What are the epidemiological side effects of mass social distancing?
April 14, 2020 5:16 PM Subscribe
I’m curious since people in a lot of places all over are keeping far enough apart to slow the spread of a really contagious disease if it is possible anything will happen to other diseases as “collateral damage.” Might we accidentally wipe out a few strains of rhinovirus, for example? Is there any documentation of this happening in previous periods of quarantine during epidemics?
Remember that many millions of Americans just lost health insurance. So I'd expect to see other diseases that would usually not be so bad when caught early increase in severity when they are diagnosed later. While telehealth is fantastic we're definitely going to miss some routine care as people are out of doctor's offices (and out of insurance).
A thread on the blue (I think?) also discussed how we could see an increase in measles as people miss vaccinations and herd immunity is lowered.
posted by raccoon409 at 6:55 PM on April 14, 2020 [6 favorites]
A thread on the blue (I think?) also discussed how we could see an increase in measles as people miss vaccinations and herd immunity is lowered.
posted by raccoon409 at 6:55 PM on April 14, 2020 [6 favorites]
Response by poster: Mild course correction & clarification before I step out of my Ask: I’m interested in all info, but particularly sourced info about unexpected side effects of this quarantine or previous quarantines. I don’t mind a little personal speculation, but my holy grail for this Ask is definitely weird data, historical accounts, etc. The possibility of measles coming back because people are missing vaccines is a great example of the kind of unexpected tidbit I’m looking for.
If it’s unlikely that social distancing would wipe out or dramatically affect any disease, I’d really like an explanation why that is! Could we really not end up wiping out some random smalltime rhinovirus? Current social distancing measures are designed around a virus that is novel and incredibly contagious, and some places are flattening its curve pretty successfully. It seems to follow that like e.g. a smalltime rhinovirus with a small R0 might struggle. Please tell me why I’m wrong if I am!
posted by Gymnopedist at 7:25 PM on April 14, 2020 [2 favorites]
If it’s unlikely that social distancing would wipe out or dramatically affect any disease, I’d really like an explanation why that is! Could we really not end up wiping out some random smalltime rhinovirus? Current social distancing measures are designed around a virus that is novel and incredibly contagious, and some places are flattening its curve pretty successfully. It seems to follow that like e.g. a smalltime rhinovirus with a small R0 might struggle. Please tell me why I’m wrong if I am!
posted by Gymnopedist at 7:25 PM on April 14, 2020 [2 favorites]
Best answer: Here's a thing...
It depends on the reservoirs. For example, smallpox was totally eradicable in the 70s - we had the field-worker-innoculator-heroes, the vaccine technology, and the leadership of DA Henderson. And the reason that outcome was medically possible is...smallpox had nowhere else to go. It's only reservoir is humans. It cannot infect anything else *. Everyplace it flared up, the field workers would jump in and vaccinate everyone around them. Until no one had it at all, anywhere.
As long as a virus can survive in another reservoir, and non-immune humans exist, infection is possible.
So, think of a virus (ebola), find out if it has a non-human reservoir (at least bats, probably, after decades of research). As long as bats and humans exist, outbreaks of ebola will occur. Fewer, if the humans/bat population overlap is vaccinated. But eradication is pretty impossible.
So if there's someplace for a virus to go, it's incidence in humans may be reduced, but it's coming back with its same R0.
This is complicated with mutation rate and I'm sure many other factors.
With distancing, we're forcing a temporary recalculation of R0 for SARS-CoV-2. It can't easily spread from one human to another. But it still lives in an animal reservoir in/around China (at least).
I am not so smart and probably couldn't name something else that is common enough that is also affected. I could guess at HPV, Herpes, and any other STD virus. I guess any of the measles-infected anti-vax people are probably creating fewer transmissions. I think rhinovirus mutates too quickly so we'll never have herd immunity.
And that's all I know about that. These are authors of accessible books about germs: David Quammen, Joe McCormack, Laurie Garrett, Karl Greenfield, and Richard Preston.
*Someone at CDC was able to force an animal-model of smallpox with some sciencey mojo, like a massive exposure and a purposefully weakened immune system. A chimp, maybe? Anyway, there was a huge ethical thing about it. So, practically, smallpox is a human-only disease.
posted by j_curiouser at 10:36 PM on April 14, 2020 [17 favorites]
It depends on the reservoirs. For example, smallpox was totally eradicable in the 70s - we had the field-worker-innoculator-heroes, the vaccine technology, and the leadership of DA Henderson. And the reason that outcome was medically possible is...smallpox had nowhere else to go. It's only reservoir is humans. It cannot infect anything else *. Everyplace it flared up, the field workers would jump in and vaccinate everyone around them. Until no one had it at all, anywhere.
As long as a virus can survive in another reservoir, and non-immune humans exist, infection is possible.
So, think of a virus (ebola), find out if it has a non-human reservoir (at least bats, probably, after decades of research). As long as bats and humans exist, outbreaks of ebola will occur. Fewer, if the humans/bat population overlap is vaccinated. But eradication is pretty impossible.
So if there's someplace for a virus to go, it's incidence in humans may be reduced, but it's coming back with its same R0.
This is complicated with mutation rate and I'm sure many other factors.
With distancing, we're forcing a temporary recalculation of R0 for SARS-CoV-2. It can't easily spread from one human to another. But it still lives in an animal reservoir in/around China (at least).
