Social distancing

Last updated

People socially distancing while queuing to enter a supermarket in London during the COVID-19 pandemic Social distancing queueing for the supermarket J. Sainsbury's north London Coronavirus Covid 19 pandemic - 30 March 2020.jpg
People socially distancing while queuing to enter a supermarket in London during the COVID-19 pandemic
Without social distancing and other pandemic containment measures, pathogens can spread exponentially. This graphic shows how early adoption of containment measures tends to protect wider swaths of the population. 20200609 Effect of pandemic containment measures.gif
Without social distancing and other pandemic containment measures, pathogens can spread exponentially. This graphic shows how early adoption of containment measures tends to protect wider swaths of the population.

In public health, social distancing, also called physical distancing, [2] [3] [4] is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. [2] [5] It usually involves keeping a certain distance from others (the distance specified differs from country to country and can change with time) and avoiding gathering together in large groups. [6] [7]


By minimising the probability that a given uninfected person will come into physical contact with an infected person, the disease transmission can be suppressed, resulting in fewer deaths. [2] The measures may be used in combination with others, such as good respiratory hygiene, face masks and hand washing. [8] [9] To slow down the spread of infectious diseases and avoid overburdening healthcare systems, particularly during a pandemic, several social-distancing measures are used, including the closing of schools and workplaces, isolation, quarantine, restricting the movement of people and the cancellation of mass gatherings. [5] [10] Drawbacks of social distancing can include loneliness, reduced productivity and the loss of other benefits associated with human interaction. [11]

Social distancing measures are most effective when the infectious disease spreads via one or more of the following methods, droplet contact (coughing or sneezing), direct physical contact (including sexual contact), indirect physical contact (such as by touching a contaminated surface), and airborne transmission (if the microorganism can survive in the air for long periods). The measures are less effective when an infection is transmitted primarily via contaminated water or food or by vectors such as mosquitoes or other insects. [12] Authorities have encouraged or mandated social distancing during the COVID-19 pandemic as it is an important method of preventing transmission of COVID-19. COVID-19 is much more likely to spread over short distances than long ones. However, it can spread over distances longer than 2 m (6 ft) in enclosed, poorly ventilated places and with prolonged exposure. [13]

Although the term "social distancing" was not introduced until the 21st century, [14] social-distancing measures date back to at least the 5th century BC. The Bible contains one of the earliest known references to the practice in the Book of Leviticus 13:46: "And the leper in whom the plague is... he shall dwell alone; [outside] the camp shall his habitation be." [15] During the Plague of Justinian of 541 to 542, Emperor Justinian enforced an ineffective quarantine on the Byzantine Empire, including dumping bodies into the sea; he predominantly blamed the widespread outbreak on "Jews, Samaritans, pagans, heretics, Arians, Montanists and homosexuals". [16] In modern times, social distancing measures have been successfully implemented in several epidemics. In St. Louis, shortly after the first cases of influenza were detected in the city during the 1918 flu pandemic, authorities implemented school closures, bans on public gatherings and other social-distancing interventions. The influenza fatality rates in St. Louis were much less than in Philadelphia, which had fewer cases of influenza but allowed a mass parade to continue and did not introduce social distancing until more than two weeks after its first cases. [17]

The World Health Organization (WHO) has suggested using the term "physical distancing" instead of "social distancing" because it is physical separation which prevents transmission; people can remain socially connected by meeting outdoors at a safe distance (when there is no stay-at-home order) and by meeting via technology. [2] [3] [18] [19]


A video explaining social distancing from the California Department of Parks and Recreation.

The American Centers for Disease Control and Prevention (CDC) have described social distancing as a set of "methods for reducing frequency and closeness of contact between people in order to decrease the risk of transmission of disease". [10] During the 2009 swine flu pandemic the WHO described social distancing as "keeping at least an arm's length distance from others, [and] minimizing gatherings". [8] During the COVID-19 pandemic, the CDC defined social distancing as "remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately six feet or two meters) from others when possible". [6] [7]

Social distancing, combined with the use of face masks, good respiratory hygiene and hand washing, is considered the most feasible way to reduce or delay a pandemic. [8] [20]


Social distancing helps prevent a sharp peak of infections ("flattens the epidemic curve") to help healthcare services deal with demand, and extends time for healthcare services to be increased and improved. 20200403 Flatten the curve animated GIF.gif
Social distancing helps prevent a sharp peak of infections ("flattens the epidemic curve") to help healthcare services deal with demand, and extends time for healthcare services to be increased and improved.

Several social distancing measures are used to control the spread of contagious illnesses. Research indicates that measures must be applied rigorously and immediately in order to be effective. [25]

Avoiding physical contact

Social distancing includes eliminating the physical contact that occurs with the typical handshake, hug, or hongi; this New Zealand illustration offers eight alternatives. Covid-19-Handshake-Alternatives-v3.gif
Social distancing includes eliminating the physical contact that occurs with the typical handshake, hug, or hongi; this New Zealand illustration offers eight alternatives.

Keeping a set physical distance from each other and avoiding hugs and gestures that involve direct physical contact, reduce the risk of becoming infected during outbreaks of infectious respiratory diseases (for example, flu pandemics and the COVID-19 pandemic of 2020.) [6] [26] These distances of separation, in addition to personal hygiene measures, are also recommended at places of work. [27] Where possible it may be recommended to work from home. [9] [28]

The distance advised by authorities varies. During the COVID-19 pandemic, for example, the World Health Organization recommends that a distance of 1 m (3.3 ft) or more is safe. Subsequently, China, Denmark, France, Hong Kong, Lithuania and Singapore adopted a 1 m social distancing policy. South Korea adopted 1.4 m (4.6 ft). Australia, Belgium, Germany, Greece, Italy, Netherlands, Portugal and Spain adopted 1.5 m (4.9 ft). The United States adopted 6 ft (1.8 m), and Canada adopted 2 m (6.6 ft). The United Kingdom first advised 2 m, then on July 4, 2020 reduced this to "one metre plus" where other methods of mitigation such as face masks were in use. [29]

The WHO's one-metre recommendation stems from research into droplet-based transmission of tuberculosis by William F. Wells, which had found that droplets produced by exhalation, coughs, or sneezes landed an average of 3 ft (0.9 m) from where they were expelled. [30] [31] [32] Quartz speculated that the U.S. CDC's adoption of 6 ft (1.8 m) may have stemmed from a study of SARS transmission on an airplane, published in The New England Journal of Medicine. When contacted, however, the CDC did not provide any specific information. [33]

Some have suggested that distances greater than 1–2 m (3.3–6.6 ft) should be observed. [34] [35] [36] [37] [38] [39] One minute of loud speaking can produce oral droplets with a load of 7 million SARS-CoV-2 virus per milliliter that can remain for more than eight minutes, [40] a time-period during which many people could enter or remain in the area. A sneeze can distribute such droplets as far as 7 m (23 ft) or 8 m (26 ft). [41] Social distancing is less effective than face masks at reducing the spread of COVID-19. [42]

Various alternatives have been proposed for the tradition of handshaking. The gesture of namaste, placing one's palms together, fingers pointing upwards, drawing the hands to the heart, is one non-touch alternative. During the COVID-19 pandemic in the United Kingdom, this gesture was used by Prince Charles upon greeting reception guests, and has been recommended by the Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, and Israeli Prime Minister Benjamin Netanyahu. [43] Other alternatives include the popular thumbs up gesture, the wave, the shaka (or "hang loose") sign, and placing a palm on one's heart, as practiced in parts of Iran. [43]

Muslims in Indonesia pray in congregation while imposing to strict physical-distancing protocols during the COVID-19 pandemic. During the pandemic, Mosques in Indonesia has also removed the indoor rugs and has ordered worshipers to bring their own personal prayer rugs to prevent the spreading of the virus. Some mosques which are located in the most infected regions even are ordered to be closed for worship Islamic Congregational Prayer with Physical Distancing during the Covid-19 Pandemic.jpg
Muslims in Indonesia pray in congregation while imposing to strict physical-distancing protocols during the COVID-19 pandemic. During the pandemic, Mosques in Indonesia has also removed the indoor rugs and has ordered worshipers to bring their own personal prayer rugs to prevent the spreading of the virus. Some mosques which are located in the most infected regions even are ordered to be closed for worship

School closures

Swine flu cases per week in the United Kingdom in 2009; schools typically close for summer in mid-July and re-open in early September. Swineflu uk hpa model.svg
Swine flu cases per week in the United Kingdom in 2009; schools typically close for summer in mid-July and re-open in early September.

