While Hard, Societal Sacrifices Are Measurably Paying Off

The SARS-COV-2 (COVID-19) pandemic has infiltrated almost all aspects of our lives, bringing much of normal societal flow to a grinding halt. Social distancing has restricted contact with others, business closures have reversed economic growth, and other safety and prevention measures have resulted in an abrupt and dramatic change to daily life. Despite these drastic actions, there are still nearly 13 million confirmed cases worldwide and well over 3 million in the United States (U.S.) alone, at the time of this writing. The vast number of COVID-19 infections and, worse, deaths from the virus, begs the question, have the steps we’ve taken made any difference? Is that measurable and, if so, how? Answers to these questions are crucial for a number of reasons. First, the changes we’ve been collectively making are hard. So, knowing whether these steps are saving lives and reducing infections can be motivating. Similarly, some leaders have sown doubt, causing a certain percentage of citizens to ignore scientific recommendations and raising wonder about whether the collective inconvenience, job loss, diminished learning, and isolation are worthwhile or not?

knowing whether these steps are saving lives and reducing infections can be motivating

To address this concern and curb the public skepticism, researchers from the University of Berkeley recently analyzed data to assess the effectiveness of a variety of protective measures across six major epicenters of COVID-19 including the U.S., Iran, France, China, South Korea, and Italy. Gathering 1,717 points of information from the six countries, the researchers assessed the significance of the effect by comparing the growth rate of COVID-19 just prior to the intervention (or interventions) to the change in growth rate soon after the implementation of one or more policies including, but not limited to:

If Nothing Had Been Done, 530 Million People Infected Worldwide

Without any policy action at all, the researchers estimated that the growth rate of COVID-19 infection would have been 43% higher per day across the six countries studied. This would have translated to 14 times more identified COVID-19 infections (i.e. nearly 5 million more cases) in the US alone as of the first week in April. In total, the study predicted that without intervention, there would have been 62 million more confirmed cases (again, as of early April) in the six countries, corresponding to 530 million total infections across the world.

Fig. 4 | Estimated cumulative confirmed COVID-19 infections with and without anti-contagion policies.

The current total of confirmed cases, close to 13 million, pale in comparison to these predicted values if no measures had been implemented in these 6 countries. It is clear that policy measures “significantly and substantially slowed the pandemic” spread. 

A similar study published in Health Affairs, discovered comparable trends in reduced growth rate of infection in the U.S. after implementation of shelter in place orders (SIPO). Following policies until the end of April, the Health Affairs researchers projected that without SIPO, there would have been 10 million more cases across the U.S. and without additional measures of event bans and closures (discussed below), there would have been 35 million more cases. Since two independent studies produced parallel results, we can feel confident about the accuracy of the estimated number of cases averted and lives saved as predicted by these statistical models. In other words, our collective actions and sacrifices, both as individuals and society at large, have mattered and have saved lives.

our collective actions and sacrifices, both as individuals and society at large, have mattered and have saved lives

If Nothing Had Been Done, 530 Million People Infected Worldwide

Both analyses went even further to try to uncover whether specific policies were most influential in mitigating spread of the disease compared with others. According to UC Berkeley and Health Affairs authors, social distancing has been especially impactful for slowing the spread of the virus; but, perhaps, school closures have not had as large an effect. Home isolation and social distancing, per the UC Berkeley analysis, reduced the growth rate of cases of coronavirus by 

-11.31% and -21.81% respectively. The study in Health Affairs also found that the SIPO provided the largest decrease in growth rate of -8% after only 21 days of implementation and that that result, in scientific terms, was statistically significant (p<0.01) – meaning the decline in spreading COVID-19 was definitely from the changed behavior, and not simply luck or chance. Additional actions that have also been emotionally draining and economically difficult, like business closure and quarantining those who test positive for COVID-19, have also effectively slowed the spread of COVID-19. The UC Berkeley experts report that these two actions resulted in a decrease in the rate of COVID-19 growth in the U.S. by -5.35% and -5.92% respectively, and even more in other countries like Italy (-11.40% and -6.06%, respectively). Neither of these studies examine the economic or psychological impact of these various preventative measures, which should be the subject of future research. However, this data makes it clear that while many of these protective measures are costly, challenging, and often unenjoyable, they have successfully stopped the spread of COVID-19.

What Can We Glean?

Both studies make it clear that their reports cannot determine definitively which protective measures are necessary, and which may be obsolete. Rather, these studies aim to shed light on the success of particular measures to slow the spread of COVID-19 and highlight how, all together, worldwide collective efforts have made a massive difference in combating the virus. These results prove that measures such as social distancing and home isolation have significantly slowed the spread of COVID-19, despite some dissenting opinions. In addition, while school closure and cancellation of large gatherings did not show significance or decreases in growth rate, both studies emphasize that these findings should not be interpreted as being unnecessary, nor does the data claim any stake on whether they be applied or avoided for future disease prevention.

