4 Things to Consider as We Live Through the COVID-19 Pandemic

Isolate from the first known U.S. case of COVID-19. (Centers for Disease Control and Prevention)

LIVING IN A TIME OF PANDEMIC IS SCARY, and confusing, and weird. I'm feeling all of those things right now, but I'm also feeling something else: empowered. The truth is, we each have a tremendous ability–and responsibility–to be a part of the fight against the spread of COVID-19. I thought I'd take a moment to share four things I think we should keep in mind as we consider our personal actions in the coming days.

1. 'Proving' community spread is more complicated than you think.

Some politicians and officials have approached the issue of community spread as something that must be proven. South Dakota's governor, Kristi Noem, has been among those. On Thursday, for instance, the Argus Leader quoted her as saying, "Anyone that would definitively say that we do have community spread would not be basing that on anything that would be factual at this time."
Now, on one level, Noem is right. At a certain point, the number of cases in a particular area will grow so large that it's impossible to conclude anything other than community spread.
However, the trouble with statements like Noem's is that they leave the impression that, in the absence of conclusive evidence, the epidemiological assumption is that a particular case is not the result of community spread. That impression would be inaccurate.
The reason physicians and medical staff routinely ask patients if they have traveled out of the country or if they have come into contact with someone who has tested positive for COVID-19, is that doctors want to pin down the most likely cause of the patient's infection. If the patient has traveled to China recently, or if they work alongside someone else who has the illness, there's a good chance that the travel or the proximity to the sick colleague is the cause of the individual's infection. However, if a patient hasn't traveled to a COVID-19 hotspot recently, and if they haven't knowingly come into contact with someone who has the infection, then the source of their infection is unknown. In such cases, public health officials can't afford to assume it's not community spread. Rather, they need to assume it is community spread, and take appropriate actions to stop the spread as rapidly as possible.
The point is, epidemiologists aren't going to wait until they can prove community spread to take precautionary measures; they're going to try to disprove community spread, and if they cannot do that, they will act as if the virus is spreading within the community. You and I should do the same thing.

2. You might have COVID-19, even if you have no symptoms.

A study released earlier this month found 17.9% of people who tested positive for the illness had no symptoms. Given the slow start to testing in the United States, it's quite possible that you or someone you know has the illness, even if you don't have any symptoms. Also, the vast majority of cases are mild, meaning that you might have COVID-19 even if your symptoms don't seem particularly impressive. All of this means that, when you go out, the person you meet on the street or in the restaurant might unknowingly be infected with the coronavirus. It might seem responsible enough to adopt an attitude that you'll go about your normal daily life unless or until you develop symptoms of COVID-19. The truth is, though, that having symptoms and having the illness are two different things. Yes, the majority of patients with the infection have symptoms, but a lack of symptoms does not equal a lack of the virus. And if you don't know whether or not you're infected, you're risking other people's health and lives when you interact with them.

3. You, personally, have tremendous power.

The much-discussed Imperial College model of COVID-19 had striking findings for public health officials. It found that, by averting a single infection today, public health officials could avert 2,400 cases that would otherwise be present in a month. A week later, the impact of averting a single case would be much smaller—preventing just 600 cases. In other words, it pays to act fast.
Those data were meant to inform public health officials planning COVID-19 responses on a macro level. However, the data have implications for you and me, too. Think about it–if you have the virus and you stay home and avoid infecting anyone else, you could literally prevent hundreds of other people from getting infected.
This is actually very empowering information. What it means is that when infected people practice social distancing, they have a tremendous individual impact on the overall public's health. Since most of us have no way of knowing if we're infected (the only way to know for sure is to get a test, and testing isn't available to most people), the responsible thing to do is limit social interactions and stay home as much as possible.

4. We're really, really fortunate.

This is literally the best time in all of human history to have to live in semi-isolation. Millions of people have been able to convert their work or studies to online work or study with little or no training or cost. The restaurant down the street that has never had online ordering can find a provider and get it up and running in no time. The bakery that didn't deliver yesterday can deliver today. And the church that had no idea how to livestream last Sunday can start broadcasting its sermons worldwide after a quick five-minute tutorial from a condescending millennial. To be sure, it's frustrating, and lonely, and a bit scary to have to hide from a pandemic. And the economic implications on the macro and micro level will be deep and painful and will require significant action on the part of our government. Still, most of us have the tools we need to stay safe and to communicate with friends and to entertain ourselves. Not everyone in the world is so lucky. We can show our gratitude by checking in on people who live by themselves, donating to food banks, and lending a hand to friends in need. But we can also show our gratitude by following public health recommendations, and staying home. It's the right thing to do.