Mathematical modeling has shown that transmission of an outbreak may be delayed by closing schools. However, effectiveness depends on the contacts children maintain outside of school. Often, one parent has to take time off work, and prolonged closures may be required. These factors could result in social and economic disruption. [45] [46]

Workplace closures

Modeling and simulation studies based on U.S. data suggest that if 10% of affected workplaces are closed, the overall infection transmission rate is around 11.9% and the epidemic peak time is slightly delayed. In contrast, if 33% of affected workplaces are closed, the attack rate decreases to 4.9%, and the peak time is delayed by one week. [47] [48] Workplace closures include closure of "non-essential" businesses and social services ("non-essential" means those facilities that do not maintain primary functions in the community, as opposed to essential services). [49] [28]

Canceling mass gatherings

VE Day celebrations in 2020 took place under lockdown; here a socially distanced street party is taking place on Hallfield Estate, Wetherby. Socially distanced street party for the 75th Anniversary of VE Day, Montagu Road, Wetherby (8th May 2020) 003.jpg
VE Day celebrations in 2020 took place under lockdown; here a socially distanced street party is taking place on Hallfield Estate, Wetherby.

Cancellation of mass gatherings includes sports events, films or musical shows. [50] Evidence suggesting that mass gatherings increase the potential for infectious disease transmission is inconclusive. [51] Anecdotal evidence suggests certain types of mass gatherings may be associated with increased risk of influenza transmission, and may also "seed" new strains into an area, instigating community transmission in a pandemic. During the 1918 influenza pandemic, military parades in Philadelphia [52] and Boston [53] may have been responsible for spreading the disease by mixing infected sailors with crowds of civilians. Restricting mass gatherings, in combination with other social distancing interventions, may help reduce transmission. [28] [54] A recent peer-reviewed study in the British Medical Journal (The BMJ) also suggested it as one of the key components of an effective strategy in reducing the burden of COVID-19. [24]

Travel restrictions

Border restrictions or internal travel restrictions are unlikely to delay an epidemic by more than two to three weeks unless implemented with over 99% coverage. [55] Airport screening was found to be ineffective in preventing viral transmission during the 2003 SARS outbreak in Canada [56] and the U.S. [57] Strict border controls between Austria and the Ottoman Empire, imposed from 1770 until 1871 to prevent persons infected with the bubonic plague from entering Austria, were reportedly effective, as there were no major outbreaks of plague in Austrian territory after they were established, whereas the Ottoman Empire continued to suffer frequent epidemics of plague until the mid-nineteenth century. [58] [59]

A Northeastern University study published in March 2020 found that "travel restrictions to and from China only slow down the international spread of COVID-19 [when] combined with efforts to reduce transmission on a community and an individual level. ... Travel restrictions aren't enough unless we couple it with social distancing." [60] The study found that the travel ban in Wuhan delayed the spread of the disease to other parts of mainland China only by three to five days, although it did reduce the spread of international cases by as much as 80 percent. [61]


Social distancing markers and plexiglass shield at Whole Foods Market checkout in Toronto to reduce physical contact. Whole Foods Market - Toronto - 20200501110408 (cropped).jpg
Social distancing markers and plexiglass shield at Whole Foods Market checkout in Toronto to reduce physical contact.

Shielding measures for individuals include limiting face-to-face contacts, conducting business by phone or online, avoiding public places and reducing unnecessary travel. [62] [63] [64] During the COVID-19 pandemic in the United Kingdom, shielding referred to special advisory measures put in place by the UK Government to protect those at the highest risk of serious illness from the disease. This included those with weakened immune systems (such as organ transplant recipients), as well as those with certain medical conditions such as cystic fibrosis or severe asthma. Until June 1, 2020, those shielding were strongly advised not to leave home for any reason at all, including essential travel, and to maintain a 2 m (6.6 ft) distance from anyone else in their household. Supermarkets quickly made priority grocery delivery slots available to those shielding, and the Government arranged for food boxes to be sent to those shielding who needed additional assistance, for example elderly people shielding on their own. This was gradually relaxed from June to allow shielders to spend more time outside, before being suspended indefinitely from August 1.


During the 2003 SARS outbreak in Singapore, approximately 8000 people were subjected to mandatory home quarantine and an additional 4300 were required to self-monitor for symptoms and make daily telephone contact with health authorities as a means of controlling the epidemic. Although only 58 of these individuals were eventually diagnosed with SARS, public health officials were satisfied that this measure assisted in preventing further spread of the infection. [65] Voluntary self-isolation may have helped reduce transmission of influenza in Texas in 2009. [66] Short and long-term negative psychological effects have been reported. [11]

Stay-at-home orders

The objective of stay-at-home orders is to reduce day-to-day contact between people and thereby reduce the spread of infection [67] During the COVID-19 pandemic, early and aggressive implementation of stay-at-home orders was effective in "flattening the curve" and provided the much needed time for healthcare systems to increase their capacity while reducing the number of peak cases during the initial wave of illness. [28] It is important for public health authorities to follow disease trends closely to re-implement appropriate social distancing policies, including stay-at-home orders, if secondary COVID-19 waves appear. [28]

Cordon sanitaire

In 1995, a cordon sanitaire was used to control an outbreak of Ebola virus disease in Kikwit, Zaire. [68] [69] [70] President Mobutu Sese Seko surrounded the town with troops and suspended all flights into the community. Inside Kikwit, the World Health Organization and Zaire's medical teams erected further cordons sanitaires, isolating burial and treatment zones from the general population and successfully containing the infection. [71]

Protective sequestration

During the 1918 influenza epidemic, the town of Gunnison, Colorado, isolated itself for two months to prevent an introduction of the infection. Highways were barricaded and arriving train passengers were quarantined for five days. As a result of the isolation, no one died of influenza in Gunnison during the epidemic. [72] Several other communities adopted similar measures. [73]

Other measures

Other measures include shutting down or limiting mass transit [74] and closure of sport facilities (community swimming pools, youth clubs, gymnasiums). [75] Due to the highly interconnected nature of modern transportation hubs, a highly contagious illness can achieve rapid geographic spread if appropriate mitigation measures are not taken early. [28] Consequently, highly coordinated efforts must be put into place early during an outbreak to proactively monitor, detect, and isolate any potentially infectious individuals. [28] If community spread is present, more aggressive measures may be required, up to and including complete cessation of travel in/out of a specific geographic area. [28]


Leper colonies and lazarettos were established as a means of preventing the spread of leprosy and other contagious diseases through social distancing, [76] until transmission was understood and effective treatments invented.

