How to think about coronavirus like a public health expert

If there was a single theme that defined the coronavirus pandemic response over the past week, it might be that we’re all starting to see the world the way public health experts do. Terms like “social distancing,” “pandemic,” and “flattening the curve” have become part of our everyday vocabularies. Social media is filled with examples of friends pleading with each other to stay home and “shelter in place” rather than go on with business as usual. To keep nurturing those burgeoning public health instincts, we asked Patricia Wren, public health professor and chair of UM-Dearborn’s Department of Health and Human Services, to share how she’s thinking about our collective response to the pandemic. Here’s our conversation, which has been condensed and lightly edited for clarity. 

The Reporter: I think one of the big developments of the past week was witnessing leaders — and the public — start to take this really, really seriously. Even so, there are a lot of people who see measures like closing restaurants and bars as extreme. From a public health perspective, make the case that these kinds of disruptions to our lives are worth it.

Patricia Wren: The way I’m thinking about this is that we have an opportunity right now to learn from the experiences of other nations. The data showing the rates at which this pandemic took off in China, South Korea, Iran and Italy are really compelling. In all those cases, when you look at the charts showing the spread of the disease, you see the line just shoot up like a rocket ship. We’re about two weeks behind all of those other rocket ships that launched. So we have to take dramatic action, like social distancing, to slow the movement of the virus through the population. That’s what we call “flattening the curve.” If we do that, we’ll maybe have a longer experience of whatever this crisis is, but without it overwhelming our grocery stores, our families, and we certainly don’t want it to overwhelm our healthcare system. So that’s why it’s really essential that all of us take these steps now, so that in a country like the United States, which is five times larger than Italy, we don’t experience five times the number of cases and deaths. I think that’s the kind of scale we have to keep front of mind.

Reporter: One thing I notice about the graphs showing this “flattening the curve” strategy is that they seem to suggest we could be living with things like social distancing for a long period of time. Should we think about this kind of collective response to the pandemic as a long haul?

Wren: I think all of the University of Michigan officials, from President Schlissel to Chancellor Grasso to all the experts at Michigan Medicine, have given us a clear signal. If you look at one of the latest communications from Chancellor Grasso, it already indicates that summer classes are going to be offered in an online platform. That says to me that my university is preparing for a very long horizon, at least as a possibility. Fall is still a good six months away, so we’re talking about online classes being an appropriate measure for the next six months. That’s a really big deal, and we have to begin to wrap our minds around what our neighbors are going to need, what restaurant workers are going to need, the impact on small businesses, and what our students, whose families’ livelihoods are at risk, are going to need. I think the size and scale of the impact is not yet quantifiable.

Reporter: We’ve seen the threshold for “social distancing” evolve rapidly in the last week. As of today, the best practice seems to be limiting any kind of unnecessary contact with other people, even in small groups. So how do we draw the line between what’s necessary and what’s risky?

Wren: One thing we know about human nature is that we aren’t especially good at assessing risk. This is especially the case when we’re confronted with risks that feel amorphous or vague. In my intro to public health class, I teach this to students by talking about the risk of driving to class. Statistically, that’s the single biggest risk they could take, because for people their age, motor vehicle crashes are the leading cause of death. And yet we don't think anything of jumping in the car to go to class or work or meet with friends. So now, we have this crazy pathogen thrown into the mix, and we’re having trouble sorting out what social distancing really means, and how much we really need to restrict our comings and goings. At this point, thinking about ways you can shelter in place and be more homebound is absolutely a good thing. Because people can have the virus for days before they experience symptoms, it’s not enough to not go out only if you have a cough or fatigue or fever or shortness of breath. Now can you play in your yard, take a walk, walk the dog? You bet. But you have to be much more mindful of so many details. I find myself constantly thinking about the elevator button or door handle I just touched that other people have touched. Even things like gatherings or getting family together are things we might think about doing without for a while, because we just have to be so much more cautious given the way this virus spreads.

Reporter: So let’s say you have friends or loved ones who aren’t moving in that direction and are continuing more or less like it’s business as usual. How do you get through to them?

Wren: One of the things we know about public health is that fear arousal has a short shelf life. The whole “this is your brain on drugs” or “you’re going to die if you have unprotected sex” — turns out, these worst-case scenarios and fear-based messages are easier to tune out because many of us perceive them as something that won’t apply to us. Fear, as a strategy, isn’t sustaining. So we have to think about how we do this with love. I think about my students, many of whom are first-generation college students. That makes them touchstones for their families because their families have expectations that these young people will be more knowledgeable than them. So I’m telling my students they have a responsibility and opportunity to be good role models. And we all have an opportunity to offer corrective advice, to challenge people on social media, to say with love to family members, ‘I need you to be cautious because I want you to be around to dance at my wedding.’ I think there are ways we can offer these expressions with love that are tailored to the people who we have influence over. That’s far more effective than fear. And we also have to be willing to repeat those things multiple times, multiple ways until the message gets through.

Reporter: And are you seeing evidence the public at large is getting the message?

Wren: Well, I live in Midtown Detroit and I walk the dog every night. And it was pretty wild to see all the bars and restaurants go dark after the governor made her announcement that she was temporarily closing these businesses. It was striking to see how quiet the streets were, so that does suggest that even at great financial peril, our state is coming together, our communities are coming together. We’re doing the right thing, as best we know today, to limit the impact of this pandemic.

Reporter: And finally, are you seeing anything positive amidst everything that’s going on?

Wren: One thing that comes to mind is that I think the response to coronavirus is teaching us that we are connected in ways that we have not conceived of in a while. Our health, our mental health, and our economic health is entirely interdependent. In parallel to that, the other positive I see is that we can take steps to be protective of each other. We of course need to practice good social distancing, but we are learning again what it means to be good neighbors and good family members, and have increased patience and resilience and tolerance for each other. So I'm hopeful that those are some lessons that we as a people, as a nation, might learn again.