Besides Social Distancing What Can We Do?

Bradley Tanner, MD, ME, MBA
April 5, 2020

The danger of a one size fits all solution - social distancing - is it requires a single-minded focus (and enforcement strategy) as the solution to the problem. That means there is little opportunity for highlighting other behaviors that might decrease the speed of viral spread.

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For the following items, as with social distancing, I assume that they will not stop the viral spread, they will only slow its progress. A laudable goal but an important distinction.

Stop smoking. If anyone needs a reason to stop smoking/vaping, the time is now. Not just for you but anyone near you. This is a lung disease. You need a 100% healthy lung. Smoking increases the risk be admitted to an ICU by 2.4 times. [Vardavas CI, Nikitara K COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. March 20, 2020;18. doi:10.18332/tid/119324. PMCID: PMC7083240. PMID: 32206052.] Since we have already accepted a police state that orders companies to create products, and people to not leave their homes, perhaps we could temporarily halt the sale of cigarettes and any device related to smoking. Strangely enough, tobacco stores are often considered "essential." Does this make sense?

Psychologically we need to change our vocabulary; this is not a "war." If this is a war, then it is a war against an enemy with unlimited resources since it also has access to all of our resources. Remember that it enters our lungs, replicates itself, destroys our cells, and then is expelled to potentially infect another person. This is not your average enemy. And if one assumes this is a war, let's be honest. We are losing and will lose badly. So is this a great analogy?

Instead, let's call it an ethical challenge. Do we destroy the economy and the future of some or do we save every possible loss of life due to the virus? Let's be honest, this isn't a "medical problem" this is an ethical dilemma that we have ignored until now. We flatten the curve with the decision that saving some lives is worth the economic and personal damage it might cause. We all have a right to participate in that ethical decision.

The unpleasant reality is we have been making these choices for a long time.

Those were trade-offs. This virus is no different. Let's be honest. In the current narrative, we decided that it was OK to inflict pain and suffering from some (typically younger) people to potentially save the lives of those at risk (usually older) from the virus. We may, in fact, all agree with that decision. But our leaders deserve to have an open discussion of the decision being made. Muting the voices of some who might choose differently is being dishonest to the values of a liberal society.

We need to admit that the word "defeat" is a lie. We have not defeated any other virus, except for smallpox. Even here, there is an ongoing debate if we should keep some smallpox around (we do) since otherwise, we don't have a way to fight it if it comes back. So even here, smallpox is not "gone" - it is hidden away in a laboratory. And if it escaped (intentionally or otherwise), it would attack a world with no immunity.

We will never defeat a virus that is this transmissible. We are not going to "win". Perhaps years from now, we can defeat ALL viruses, but that is currently years off. Remember how we were going to eliminate cancer? Well, that didn't happen. The goal, for now, is to

Allow activity that enhances wellbeing and avoid activity that counters wellbeing. Mental illness and stress increase our risk of disease and infection by raising cortisol and other negative effects.

  1. Let's ask the media to turn off the hype machine. Yes, there are more deaths today. There are more deaths from suicide, car accidents, maternal death, cancer, and a 1000 other reasons today as well. This is not news. In fact, the rate of new deaths may be starting to plateau, and some days the rate has decreased. But day to day there is nothing new. Nor is there anything new in terms of the opioid and obesity epidemic or for several cancers, and those are ignored. Let's stop highlighting "milestones" that have been crossed unless we are willing to note every time a gun-related death, suicide, cancer, or heart disease-related death crosses a milestone. In the US, 2.8 million people died last year. Tell us something we don't already know, or you haven't shown us 100x in the past week.

  2. Let's ask the media to stop the naked emotionalism. This is simply manipulation. Misery happens everywhere. All the misery I discussed that is due to the virus is also seen from the estimated 13 suicide deaths among our youth on an average day. None of them got a story on the news with crying family and caregivers. The media is generating fear and panic. Please stop showing pictures of people who have died or suffering families. Or give the other probably 7,600 who died yesterday equal airtime.

  3. Personally, stop watching the news. Trust me; if something is real, you will hear about it. The day treatment is shown to work, and they are giving it to 10,000 people is a day you will find out no matter how disconnected you are. For your own wellbeing disconnect from the hype machine, news briefings, emotion grabbing stories, and all the junk trying to get you to watch and help pay for the advertisements.

  4. Ask your leaders if a decision is going to harm or help wellbeing? Are you closing something because you are mad at non-compliance or because you feel it is the best interest? Is sunbathing causing the virus to spread? If I am outside, does it have to be for exercise? What if I wanted to sit and breathe some fresh air for 30 minutes? We live in a democracy still (despite the apparent evidence that it is shrinking) we can and must demand that our leaders explain their actions.

Finally, challenge the narrative. Demand explanations and answers. If you don't get an adequate response, then question their motivation. Is this a power/attention grab? Do you feel your decision is better than mine? Are you looking out for the interest of a small group? Why that one? If this is your "expert" opinion, what are you an expert in? How about expert advice of other experts in other fields?

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