I am not so smart and probably couldn't name something else that is common enough that is also affected. I could guess at HPV, Herpes, and any other STD virus. I guess any of the measles-infected anti-vax people are probably creating fewer transmissions. I think rhinovirus mutates too quickly so we'll never have herd immunity.
And that's all I know about that. These are authors of accessible books about germs: David Quammen, Joe McCormack, Laurie Garrett, Karl Greenfield, and Richard Preston.
*Someone at CDC was able to force an animal-model of smallpox with some sciencey mojo, like a massive exposure and a purposefully weakened immune system. A chimp, maybe? Anyway, there was a huge ethical thing about it. So, practically, smallpox is a human-only disease.
posted by j_curiouser at 10:36 PM on April 14, 2020 [17 favorites]
I haven't a source, but I did hear that seasonal flu has practically vanished for now in I think Japan.
posted by lokta at 4:06 AM on April 15, 2020
posted by lokta at 4:06 AM on April 15, 2020
Best answer: Hon noterar nedgångar i antalen fall av influensa, vinterkräksjuka och RS-virus, sedan virusets utbrott.
On Friday Karin Tegmark-Wisell, the head of microbiology at the Swedish national health agency (Folkhälsomyndigheten) told reporters that the number of cases of influenza, vinterkräksjuka (a winter stomach bug similar to the flu) and RS (not that I know what that is) has dropped since the outbreak of the pandemic here in Sweden. The article is all about corona, that was a kind of throw-away line in the piece.
A different article, behind a paywall, claimed the 2020 season of vinterkräksjuka ended much earlier than usual. I can only imagine it was the result of the restrictions in travel and social distancing here that have been encouraged if not mandated. Alas, it is not as interesting as the examples you gave but I promise that all the families that usually have to cope with these bugs are happy that their kids don't have them right now on top of the coronavirus worries.
posted by Bella Donna at 5:07 AM on April 15, 2020 [1 favorite]
On Friday Karin Tegmark-Wisell, the head of microbiology at the Swedish national health agency (Folkhälsomyndigheten) told reporters that the number of cases of influenza, vinterkräksjuka (a winter stomach bug similar to the flu) and RS (not that I know what that is) has dropped since the outbreak of the pandemic here in Sweden. The article is all about corona, that was a kind of throw-away line in the piece.
A different article, behind a paywall, claimed the 2020 season of vinterkräksjuka ended much earlier than usual. I can only imagine it was the result of the restrictions in travel and social distancing here that have been encouraged if not mandated. Alas, it is not as interesting as the examples you gave but I promise that all the families that usually have to cope with these bugs are happy that their kids don't have them right now on top of the coronavirus worries.
posted by Bella Donna at 5:07 AM on April 15, 2020 [1 favorite]
Best answer: This was actually a question in Randall Munroe's book What If? The question involves a hypothetical that looks like what we're doing now (as an unlikely scenario). In his scenario, we all stay home for just a few weeks.
His conclusion is that a disease like rhinovirus, which the immune system completely destroys in a couple of weeks, would be wiped out in all healthy people, but that immune-suppressed people may still be a reservoir of the virus, since they are unable to completely fight it off. Those people would likely still be sick when the separation ends and could therefore reintroduce the virus to society.
posted by gideonfrog at 5:20 AM on April 15, 2020 [2 favorites]
His conclusion is that a disease like rhinovirus, which the immune system completely destroys in a couple of weeks, would be wiped out in all healthy people, but that immune-suppressed people may still be a reservoir of the virus, since they are unable to completely fight it off. Those people would likely still be sick when the separation ends and could therefore reintroduce the virus to society.
posted by gideonfrog at 5:20 AM on April 15, 2020 [2 favorites]
Best answer: Here's an article from the New York Times about how countries are having to stop mass immunization programs, putting millions at risk for measles. (Normally behind a paywall, but their coronavirus coverage is free.)
Here's a NYT article on how doctors are reporting that a lot of "normal" emergencies, e.g., heart attacks and strokes, seem to have disappeared, though for unknown reasons.
posted by FencingGal at 6:18 AM on April 15, 2020 [1 favorite]
Here's a NYT article on how doctors are reporting that a lot of "normal" emergencies, e.g., heart attacks and strokes, seem to have disappeared, though for unknown reasons.
posted by FencingGal at 6:18 AM on April 15, 2020 [1 favorite]
and RS (not that I know what that is)
Respiratory syncytial virus possibly?
posted by atrazine at 7:02 AM on April 15, 2020
Respiratory syncytial virus possibly?
posted by atrazine at 7:02 AM on April 15, 2020
Late to the game here, but this tweet from an infectious diseases epidemiologist in Australia suggests lower flu and cold symptoms in the population this year compared with last.
posted by lulu68 at 7:51 PM on April 16, 2020
posted by lulu68 at 7:51 PM on April 16, 2020
Following up on lokta's post, I have a source: flu season in Japan ended early this year.
posted by fire, water, earth, air at 8:38 PM on April 17, 2020 [1 favorite]
posted by fire, water, earth, air at 8:38 PM on April 17, 2020 [1 favorite]
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I imagine that many infectious diseases that are spread by close contact are going to be slowed as well. Sexually transmitted diseases, for instance.
posted by tivalasvegas at 6:46 PM on April 14, 2020 [2 favorites]