Social distancing
In public health, social distancing, also called physical distancing, is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. It usually involves keeping a certain distance from others and avoiding gathering together in larger groups.
By minimising the probability that a given uninfected person will come into physical contact with an infected person, the disease transmission can be suppressed, resulting in fewer deaths. The measures may be used in combination with other public health recommendations, such as good respiratory hygiene, use of face masks when necessary, and hand washing. To slow down the spread of infectious diseases and avoid overburdening healthcare systems, particularly during a pandemic, several social-distancing measures have been used, including the closing of schools and workplaces, isolation, quarantine, restricting the movement of people and the cancellation of mass gatherings. Drawbacks of social distancing can include loneliness, reduced productivity and the loss of other benefits associated with human interaction.
Social distancing measures are most effective when the infectious disease spreads via one or more of the following methods: droplet contact, direct physical contact, indirect physical contact, and airborne transmission. The measures are less effective when an infection is transmitted primarily via contaminated water or food or by vectors such as mosquitoes or other insects. Authorities have encouraged or mandated social distancing during the COVID-19 pandemic as it is an important method of preventing transmission of COVID-19. COVID-19 is much more likely to spread over short distances than long ones. COVID-19 can spread over distances longer than 2 m in enclosed, poorly ventilated places and with prolonged exposure.
The term "social distancing" was not introduced until 2003. Social distancing measures have been successfully implemented in several epidemics. In St. Louis, shortly after the first cases of influenza were detected in the city during the 1918 flu pandemic, authorities implemented school closures, bans on public gatherings and other social-distancing interventions. The influenza fatality rates in St. Louis were much less than in Philadelphia, which had fewer cases of influenza but allowed a mass parade to continue and did not introduce social distancing until more than two weeks after its first cases.
The World Health Organization has suggested using the term "physical distancing" instead of "social distancing" because it is physical separation which prevents transmission; people can remain socially connected by meeting outdoors at a safe distance and by meeting via technology.
Definition
The American Centers for Disease Control and Prevention have described social distancing as a set of "methods for reducing frequency and closeness of contact between people in order to decrease the risk of transmission of disease". During the 2009 swine flu pandemic the WHO described social distancing as "keeping at least an arm's length distance from others, minimizing gatherings". During the COVID-19 pandemic, the CDC defined social distancing as "remaining out of congregate settings, avoiding mass gatherings, and maintaining distance from others when possible".Social distancing, combined with the use of face masks, good respiratory hygiene and hand washing, is considered the most feasible way to reduce or delay a pandemic.
Measures
Several social distancing measures are used to control the spread of contagious illnesses. Research indicates that measures must be applied rigorously and immediately in order to be effective.Avoiding physical contact
Keeping a set physical distance from each other and avoiding hugs and gestures that involve direct physical contact, reduce the risk of becoming infected during outbreaks of infectious respiratory diseases These distances of separation, in addition to personal hygiene measures, are also recommended at places of work. Where possible, remote work may be encouraged.The distance advised by authorities varies. During the COVID-19 pandemic, for example, the World Health Organization recommends that a distance of or more is safe. Subsequently, China, Denmark, France, Hong Kong, Lithuania and Singapore adopted a 1 m social distancing policy. South Korea adopted. Australia, Belgium, Germany, Greece, Italy, Netherlands, Portugal and Spain adopted. The United States adopted, and Canada adopted. The United Kingdom first advised 2 m, then on 4 July 2020 reduced this to "one metre plus" where other methods of mitigation such as face masks were in use.
The WHO's one-metre recommendation stems from research into droplet-based transmission of tuberculosis by William F. Wells, which had found that droplets produced by exhalation, coughs, or sneezes landed an average of from where they were expelled. Quartz speculated that the U.S. CDC's adoption of may have stemmed from a study of SARS transmission on an airplane, published in The New England Journal of Medicine. When contacted, however, the CDC did not provide any specific information.
Some have suggested that distances greater than should be observed. One minute of loud speaking can produce oral droplets with a load of 7 million SARS-CoV-2 virus per milliliter that can remain for more than eight minutes, a time-period during which many people could enter or remain in the area. A sneeze can distribute such droplets as far as or. Social distancing is less effective than face masks at reducing the spread of COVID-19.
