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Social distancing

Social distancing.
Source: Fathromi Ramdlon from Pixabay.

As we have already described in the page dedicated to the COVID-19 disease, this is mainly transmitted through the inhalation of respiratory droplets but also by air, therefore it is possible to mitigate their diffusion through a series of non-pharmaceutical measures.

The non-pharmaceutical measures implemented are substantially three: social distancing, hygiene and the use of personal protection devices or PPE. The social distancing measures, undertaken between the end of February and the first days of March, consist in isolating patients, closing schools, workplaces and any other activity or place that involves the gathering of people, such as stadiums, cinemas , restaurants etc.

Come lavarsi le mani per prevenire il contagio

How to wash hands properly.
By: Giacomo Baldon / CC BY-SA

There are two hygiene measures. The first is a thorough cleaning of the hands, studies have found that the SARS-CoV-2 virus does not survive washing with soap and water or alcohol-based disinfectants, provided that it is at least 70% ethanol. It is essential that the washing or disinfection is carried out correctly, for washing with soap and water this must be done for at least one minute, in the case of disinfection with alcohol-based products one must proceed in the same way but can reduce the time to forty seconds, given the greater effectiveness of these products. In both cases it is necessary to correctly implement the cleaning procedure and not only respect the duration of these operations.

The second measure is the recommendation not to put your hands on your face unless you have washed or disinfected them thoroughly. At first, the use of disposable gloves had been made mandatory for this reason, later it was understood that this is not very useful or counterproductive, both because people do not know how to use it correctly, do not change gloves at each use, they do not know how to wear and remove them correctly and they think that using gloves it is not necessary to wash or hygienise their hands thoroughly.

The use of PPE, mask and gloves, is a mandatory act in the professional field, doctors and staff are obliged to use PPE and have a specific culture of how these must be worn and removed correctly. Operators are required to use PPE that have precise specifications, while for all others it is also possible to use homemade masks since, in this case, they are more useful to avoid the spread of the virus that not to prevent contracting the disease. The other PPE that had been made mandatory at the end of the lockdown were disposable gloves which, for the reasons explained above, were not particularly effective.

Celebrations in Philadelphia for the announcement of the armistice of The First World War, .

Graph that compares the trend of the Spanish flu pandemic between Philadelphia and St. Louis in 1918.

Comparison between Philadelphia and St. Louis.

A study on measures taken to counter the Spanish flu pandemic, Public health interventions and epidemic intensity during the 1918 influenza pandemic, which compared the data of two US cities, Philadelphia and St. Louis, made it possible to understand the usefulness of non-pharmaceutical measures in slowing the spread of the disease.

In Philadelphia no social distancing measure or prohibition of aggregation was taken, unlike in St. Louis where, two days after the first flu case, schools, parks, courts and churches were closed; shifts were staggered, public transport was strictly limited and assembling in public of groups of more than twenty people was prohibited.

The result was that in St. Louis the contagion curve remained low and manageable by the hospital structures, while in Philadelphia, three days after a march in support of the soldiers leaving for Europe for the First World War that collected more of 200,000 people, all the beds in the 31 hospitals were occupied by the sick and dying, infected with the flu.

It is therefore evident that social distancing is the most effective non-pharmaceutical measure in preventing the spread of infectious diseases such as COVID-19 or others with similar transmissibility characteristics.