The results of these analyses should be comforting since most of the preventative measures have produced what they intended.

The results of these analyses should be comforting since most of the preventative measures have produced what they intended. Through these measures, nations across the world were able to unite to implement meaningful action to slow the spread of COVID-19 and were able to prevent upwards of 530 million global infections. Dr. Kendon Bell, one of the UC Berkeley researchers, stated that as a global population, “we should be very proud” of our teamwork and collective actions to address the pandemic. 

These studies lay the foundation for effective statistical analysis of virus prevention and provide a template for what actions should be considered when facing the next pandemic. Our collaborative efforts to practice social distancing, in particular, and other measures have paid off. We have successfully cared for and protected one another. Let’s continue.

Written & Reported by Robert Shepard; Edited by Dr. Jacki Hart

Will 21-Year-Olds Learn to Take the Pandemic Seriously?

Doug, a 21-year old college student in Boulder, Colorado (CO), tested positive for COVID-19. Unlike others who have had much more serious cases, Doug was lucky. He only showed symptoms for a single day and, thankfully, never entered a hospital or emergency room. In fact, Doug assumed, at first, that he had the flu. 

Reflecting on his experience, Doug describes his main lessons from his quick brush with coronavirus. Doug learned, in large part, that his peers tend to take COVID-19 for granted. In fact, many in his friend group wound up testing positive, including the person from whom Doug contracted the virus. But few have taken it seriously enough to alter their habits and behaviors. 

Despite having had a smooth, easy course without complications, Doug now recognizes how contagious the virus is and tries to communicate with his friends the importance of wearing masks and taking other precautionary measures. Doug bases his newfound caution on the fact that he was exposed to the virus when in the same room with one or more who later tested positive. In fact, as Doug recounts, he was never in direct contact with an infectious person, just in the general vicinity

Even before having any symptoms, Doug sought testing because of this exposure. He found it difficult to locate a site; then, serendipitously, he developed symptoms one day later, which lasted less than 24 hours. Doug was quarantining from the time that he learned of the exposure. Three days after his symptoms began, his test results came back positive. His housemates and several friends, who had also been at that party, all tested positive; but no one had more than short-lived, mild symptoms.

While quarantining with housemates, their community came through with support. Other friends without COVID-19 delivered groceries and other supplies. The day that Doug shared his story with Covid-Recovery.org, he was scheduled to get his follow up test back the next day. He was anxious to know the results because he had stayed out of work for nearly a month. 

few his age seem to be taking the virus seriously enough.

When probed about the opinions of COVID-19 held by his peers, Doug described stories similar to what is shown in popular media: few his age seem to be taking the virus seriously enough. Those in Boulder, CO are still holding house parties, and while they wear masks when entering shops and bars, which are mandated, they’re not participating in strict social distancing. Doug believes that people his age might be convinced to change their behavior if their return to college was in jeopardy. Universities, like all schools throughout the country, are making a range of decisions based on the risks within their regions and many other factors. Part of the problem is that the delay between the risky behaviors that might spread the infection and any rise in rates could preclude students from connecting their actions and the schools’ decisions or altered policies. 

As far as Doug’s own behaviors — even though his case was mild, he carries an important message for people of all ages: listen to your doctors and wear your masks! 

Written & Reported by Robert Shepard
Edited by Dr. Jacki Hart

Reports Lag Behind Surges of Abuse & Domestic Violence

My Covid Story:

As Law Enforcement Partnership Coordinator at RESPOND, Victoria H has helped 100s of DV survivors from all over the world not only find safety but also success.

Nobody is immune to the impacts of COVID-19 on the way we live, but the consequences can be particularly severe for those suffering from domestic abuse. Numerous studies suggest that levels of violence have increased due to the toxic mix of heightened economic pressures, health-related issues, and “stay at home” rules that increase exposure to tense or already abusive relationships and eliminate a victim’s access to safe spaces during the day. These trends are further complicated by greater difficulties reaching out for help and getting access to the usual support organizations in one’s community.  

Stay-At-Home Rules Leave Jane Trapped

The story of Jane (name changed for privacy), a suburban high school student, begins in a way that is all too common within the foster care system – a teen reaching out to her school for help escaping from an abusive home. From that starting point, Jane faced hurdle after hurdle in her quest for safety because her cry for help took place during the emergence of the COVID-19 pandemic.  

On March 12th, Jane contacted her high school to say that recent “stay at home” rules left her trapped around the clock in an abusive home. Administrators worked diligently to set up a day in court. However, on the day of Jane’s scheduled hearing, courts across her state were shut down indefinitely. In the days that followed, social workers from the Department of Children and Families (DCF) navigated the new rules and managed to find Jane a safe home, only to watch their plans crumble once again – this time because a member of the foster-family tested positive for COVID-19. Luckily, local police worked closely with school administrators and DCF to keep a watchful eye on Jane’s abusive family while the support service agencies searched for another solution.  

