dose of social distancing is two-pronged:

• How do we alleviate the burden on critical care and save lives?
• How do we develop herd immunity while a vaccine or other intervention is developed?

If COVID-19 follows the flu and cold pattern, then cases will peak in colder months. If that’s the case, researchers say a single bout of social distancing right now won’t do, and the undulating seasonal infection pattern will repeat annually without adequate time for herd immunity to develop. The researchers note that this is “because under any scenario considered it leaves enough of the population susceptible that a rebound in transmission after the end of the period will lead to an epidemic that exceeds this capacity.”

“In the case of a 20-week period of social distancing with 60% reduction in R0, for example, the resurgence peak size is nearly the same as the peak size of the uncontrolled epidemic: the social distancing is so effective that virtually no population immunity is built,” the team wrote.

With the time horizon for a vaccine or similar intervention being 12-18 months away, if we want to alleviate the critical care burden while simultaneously building herd immunity, the answer is to monitor COVID-19 infection numbers and undulate social distance accordingly.

Intermittent social distancing, while an immediate inconvenience, is actually delayed gratification in the sense that it will shorten the epidemic duration, as well as the total length of social distancing. It represents, the researchers wrote, “the only way to avoid overwhelming critical care capacity while building population immunity.”

TL;DR

• A vaccine or similar COVID-19 intervention may take months or years to develop.
• A single bout of social distancing will lead to seasonal COVID-19 rebounding and an annual critical care strain.
• Curbing COVID-19 transmission may require careful year-round monitoring of transmission rates and periodic social distancing.
• This alleviates the strain on critical care and allows population immunity to develop.

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