1916 New York City polio epidemic

During the 1916 New York City polio epidemic, when there were more than 27,000 cases and more than 6,000 deaths due to polio in the United States, with more than 2,000 deaths in New York City alone, movie theaters were closed, meetings were cancelled, public gatherings were almost non-existent, and children were warned not to drink from water fountains, and told to avoid amusement parks, swimming pools and beaches. [78] [79]

Influenza, 1918 to present

During the influenza pandemic of 1918, Philadelphia saw its first cases of influenza on 17 September. [80] [17] The city continued with its planned parade and gathering of more than 200000 people on 28 September and over the subsequent three days, the city's 31 hospitals became fully occupied. During the week ending 16 October, over 4500 people died. [52] [81] Social distancing measures were introduced on 3 October, on the orders of St. Louis physician Max C. Starkloff, [82] more than two weeks after the first case. [17] Unlike Philadelphia, St. Louis experienced its first cases of influenza on 5 October and the city took two days to implement several social distancing measures, [17] including closing schools, theatres, and other places where people get together. It banned public gatherings, including funerals. The actions slowed the spread of influenza in St. Louis and a spike in cases and deaths, as had happened in Philadelphia, did not occur. [83] The final death rate in St. Louis increased following a second wave of cases, but remained overall less than in other cities. [84] Bootsma and Ferguson analyzed social distancing interventions in sixteen U.S. cities during the 1918 epidemic and found that time-limited interventions reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because the interventions were introduced too late and lifted too early. It was observed that several cities experienced a second epidemic peak after social distancing controls were lifted, because susceptible individuals who had been protected were now exposed. [85]

School closures were shown to reduce morbidity from the Asian flu by 90% during the 1957–1958 pandemic, [86] and up to 50% in controlling influenza in the U.S., 2004–2008. [87] Similarly, mandatory school closures and other social distancing measures were associated with a 29% to 37% reduction in influenza transmission rates during the 2009 flu epidemic in Mexico. [88]

The 2009 swine flu pandemic caused social distancing to rise in popularity, most notably in Mexico, with the country's Ministry of Health advising people to avoid handshakes and kissing as ways of greeting people. [89] A mandatory nationwide school closure enacted in Mexico, which lasted for 18 days from late April 2009 to early May 2009, was a form of social distancing aimed at reducing the transmission of Swine flu. [90] A study from 2011 found the mandatory nationwide school closure and other forms of social distancing in Mexico were effective at reducing influenza transmission rates. [90]

During the swine flu outbreak in 2009 in the UK, in an article titled "Closure of schools during an influenza pandemic" published in The Lancet Infectious Diseases , a group of epidemiologists endorsed the closure of schools to interrupt the course of the infection, slow the further spread and buy time to research and produce a vaccine. [91] Having studied previous influenza pandemics including the 1918 flu pandemic, the influenza pandemic of 1957 and the 1968 flu pandemic, they reported on the economic and workforce effect school closure would have, particularly with a large percentage of doctors and nurses being women, of whom half had children under the age of 16. They also looked at the dynamics of the spread of influenza in France during French school holidays and noted that cases of flu dropped when schools closed and re-emerged when they re-opened. They noted that when teachers in Israel went on strike during the flu season of 1999–2000, visits to doctors and the number of respiratory infections dropped by more than a fifth and more than two fifths respectively. [92]

SARS 2003

During the SARS outbreak of 2003, social distancing measures were implemented, such as banning large gatherings, closing schools and theaters, and other public places, supplemented public health measures such as finding and isolating affected people, quarantining their close contacts, and infection control procedures. This was combined with the wearing of masks for certain people. [93] During this time in Canada, "community quarantine" was used to reduce transmission of the disease with moderate success. [94]

COVID-19 pandemic

Simulations comparing rate of spread of infection, and number of deaths due to overrun of hospital capacity, when social interactions are "normal" (left, 200 people moving freely) and "distanced" (right, 25 people moving freely).
Green = Healthy, uninfected individuals
Red = Infected individuals
Blue = Recovered individual
Black = Dead individuals Katapult importance social distancing.gif
Simulations comparing rate of spread of infection, and number of deaths due to overrun of hospital capacity, when social interactions are "normal" (left, 200 people moving freely) and "distanced" (right, 25 people moving freely).
Green = Healthy, uninfected individuals
Red = Infected individuals
Blue = Recovered individual
Black = Dead individuals

During the COVID-19 pandemic, social distancing and related measures are emphasized by several governments as alternatives to an enforced quarantine of heavily affected areas. [28] According to UNESCO monitoring, more than a hundred countries have implemented nationwide school closures in response to COVID-19, impacting over half the world's student population. [96] In the United Kingdom, the government advised the public to avoid public spaces, and cinemas and theaters voluntarily closed to encourage the government's message. [97]

With many people disbelieving that COVID-19 is any worse than the seasonal flu, [98] it has been difficult to convince the public—particularly youth, and the anti vaxx community to voluntarily adopt social distancing practices. [99] [100] In Belgium, media reported a rave was attended by at least 300 before it was broken up by local authorities. In France, teens making nonessential trips are fined up to US$ 150. Beaches were closed in Florida and Alabama to disperse partygoers during spring break. [101] Weddings were broken up in New Jersey and an 8 p.m. curfew was imposed in Newark. New York, New Jersey, Connecticut and Pennsylvania were the first states to adopt coordinated social distancing policies which closed down non-essential businesses and restricted large gatherings. Shelter in place orders in California were extended to the entire state on 19 March. On the same day Texas declared a public disaster and imposed statewide restrictions. [102]

These preventive measures such as social-distancing and self-isolation prompted the widespread closure of primary, secondary, and post-secondary schools in more than 120 countries. As of 23 March 2020, more than 1.2 billion learners were out of school due to school closures in response to COVID-19. [96] Given low rates of COVID-19 symptoms among children, the effectiveness of school closures has been called into question. [103] Even when school closures are temporary, it carries high social and economic costs. [104] However, the significance of children in spreading COVID-19 is unclear. [105] [106] While the full impact of school closures during the coronavirus pandemic are not yet known, UNESCO advises that school closures have negative impacts on local economies and on learning outcomes for students. [107]

In early March 2020, the sentiment "Stay Home" was coined by Florian Reifschneider, a German engineer and was quickly echoed by notable celebrities such as Taylor Swift, Ariana Grande [108] [109] and Busy Philipps [110] in hopes of reducing and delaying the peak of the outbreak. Facebook, Twitter and Instagram also joined the campaign with similar hashtags, stickers and filters under #staythefhome, #stayhome, #staythefuckhome and began trending across social media. [111] [112] [113] [114] The website claims to have reached about two million people online and says the text has been translated into 17 languages. [114]

Impact on mental health

There are concerns that social distancing can have adverse affects on participants' mental health. [28] [115] It may lead to stress, anxiety, depression or panic, especially for individuals with preexisting conditions such as anxiety disorders, obsessive compulsive disorders, and paranoia. [28] [116] Widespread media coverage about a pandemic, its impact on economy, and resulting hardships may create anxiety. Change in daily circumstances and uncertainty about the future may add onto the mental stress of being away from other people. [28] [117]

People with autism also suffer impact from social distancing. Adjusting to a new routine can be stressful for everyone within the spectrum but especially for children who have trouble with change. [118] [119] Children with autism may not know what is going on or might not be able to express their fears and frustrations. [118] They also may need extra support to understand what's expected of them in some situations. [118] [119] The adjustment to a new situation can lead to challenging behavior uncharacteristic of the autistic individual's true character. [119] In some countries and demographics, teenagers and young adults within the autistic spectrum disorder (ASD) receive support services including special education, behavioral therapy, occupational therapy, speech services, and individual aides through school, but this can be a major challenge, particularly since many teenagers with ASD already have social and communication difficulties. [120] Aggressive and self-injurious behaviors may increase during this time of fear and uncertainty. [120]

Portrayal in literature

In his 1957 science fiction novel The Naked Sun , Isaac Asimov portrays a planet where people live with social distancing. They are spread out, miles from each other, across a sparsely-populated world. Communication is primarily through technology. A male and a female still need to engage in sex to make a baby, but it is seen as a dangerous, nasty chore. In contrast, when communication is through technology the situation is the reverse: there is no modesty, and casual nudity is frequent. The novel's point of departure is a murder: this seemingly idyllic world, in fact, has serious social problems.