Eventually, they found a safe new home for Jane. Nonetheless,

Jane’s harrowing story highlights the range of difficulties faced by those experiencing domestic abuse in the COVID-19 era

Jane’s harrowing story highlights the range of difficulties faced by those experiencing domestic abuse in the COVID-19 era, from the violence and trauma itself to the risk of contracting the virus from a stranger to adjusting to a whole new living circumstance at a time that is already fraught with fear and uncertainty. 

What Do the Experts Say?

Victoria Helberg, an employee at Respond (an organization that works with victims of domestic violence) noted how life during the pandemic makes it hard for those in need to reach out for help or to be identified by the community. Ms. Helberg said that there was a decrease in calls to Respond at the start of the pandemic. This trend may seem counterintuitive. But, as Ms. Helberg explains “people don’t have the opportunity to make calls because they were now at home with their abusive partner.”

people don’t have the opportunity to make calls because they were now at home with their abusive partner.

Ms. Helberg’s experience was echoed by a United Nations (UN) report that there has been a notable decrease in domestic violence reports during lockdown. Confirming Ms. Helberg’s real-life experience, the UN speculates that this is due to the hesitance of women to find help or address these incidents when forced to share their lockdown space with their abusers.

Despite increased difficulties reaching out for help reported by many experts, certain locations have still noted a spike in hotline activity regarding abuse. In Spain, the domestic violence hotline received 18% more calls in the first two weeks of lockdown than in the same period just one month earlier. Similarly, the United States and France reported roughly 30% increases in domestic complaints or occurrences of violence. These numbers are striking; yet, based on Ms. Helberg’s experience and the United Nations report, these statistics likely still underestimate the actual increase in incidents of abuse. For example,

Google noticed a 75% increase in Internet searches regarding support for domestic violence in Australia

Google noticed a 75% increase in Internet searches regarding support for domestic violence in Australia, demonstrating the large sum of victims who have likely been unable to receive help during the pandemic but are scouring the web for help. 

No Safe Space

The surge in cases of domestic abuse is also complicated by a lack of access to safe spaces for victims. Ms. Helberg states that “before, their abusive partner may be off to work, or they would be off to work, and they would have those kinds of moments in between to make [such] calls.” With no access to those private times and spaces today, difficult situations are made worse. Even children witnessing or experiencing abuse would rely more on the safety of schools and other locations for both a break from their homes and a place to get help. 

children witnessing or experiencing abuse would rely more on the safety of schools and other locations for both a break from their homes and a place to get help.

How Nations and Localities are Responding to this Crisis within a Crisis

During this extreme time, nations and local organizations have been taking the issue of abuse and domestic violence seriously. UN Secretary-General Antonio Guterres recently brought to light the importance of countries prioritizing support for those dealing with domestic violence. As a result, in France (for example), grocery stores set up a system using certain signals or code words to let the staff know that they need help. Around the globe, local organizations such as Respond have been helping as well, providing many services 100% virtually, while continuing to keep their shelter program staffed 24/7. 

The COVID-19 pandemic has created numerous additional complications for victims of abuse. At the same time, it is helping to shine a light on the seriousness of the ongoing problem and the need for vigilance. Even post-pandemic, governments and organizations need to continue to uncover the incidents, address the challenges, and create viable solutions to end domestic abuse and temper its devastating impact. 

Written & Reported by Ella Gavin; Edited by Dr. Jacki Hart

Mass. General Vaccine Chief Warns Coronavirus Still ‘Highly Infectious’

Dr. Poznansky discusses the risk of COVID-19 transmission during crowded Memorial Day celebrations, as well as the current status of vaccine development.

“From a crowded pool party at Lake of the Ozarks in Missouri to a street party in Daytona Beach, Florida, Memorial Day festivities brought hundreds close together in several U.S. cities Monday ⁠— largely without masks or other such precautions…”

Look to the ‘Lady with the Lamp’ as we respond to COVID-19 worldwide

Florence Nightingale offers lessons of leadership; those who emulate her style are successfully keeping down numbers of COVID-19 infections and deaths in their countries. 

Born on May 12, 200 years ago in Italy, Florence Nightingale is known for revolutionizing the nursing profession and introducing hygienic practices that, even now, save countless lives. At this moment in history, world leaders who emulate her transformative governance style are achieving noteworthy outcomes for their respective countries during the COVID-19 crisis. Today, it is many women heads of state who rise to Nightingale’s level of laudable leadership…

How do we go back to work? One hospital’s procedures show the way

Drs. Hart and Poznansky share what we can learn from hospital settings to help us all return to work. Hint: We do the best that we can based on the amount of information we have at a given time to drive decisions.

There is a basic tenet about mistakes in medicine, brought to bear by a well-known family practitioner named David Hilfiker. Dr. Hilfiker cautions that a mistake in medicine is not looking back with new information and data to say that you’d now handle a circumstance differently. A mistake in medicine is when you look back and determine that, with the exact same knowledge and set of data that you had at that time, you should have made a different decision…