Various alternatives have been proposed for the tradition of handshaking. The gesture of namaste, placing one's palms together, fingers pointing upwards, drawing the hands to the heart, is one non-touch alternative. During the COVID-19 pandemic in the United Kingdom, this gesture was used by Prince Charles upon greeting reception guests, and has been recommended by the Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, and Israeli Prime Minister Benjamin Netanyahu. Other alternatives include the popular thumbs up gesture, the wave, the shaka sign, and placing a palm on one's heart, as practiced in parts of Iran.
File:Islamic Congregational Prayer with Physical Distancing during the Covid-19 Pandemic.jpg|thumb|326px|Muslims in Indonesia pray in congregation while imposing to strict physical-distancing protocols during the COVID-19 pandemic. During the pandemic, Mosques in Indonesia has also removed the indoor rugs and has ordered worshipers to bring their own personal prayer rugs to prevent the spreading of the virus. Some mosques which are located in the most infected regions even are ordered to be closed for worship
School closures
Mathematical modeling has shown that transmission of an outbreak may be delayed by closing schools. However, effectiveness depends on the contacts children maintain outside of school. Often, one parent has to take time off work, and prolonged closures may be required. These factors could result in social and economic disruption.Workplace closures
studies based on U.S. data suggest that if 10% of affected workplaces are closed, the overall infection transmission rate is around 11.9% and the epidemic peak time is slightly delayed. In contrast, if 33% of affected workplaces are closed, the attack rate decreases to 4.9%, and the peak time is delayed by one week. Workplace closures include closure of "non-essential" businesses and social services.Canceling mass gatherings
Cancellation of mass gatherings includes sports events, films or musical shows. Evidence published in 2006 suggesting that mass gatherings increase the potential for infectious disease transmission is inconclusive. Anecdotal evidence suggests certain types of mass gatherings may be associated with increased risk of influenza transmission, and may also "seed" new strains into an area, instigating community transmission in a pandemic. During the 1918 influenza pandemic, military parades in Philadelphia and Boston may have been responsible for spreading the disease by mixing infected sailors with crowds of civilians. Restricting mass gatherings, in combination with other social distancing interventions, may help reduce transmission. A 2020 peer-reviewed study in the British Medical Journal also suggested it as one of the key components of an effective strategy in reducing the burden of COVID-19.Travel restrictions
Border restrictions or internal travel restrictions are unlikely to delay an epidemic by more than two to three weeks unless implemented with over 99% coverage. Airport screening was found to be ineffective in preventing viral transmission during the 2003 SARS outbreak in Canada and the U.S. Strict border controls between Austria and the Ottoman Empire, imposed from 1770 until 1871 to prevent persons infected with the bubonic plague from entering Austria, were reportedly effective, as there were no major outbreaks of plague in Austrian territory after they were established, whereas the Ottoman Empire continued to suffer frequent epidemics of plague until the mid-nineteenth century.A Northeastern University study published in March 2020 found that "travel restrictions to and from China only slow down the international spread of COVID-19 combined with efforts to reduce transmission on a community and an individual level.... Travel restrictions aren't enough unless we couple it with social distancing." The study found that the travel ban in Wuhan delayed the spread of the disease to other parts of mainland China only by three to five days, although it did reduce the spread of international cases by as much as 80 percent.
Shielding
Shielding measures for individuals include limiting face-to-face contacts, conducting business by phone or online, avoiding public places and reducing unnecessary travel.During the COVID-19 pandemic in the United Kingdom, shielding referred to special advisory measures put in place by the UK Government to protect those at the highest risk of serious illness from the disease. This included those with weakened immune systems, as well as those with certain medical conditions such as cystic fibrosis or severe asthma. Until 1 June 2020, those shielding were strongly advised not to leave home for any reason at all, including essential travel, and to maintain a distance from anyone else in their household. Supermarkets quickly made priority grocery delivery slots available to those shielding, and the Government arranged for food boxes to be sent to those shielding who needed additional assistance, for example elderly people shielding on their own. This was gradually relaxed from June to allow shielders to spend more time outside, before being suspended indefinitely from 1 August.