Theoretical basis

From the perspective of epidemiology, the basic goal behind social distancing is to decrease the effective reproduction number, or , which in the absence of social distancing would equate to the basic reproduction number, i.e. the average number of secondary infected individuals generated from one primary infected individual in a population where all individuals are equally susceptible to a disease. In a basic model of social distancing, [121] where a proportion of the population engages in social distancing to decrease their interpersonal contacts to a fraction of their normal contacts, the new effective reproduction number is given by: [121]

Where the value of can be brought below 1 for sufficiently long, containment is achieved, and the number infected should decrease. [122]

For any given period of time, the growth in the number of infections can be modeled as: [123]


Using COVID-19 as an example, the following table shows the infection spread given:

Number of infections after days for various values of
5 days
(1 incubation period)
30 days
(6 incubation periods)


An empirical study published in July 2020 in The BMJ (British Medical Journal) analyzed data from 149 countries, and reported an average of 13% reduction in COVID-19 incidence after the implementation of social distancing policies. [24] Another study found that four social distancing interventions combined resulted in a reduction of the infection rate from 66% to less than 1%. [124]

Animals also practice social distancing to avoid disease. [125]

See also

Related Research Articles

Pandemic Global epidemic of infectious disease

A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people. A widespread endemic disease with a stable number of infected people is not a pandemic. Widespread endemic diseases with a stable number of infected people such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.

Zoonosis Disease that can be transmitted from other species to humans

A zoonosis is an infectious disease caused by a pathogen that has jumped from an animal to a human. Typically, the first infected human transmits the infectious agent to at least one other human, who, in turn, infects others.

Epidemic Rapid spread of disease affecting a large number of people in a short time

An epidemic is the rapid spread of disease to a large number of people in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.

Spanish flu 1918–1920 pandemic of H1N1 influenza A virus

Spanish flu, also known as the Great Influenza epidemic or the 1918 influenza pandemic, was an exceptionally deadly global influenza pandemic caused by the H1N1 influenza A virus. The earliest documented case was March 1918 in Kansas, United States, with further cases recorded in France, Germany and the United Kingdom in April. Two years later, nearly a third of the global population, or an estimated 500 million people, had been infected in four successive waves. Estimates of deaths range from 17.4 million to 100 million, with an accepted general range of 25–50 million, making it one of the deadliest pandemics in human history.

Influenza pandemic Epidemic of a flu that spreads on a worldwide scale and infects a large proportion of the human population

An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been five in the last 140 years, with the 1918 flu pandemic being the most severe; this pandemic is estimated to have been responsible for the deaths of 50–100 million people. The most recent, the 2009 swine flu pandemic, resulted in under 300,000 deaths and is considered relatively mild. These pandemics occur irregularly.

Influenza prevention involves taking steps that one can use to decrease their chances of contracting flu viruses, such as the Pandemic H1N1/09 virus, responsible for the 2009 flu pandemic.

1889–1890 pandemic Global pandemic

In 1889–1890, a pandemic, sometimes known as the "Asiatic flu" or "Russian flu", killed about 1 million people worldwide, out of a population of about 1.5 billion. It was the last great pandemic of the 19th century, and is among the deadliest pandemics in history. The most reported effects of the pandemic took place from October 1889 to December 1890, with recurrences in March to June 1891, November 1891 to June 1892, winter of 1893–1894, and early 1895.

Neil Ferguson (epidemiologist) British epidemiologist and researcher

Neil Morris Ferguson is a British epidemiologist and professor of mathematical biology, who specialises in the patterns of spread of infectious disease in humans and animals. He is the director of the Jameel Institute for Disease and Emergency Analytics (J-IDEA), director of the MRC Centre for Global Infectious Disease Analysis, and head of the Department of Infectious Disease Epidemiology in the School of Public Health and Vice-Dean for Academic Development in the Faculty of Medicine, all at Imperial College London.

Anders Tegnell Swedish physician and civil servant

Nils Anders Tegnell is a Swedish civil servant and physician specialising in infectious disease. He is the current state epidemiologist of Sweden.

Outbreak response

Outbreak response or outbreak control measures are acts which attempt to minimize the spread of or effects of a disease outbreak. Outbreak response includes aspects of general disease control such as maintaining adequate hygiene, but may also include responses that extend beyond traditional healthcare settings and are unique to an outbreak, such as physical distancing, contact tracing, mapping of disease clusters, or quarantine. Some measures such as isolation are also useful in preventing an outbreak from occurring in the first place.

Caitlin Rivers American emerging infectious disease epidemiologist

Caitlin M. Rivers is an American epidemiologist who as Senior Scholar at the Johns Hopkins Center for Health Security and assistant professor at the Johns Hopkins Bloomberg School of Public Health, specializing on improving epidemic preparedness. Rivers is currently working on the American response to the COVID-19 pandemic with a focus on the incorporation of infectious disease modeling and forecasting into public health decision making.

1957–1958 influenza pandemic

The 1957–1958 Asian flu pandemic was a global pandemic of influenza A virus subtype H2N2 that originated in Guizhou in southern China. The number of deaths caused by the 1957–1958 pandemic is estimated between one and four million worldwide, making it one of the deadliest pandemics in history. A decade later, a reassorted viral strain H3N2 further caused the Hong Kong flu pandemic (1968–1969).

Cloth face mask mask made of common textiles worn over the mouth and nose

A cloth face mask is a mask made of common textiles, usually cotton, worn over the mouth and nose. When more effective masks are not available, and when physical distancing is impossible, cloth face masks are recommended by public health agencies for disease "source control" in epidemic situations to protect others from virus laden droplets in infected mask wearers' breath, coughs, and sneezes. Because they are less effective than N95 masks, surgical masks, or physical distancing in protecting the wearer against viruses, they are not considered to be personal protective equipment by public health agencies. They are used by the general public in household and community settings as protection against both infectious diseases and particulate air pollution.

Allison McGeer is a Canadian infectious disease specialist in the Sinai Health System, a Professor at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air.

Cécile Viboud is a Staff Scientist based in the Fogarty International Center at the National Institutes of Health, where she is part of the Multinational Influenza Seasonal Mortality Study (MISMS). Viboud specialises in the mortality of infectious disease. Viboud was involved with epidemiological analysis during the COVID-19 pandemic.

The Central Epidemic Command Center is an agency of the National Health Command Center (NHCC). It has been activated by the government of Taiwan for several disease outbreaks, such as the 2009 swine flu pandemic and the COVID-19 pandemic. The head of the agency is Chen Shih-chung, the minister of Health and Welfare. The CECC is associated with the Taiwan Centers for Disease Control.

In epidemiology, a non-pharmaceutical intervention (NPI) is any method to reduce the spread of an epidemic disease without requiring pharmaceutical drug treatments. Examples of non-pharmaceutical interventions that reduce the spread of infectious diseases include wearing a face mask and staying away from sick people.

Helen Y. Chu is an American immunologist who is an Assistant Professor of Medicine at the University of Washington. Her research considers maternal immunization, with a focus on influenza and respiratory syncytial virus. During the COVID-19 pandemic, Chu was the first physician to recognise community transmission of the coronavirus disease within the United States.

Impact of the COVID-19 pandemic on other health issues Health consequences of outbreak beyond the COVID-19 disease itself

The COVID-19 pandemic has had many impacts on global health beyond those caused by the COVID-19 disease itself. It has led to a reduction in hospital visits for other reasons. There have been 38 per cent fewer hospital visits for heart attack symptoms in the United States and 40 per cent fewer in Spain. The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital." There is also concern that people with strokes and appendicitis are not seeking timely treatment. Shortages of medical supplies have impacted people with various conditions.

Public health mitigation of COVID-19 Measures to halt the spread of the respiratory disease among populations

Speed and scale are key to mitigation of COVID-19, due to the fat-tailed nature of pandemic risk and the exponential growth of COVID-19 infections. For mitigation to be effective, (a) chains of transmission must be broken as quickly as possible through screening and containment, (b) health care must be available to provide for the needs of those infected, and (c) contingencies must be in place to allow for effective rollout of (a) and (b).


  1. Maier, Benjamin F.; Brockmann, Dirk (2020-05-15). "Effective containment explains subexponential growth in recent confirmed COVID-19 cases in China". Science. 368 (6492): 742–746. Bibcode:2020Sci...368..742M. doi: 10.1126/science.abb4557 . PMC   7164388 . PMID   32269067. ("...initial exponential growth expected for an unconstrained outbreak.")
  2. 1 2 3 4 Harris, Margaret; Adhanom Ghebreyesus, Tedros; Liu, Tu; Ryan, Michael "Mike" J.; Vadia; Van Kerkhove, Maria D.; Diego; Foulkes, Imogen; Ondelam, Charles; Gretler, Corinne; Costas (2020-03-20). "COVID-19" (PDF). World Health Organization. Archived (PDF) from the original on 2020-03-25. Retrieved 2020-03-29.
  3. 1 2 Hensley, Laura (2020-03-23). "Social distancing is out, physical distancing is in – here's how to do it". Global News . Corus Entertainment Inc. Archived from the original on 2020-03-26. Retrieved 2020-03-29.
  4. Venske, Regula (2020-03-26). Schwyzer, Andrea (ed.). "Die Wirkung von Sprache in Krisenzeiten" [The effect of language in times of crisis] (Interview). NDR Kultur (in German). Norddeutscher Rundfunk. Archived from the original on 2020-03-27. Retrieved 2020-03-27. (NB. Regula Venske is president of the PEN Centre Germany.)
  5. 1 2 Johnson, Carolyn Y.; Sun, Lena; Freedman, Andrew (2020-03-10). "Social distancing could buy U.S. valuable time against coronavirus". The Washington Post . Archived from the original on 2020-03-27. Retrieved 2020-03-11.
  6. 1 2 3 Pearce, Katie (2020-03-13). "What is social distancing and how can it slow the spread of COVID-19?". The Hub. Johns Hopkins University. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  7. 1 2 "Risk Assessment and Management". Centers for Disease Control and Prevention. 2020-03-22. Archived from the original on 2020-03-04. Retrieved 2020-03-29.
  8. 1 2 3 "Pandemic influenza prevention and mitigation in low resource communities" (PDF). World Health Organization. 2009-05-02. Retrieved 2020-03-29.
  9. 1 2 "Guidance on social distancing for everyone in the UK". GOV.UK. Archived from the original on 2020-03-24. Retrieved 2020-03-29.
  10. 1 2 Kinlaw, Kathy; Levine, Robert J. (2007-02-15). "Ethical guidelines in Pandemic Influenza – Recommendations of the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 2020-02-05. Retrieved 2020-03-23. (12 pages)
  11. 1 2 Brooks, Samantha K.; Webster, Rebecca K.; Smith, Louise E.; Woodland, Lisa; Wessely, Simon; Greenberg, Neil; Rubin, Gideon James (2020-03-14). "The psychological impact of quarantine and how to reduce it: rapid review of the evidence". The Lancet . 395 (10227): 912–920. doi:10.1016/S0140-6736(20)30460-8. ISSN   0140-6736. PMC   7158942 . PMID   32112714. Archived from the original on 2020-03-13.
  12. "Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States – Early, Targeted, Layered Use of Nonpharmaceutical Interventions" (PDF). Centers for Disease Control and Prevention. February 2007. CS10848. Archived (PDF) from the original on 2020-03-19. Retrieved 2020-03-29.
  13. CDC (2020-02-11). "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. Retrieved 2020-10-21.
  14. "social distancing". Merriam-Webster. Retrieved 2020-05-07.
  15. "Bible Gateway passage: Leviticus 13 – Authorized (King James) Version". Bible Gateway.
  16. Drews, Kelly (2013-05-01). "A Brief History of Quarantine". The Virginia Tech Undergraduate Historical Review. 2. doi: 10.21061/vtuhr.v2i0.16 . ISSN   2165-9915.
  17. 1 2 3 4 Ryan, Jeffrey R. (2008-08-01). "Chapter 6.3.3. Response and Containment: Lessons from the 1918 Pandemic Can Help Communities Today". Pandemic Influenza: Emergency Planning and Community Preparedness. CRC Press. pp. 123–133 [133]. ISBN   978-1-4200-6088-1. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  18. Tangermann, Victor (2020-03-24) [20 March 2020]. "It's Officially Time to Stop Using The Phrase 'Social Distancing'". science alert (Futurism / The Byte). Archived from the original on 2020-03-26. Retrieved 2020-03-29.
  19. Kumar, Satyendra (2020-03-28). "Corona Virus Outbreak: Keep Physical Distancing, Not Social Distancing". Rochester, NY. SSRN   3568435 .Cite journal requires |journal= (help)
  20. "Winning together: Novel coronavirus (COVID-19) infographic". ResearchGate . Retrieved 2020-05-16.
  21. Wiles, Siouxsie (2020-03-09). "The three phases of Covid-19 – and how we can make it manageable". The Spinoff . Morningside, Auckland, New Zealand. Archived from the original on 2020-03-27. Retrieved 2020-03-09.
  22. Wiles, Siouxsie (2020-03-14). "After 'Flatten the Curve', we must now 'Stop the Spread'. Here's what that means". The Spinoff . Morningside, Auckland, New Zealand. Archived from the original on 2020-03-26. Retrieved 2020-03-13.
  23. Anderson, Roy Malcom; Heesterbeek, Hans J. A. P.; Klinkenberg, Don; Hollingsworth, T. Déirdre (2020-03-09). "How will country-based mitigation measures influence the course of the COVID-19 epidemic?". The Lancet . 395 (10228): 931–934. doi: 10.1016/S0140-6736(20)30567-5 . ISSN   0140-6736. PMC   7158572 . PMID   32164834. A key issue for epidemiologists is helping policy makers decide the main objectives of mitigation—e.g., minimising morbidity and associated mortality, avoiding an epidemic peak that overwhelms health-care services, keeping the effects on the economy within manageable levels, and flattening the epidemic curve to wait for vaccine development and manufacture on scale and antiviral drug therapies.
  24. 1 2 3 Islam, Nazrul; Sharp, Stephen J; Chowell, Gerardo; Shabnam, Sharmin; Kawachi, Ichiro; Lacey, Ben; Massaro, Joseph M; D’Agostino, Ralph B; White, Martin (2020-07-15). "Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries". BMJ. 370: m2743. doi:10.1136/bmj.m2743. ISSN   1756-1833. PMC   7360923 . PMID   32669358.
  25. Maharaj, Savi; Kleczkowski, Adam (2012). "Controlling epidemic spread by social distancing: Do it well or not at all". BMC Public Health . 12 (1): 679. doi:10.1186/1471-2458-12-679. PMC   3563464 . PMID   22905965.
  26. "Guidance on Preparing Workplaces for an Influenza Pandemic". Occupational Safety and Health Act of 1970 . United States Department of Labor. OSHA 3327-02N 2007. Archived from the original on 2020-03-25. Retrieved 2020-03-18.
  27. "Social Distancing". Department of Safety & Security, The University of Chicago. 2015. Archived from the original on 2020-03-24. Retrieved 2020-03-29.
  28. 1 2 3 4 5 6 7 8 9 10 11 12 "The 2019–2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine‑World Academic Council of Emergency Medicine Multidisciplinary COVID‑19 Working Group Consensus Paper". ResearchGate . Retrieved 2020-05-16.
  29. Shukman, David (2020-06-23). "Is it safe to relax the 2m rule?". BBC News. Retrieved 2020-07-01.
  30. Foley, Katherine Ellen. "Where does the six-foot guideline for social distancing come from?". Quartz. Retrieved 2020-08-04.
  31. Riley, R. L. (1983-01-22). "The contagiosity of tuberculosis". Schweizerische Medizinische Wochenschrift. 113 (3): 75–79. ISSN   0036-7672. PMID   6338584.
  32. Wells, W. F. (1934-11-01). "On Air-borne Infection Study II. Droplets and Droplet Nuclei". American Journal of Epidemiology. 20 (3): 611–618. doi:10.1093/oxfordjournals.aje.a118097. ISSN   0002-9262.
  33. Olsen, Sonja J.; Chang, Hsiao-Ling; Cheung, Terence Yung-Yan; Tang, Antony Fai-Yu; Fisk, Tamara L.; Ooi, Steven Peng-Lim; Kuo, Hung-Wei; Jiang, Donald Dah-Shyong; Chen, Kow-Tong; Lando, Jim; Hsu, Kwo-Hsiung (2003-12-18). "Transmission of the Severe Acute Respiratory Syndrome on Aircraft". New England Journal of Medicine. 349 (25): 2416–2422. doi: 10.1056/NEJMoa031349 . ISSN   0028-4793. PMID   14681507.
  34. Setti, L.; Passarini, F.; De Gennaro, G. (2020-04-23). "Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough". Int. J. Environ. Res. Public Health . 17 (8): 2932. doi: 10.3390/ijerph17082932 . PMC   7215485 . PMID   32340347.
  35. Reynolds, G. (2020-04-15). "For Runners, Is 15 Feet the New 6 Feet for Social Distancing? When we walk briskly or run, air moves differently around us, increasing the space required to maintain a proper social distance". New York Times . Retrieved 2020-04-01.
  36. Sheikh, K.; Gorman, J.; Chang, K. (2020-04-14). "Stay 6 Feet Apart, We're Told. But How Far Can Air Carry Coronavirus? Most of the big droplets travel a mere six feet. The role of tiny aerosols is the 'trillion-dollar question.'". New York Times . Retrieved 2020-04-01.
  37. Huang, S. (2020-03-26). "Why we should all wear masks – There is new scientific rationale". Medium . Retrieved 2020-04-01.
  38. Letzter, R. (2020-03-31). "Is 6 feet enough space for social distancing? Not everyone thinks that's enough distance". Live Science . Retrieved 2020-04-01.
  39. Thoelen, J. (2020-04-08). "Belgian-Dutch Study: Why in times of COVID-19 you should not walk/run/bike close behind each other". Medium . Retrieved 2020-04-01.
  40. Tang S, Mao Y, Jones RM, MacIntyre CR, Shi X (2020). "Aerosol transmission of SARS-CoV-2? Evidence, prevention and control". Environment International . 144: 106039. doi:10.1016/j.envint.2020.106039. PMC   7413047 . PMID   32822927.
  41. Culver, Jordan (2010-04-01). "2 meters enough for social distancing? MIT researcher says droplets carrying coronavirus can travel up to 8 meters". Medical Xpress. Retrieved 2020-08-28.
  42. Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ (2020). "Identifying airborne transmission as the dominant route for the spread of COVID-19". Proceedings of the National Academy of Sciences of the United States of America . 117 (26): 14857–14863. doi:10.1073/pnas.2009637117. PMC   7334447 . PMID   32527856.
  43. 1 2 Barajas, Julia; Etehad, Melissa (2020-03-13). "Joined palms, hands-on hearts, Vulcan salutes: Saying hello in a no-handshake era". Los Angeles Times . Archived from the original on 2020-03-27. Retrieved 2020-03-18.
  44. "2009 Press Releases". Health Protection Agency. 2009-12-24. Archived from the original on 2010-03-03. Retrieved 2009-12-24.
  45. Zumla, Alimuddin; Yew, Wing-Wai; Hui, David S. C. (2010-08-31). Emerging Respiratory Infections in the 21st Century, An Issue of Infectious Disease Clinics. 24. Elsevier Health Sciences. p. 614. ISBN   978-1-4557-0038-7. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  46. Cauchemez, Simon; Ferguson, Neil Morris; Wachtel, Claude; Tegnell, Anders; Saour, Guillaume; Duncan, Ben; Nicoll, Angus (August 2009). "Closure of schools during an influenza pandemic". The Lancet Infectious Diseases . 9 (8): 473–481. doi:10.1016/S1473-3099(09)70176-8. ISSN   1473-3099. PMC   7106429 . PMID   19628172.
  47. Rousculp, Matthew D.; Johnston, Stephen S.; Palmer, Liisa A.; Chu, Bong-Chul; Mahadevia, Parthiv J.; Nichol, Kristin L. (October 2010). "Attending Work While Sick: Implication of Flexible Sick Leave Policies". Journal of Occupational and Environmental Medicine . 52 (10): 1009–1013. doi:10.1097/jom.0b013e3181f43844. PMID   20881626. S2CID   11591504.
  48. Kumar, Supriya; Crouse Quinn, Sandra; Kim, Kevin H.; Daniel, Laura H.; Freimuth, Vicki S. (January 2012). "The Impact of Workplace Policies and Other Social Factors on Self-Reported Influenza-Like Illness Incidence During the 2009 H1N1 Pandemic". American Journal of Public Health . 102 (1): 134–140. doi:10.2105/AJPH.2011.300307. PMC   3490553 . PMID   22095353.
  49. "Social Distancing Support Guidelines For Pandemic Readiness" (PDF). Colorado Department of Public Health and Environment. March 2008. Archived from the original (PDF) on 2017-02-13. Retrieved 2017-02-13.
  50. Booy, Robert; Ward, James (2015). "Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic" (PDF). Paediatric Respiratory Reviews . National Centre for Immunisation Research and Surveillance. 16 (2): 119–126. doi:10.1016/j.prrv.2014.01.003. PMID   24630149. Archived from the original (PDF) on 2015-05-15. Retrieved 2015-05-15. (13 pages)
  51. Inglesby, Thomas V.; Nuzzo, Jennifer B.; O'Toole, Tara; Henderson, Donald Ainslie (2006). "Disease Mitigation Measures in the Control of Pandemic Influenza". Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 4 (4): 366–375. CiteSeerX . doi:10.1089/bsp.2006.4.366. PMID   17238820.
  52. 1 2 Davis, Kenneth C. (2018-09-21). "Philadelphia Threw a WWI Parade That Gave Thousands of Onlookers the Flu". Smithsonian Magazine . Archived from the original on 2020-03-27. Retrieved 2020-03-27.
  53. "The Flu in Boston". American Experience . WGBH Educational Foundation. Archived from the original on 2020-03-20. Retrieved 2020-03-28.
  54. Ishola, David A.; Phin, Nick (December 2011). "Could Influenza Transmission Be Reduced by Restricting Mass Gatherings? Towards an Evidence-Based Policy Framework". Journal of Epidemiology and Global Health. 1 (1): 33–60. doi: 10.1016/j.jegh.2011.06.004 . PMC   7104184 . PMID   23856374.
  55. Ferguson, Neil Morris; Cummings, Derek A. T.; Fraser, Christophe; Cajka, James C.; Cooley, Philip C.; Burke, Donald S. (2006). "Strategies for mitigating an influenza pandemic". Nature . 442 (7101): 448–452. Bibcode:2006Natur.442..448F. doi:10.1038/nature04795. PMC   7095311 . PMID   16642006.
  56. Bell, David M. (2004). "Public health interventions and SARS spread, 2003". Emerging Infectious Diseases . 10 (11): 1900–1906. doi:10.3201/eid1011.040729. PMC   3329045 . PMID   15550198. Archived from the original on 2009-11-05.
  57. Cetron, Martin (2004). "Isolation and Quarantine: Containment Strategies for SARS, 2003". Learning from SARS: Preparing for the Next Disease Outbreak. National Academy of Sciences. ISBN   0-30959433-2.
  58. Kohn, George Childs, ed. (2008) [2001, 1998]. Encyclopedia of Plague and Pestilence: From Ancient Times to the Present. Facts On File – Library Of World History (3 ed.). New York: Infobase Publishing. p. 30. ISBN   978-1-43812923-5. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  59. Byrne, Joseph P., ed. (2008). Encyclopedia of Pestilence, Pandemics, and Plague (PDF). 1&2. Westport, Connecticut / London: Greenwood Publishing Group, Inc. / Greenwood Press. LCCN   2008019487. 978–0–313–34102–1 (vol 1), 978–0–313–34103–8 (vol 2). Archived (PDF) from the original on 2020-02-15. Retrieved 2020-03-29.
  60. Arntsen, Emily (2020-03-06). "Closing borders can delay, but can't stop the spread of COVID-19, new report says". News@Northeastern. Northeastern University. Archived from the original on 2020-03-23. Retrieved 2020-03-28.
  61. Chinazzi, Matteo; Davis, Jessica T.; Ajelli, Marco; Gioannini, Corrado; Litvinova, Maria; Merler, Stefano; Pastore y Piontti, Ana; Mu, Kunpeng; Rossi, Luca; Sun, Kaiyuan; Viboud, Cécile; Xiong, Xinyue; Yu, Hongjie; Halloran, M. Elizabeth; Longini, Jr., Ira M.; Vespignani, Alessandro (2020-03-06). "The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak". Science . 368 (6489): 395–400. Bibcode:2020Sci...368..395C. doi:10.1126/science.aba9757. PMC   7164386 . PMID   32144116.
  62. Glass, Robert J.; Glass, Laura M.; Beyeler, Walter E.; Min, H. Jason (November 2006). "Targeted Social Distancing Designs for Pandemic Influenza". Emerging Infectious Diseases . Centers for Disease Control and Prevention. 12 (11): 1671–1681. doi:10.3201/eid1211.060255. PMC   3372334 . PMID   17283616. Archived from the original on 2020-03-23. Retrieved 2020-03-29.
  63. "Social Distancing Guidelines (for workplace communicable disease outbreaks)". Society for Human Resource Management. 2017. Archived from the original on 2017-04-23. Retrieved 2017-04-23.
  64. "What's the difference between shielding, self-isolation and social distancing?". Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  65. Tan, Chorh-Chuan (May 2006). "SARS in Singapore – Key Lessons from an Epidemic" (PDF). Annals Academy of Medicine. 35 (5): 345–349. PMID   16830002. Archived from the original (PDF) on 2017-04-24. Retrieved 2017-04-23.
  66. Teh, Benjamin; Olsen, Karen; Black, Jim; Cheng, Allen C.; Aboltins, Craig; Bull, Kirstin; Johnson, Paul D. R.; Grayson, M. Lindsay; Torresi, Joseph (2012) [2011-11-22, 2011-09-26, 29 June 2011]. "Impact of swine influenza and quarantine measures on patients and households during the H1N1/09 pandemic". Scandinavian Journal of Infectious Diseases . 44 (4): 289–296. doi:10.3109/00365548.2011.631572. PMID   22106922. S2CID   24255689.
  67. "Staying at home and away from others (social distancing)". GOV.UK.
  68. Garrett, Laurie (2014-08-14). "Heartless but Effective: I've Seen 'Cordon Sanitaire' Work Against Ebola". The New Republic . Archived from the original on 2017-09-10. Retrieved 2017-06-05.
  69. "Outbreak of Ebola Viral Hemorrhagic Fever – Zaire, 1995". Morbidity and Mortality Weekly Report . 44 (19). 1995-05-19. pp. 381–382. Archived from the original on 2019-08-25. Retrieved 2017-06-05.
  70. Kaplan Hoffmann, Rachel; Hoffmann, Keith (2015-02-19). "Ethical Considerations in the Use of Cordons Sanitaires". Clinical Correlations. NYU Langone, New York: New York University. eISSN   1944-0030. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  71. Garrett, Laurie (2011). Betrayal of Trust: The Collapse of Global Public Health. Hachette Books. ISBN   978-1-40130386-0.
  72. "Gunnison: Case Study". Center for the History of Medicine. University of Michigan Medical School. Archived from the original on 2018-06-15. Retrieved 2017-06-06.
  73. Markel, Howard; Stern, Alexandra Minna; Navarro, J. Alexander; Michalsen, Joseph R.; Monto, Arnold S.; DiGiovanni, Jr., Cleto (December 2006). "Nonpharmaceutical Influenza Mitigation Strategies, US Communities, 1918–1920 Pandemic" (PDF). Emerging Infectious Diseases . 12 (12): 1961–1964. doi:10.3201/eid1212.060506. PMC   3291356 . PMID   17326953. Archived (PDF) from the original on 2017-02-16. Retrieved 2017-06-06.
  74. Taylor, Kate (2020-03-20) [2020-03-17]. "No Bus Service. Crowded Trains. Transit Systems Struggle With the Virus. U.S. cities with public transit systems are being forced to adapt to the risks posed by the coronavirus, implementing new sanitation protocols while contending with fewer riders and workers". The New York Times . ISSN   0362-4331. Archived from the original on 2020-03-25. Retrieved 2020-03-25.
  75. "Flu Pandemic Mitigation – Social Distancing". Archived from the original on 2020-03-22. Retrieved 2020-03-23.
  76. Souvay, Charles Léon (1913). "Leprosy". Catholic Encyclopedia. 9. Archived from the original on 2020-03-28. Retrieved 2020-03-28.
  77. Popular science monthly. New York: D. Appleton. 1916. p. 400.
  78. Pabst Battin, Margaret; Francis, Leslie P.; Jacobson, Jay A.; Smith, Charles B. (2009). The Patient as Victim and Vector: Ethics and Infectious Disease. Oxford University Press. p. 351. ISBN   978-0-19-533583-5. Archived from the original on 2020-03-28. Retrieved 2020-03-28.
  79. Melnick, Joseph L. (1996-07-01). "Current Status of Poliovirus Infections" (PDF). Clinical Microbiology Reviews . American Society for Microbiology. 9 (3): 293–300. doi:10.1128/CMR.9.3.293. PMC   172894 . PMID   8809461. Archived (PDF) from the original on 2019-04-30.
  80. Hatchett, Richard J.; Mecher, Carter E.; Lipsitch, Marc (2007-05-01) [2007-04-06, 2007-02-14, 9 December 2006]. Singer, Burton H. (ed.). "Public health interventions and epidemic intensity during the 1918 influenza pandemic". Proceedings of the National Academy of Sciences of the United States of America . 104 (18): 7582–7587. Bibcode:2007PNAS..104.7582H. doi: 10.1073/pnas.0610941104 . PMC   1849867 . PMID   17416679.
  81. Starr, Isaac (1976-10-01). "Influenza in 1918: Recollections of the Epidemic in Philadelphia". Annals of Internal Medicine . 85 (4): 516–518. doi:10.7326/0003-4819-85-4-516. PMID   788585.
  82. McKinsey, David S.; McKinsey, Joel P.; Enriquez, Maithe (Jul–Aug 2018). "The 1918 Influenza in Missouri: Centennial Remembrance of the Crisis". Missouri Medicine. 115 (4): 319–324. ISSN   0026-6620. OCLC   7850378090. PMC   6140242 . PMID   30228752.
  83. Smith, Richard (2007-06-30). "Social measures may control pandemic flu better than drugs and vaccines". British Medical Journal . 334 (7608): 1341. doi:10.1136/bmj.39255.606713.DB. ISSN   0959-8138. PMC   1906625 . PMID   17599996.
  84. Kalnins, Irene (September 2006). "The Spanish influenza of 1918 in St. Louis, Missouri". Public Health Nursing . Boston, Massachusetts. 23 (5): 479–483. doi:10.1111/j.1525-1446.2006.00586.x. ISSN   0737-1209. PMID   16961567.
  85. Bootsma, Martin C. J.; Ferguson, Neil Morris (2007-05-01) [2007-03-13, 13 December 2006]. Singer, Burton H. (ed.). "The effect of public health measures on the 1918 influenza pandemic in U.S. cities". Proceedings of the National Academy of Sciences of the United States of America . 104 (18): 7588–7593. Bibcode:2007PNAS..104.7588B. doi: 10.1073/pnas.0611071104 . PMC   1849868 . PMID   17416677. (6 pages)
  86. Chin, Tom D. Y.; Foley, John F.; Doto, Irene L.; Gravelle, Clifton R.; Weston, Jean (February 1960). "Morbidity and mortality characteristics of Asian strain influenza". Public Health Reports . Sage Publications, Inc. 75 (2): 149–158. doi:10.2307/4590751. JSTOR   4590751. PMC   1929395 . PMID   19316351. (19 pages)
  87. Wheeler, Colleen C.; Erhart, Laura M.; Jehn, Megan L. (November–December 2010). "Effect of School Closure on the Incidence of Influenza Among School-Age Children in Arizona". Public Health Reports . 125 (6): 851–859. doi:10.1177/003335491012500612. PMC   2966666 . PMID   21121230.
  88. "Flu Pandemic Study Supports Social Distancing". NIH Research Matters. National Institutes of Health. 2011-06-06. Archived from the original on 2017-04-23. Retrieved 2017-04-22.
  89. Wong, Grace (2009-05-01). "Flu virus sparks 'social distancing' trend". CNN. Retrieved 2021-03-30.
  90. 1 2 "Flu Pandemic Study Supports Social Distancing". National Institutes of Health . 2011-06-06. Retrieved 2021-03-30.
  91. Wardrop, Murray (2009-07-21). "Swine flu: schools should close to halt spread of virus, ministers told" . The Telegraph . ISSN   0307-1235. Archived from the original on 2020-02-16. Retrieved 2020-03-17.
  92. Walsh, Eric, ed. (2009-07-20). "Closing schools won't stop pandemics: study". Reuters. Archived from the original on 2020-04-04. Retrieved 2020-03-17.
  93. Bell, David M. (November 2004). "Public Health Interventions and SARS Spread, 2003". Emerging Infectious Diseases . 10 (11): 1900–1906. doi:10.3201/eid1011.040729. ISSN   1080-6040. PMC   3329045 . PMID   15550198.
  94. Bondy, Susan J.; Russell, Margaret L.; Laflèche, Julie M. L.; Rea, Elizabeth (2009-12-24). "Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine". BMC Public Health . 9 (1): 488. doi:10.1186/1471-2458-9-488. PMC   2808319 . PMID   20034405.
  95. Stevens, Harry (2020-03-14). "These simulations show how to flatten the coronavirus growth curve". Washington Post . Archived from the original on 2020-03-30. Retrieved 2020-03-29.
  96. 1 2 "COVID-19 Educational Disruption and Response". UNESCO . 2020-03-04. Archived from the original on 2020-03-29. Retrieved 2020-03-23.
  97. "Most UK cinemas shut after virus advice". BBC News . 2020-03-17. Archived from the original on 2020-03-23. Retrieved 2020-03-21.
  98. 'We're going to have more deaths': Influenza kills more people than the coronavirus so everyone is overreacting, right? Wrong—and here's why Archived 8 April 2020 at the Wayback Machine , MarketWatch, Quentin Fottrell, 9 March 2020
  99. Shear, Michael D.; Mervosh, Sarah (2020-04-17). "Trump Encourages Protest Against Governors Who Have Imposed Virus Restrictions" . Retrieved 2020-10-24. Updated 29 April 2020
  100. Gammon, Katharine (2020-04-16). "How the Anti-Vaccine Community Is Responding to Covid-19". Undark. Retrieved 2020-10-24.
  101. "Parents, police struggle to social distance the young in coronavirus outbreak". 2020-03-20. Archived from the original on 2020-03-23. Retrieved 2020-03-23.
  102. Young, Elise; Baker, David R. (2020-03-20). "Uh-Oh Moment Finally Hits States Slow to Adopt Social Distancing". Bloomberg News . Bloomberg L.P. Archived from the original on 2020-03-23. Retrieved 2020-03-29.
  103. Frieden, Tom. "Lessons from Ebola: The secret of successful epidemic response". CNN . Archived from the original on 2020-03-23. Retrieved 2020-03-23.
  104. "Coronavirus deprives nearly 300 million students of their schooling: UNESCO". The Telegram . Archived from the original on 2020-03-28. Retrieved 2020-03-23 via Reuters.
  105. Lipsitch, Marc; Swerdlow, David L.; Finelli, Lyn (2020-03-26) [2020-02-19]. "Defining the Epidemiology of Covid-19 – Studies Needed". New England Journal of Medicine . 382 (13): 1194–1196. doi: 10.1056/NEJMp2002125 . ISSN   0028-4793. PMID   32074416.
  106. Zimmermann, Petra; Curtis, Nigel (2020-03-18). "Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children". The Pediatric Infectious Disease Journal . 39 (5): 355–368. doi: 10.1097/INF.0000000000002660 . ISSN   0891-3668. PMC   7158880 . PMID   32310621.
  107. "Adverse consequences of school closures". UNESCO . 2020-03-10. Archived from the original on 2020-03-25. Retrieved 2020-03-23.
  108. Ehrlich, Brenna (2020-03-15). "Taylor Swift Urges Fans to Stay Home Amid COVID-19 Outbreak: "I love you so much and I need to express my concern that things aren't being taken seriously enough right now," superstar writes". Rolling Stone . Archived from the original on 2020-03-19. Retrieved 2020-03-28.
  109. Reifschneider, Florian (2020). "A Movement to Stop the COVID-19 Pandemic". #StayTheFuckHome. Archived from the original on 2020-03-29. Retrieved 2020-03-29.
  110. Hudson, Alex (2020-03-17). "Busy Philipps Joins Cameo to Record "Stay the Fuck Home" Messages for Coronavirus". Archived from the original on 2020-03-27. Retrieved 2020-03-29.
  111. "AMA, AHA, ANA: #StayHome to confront COVID-19". Chicago, USA: American Medical Association. Archived from the original on 2020-03-28. Retrieved 2020-03-30.
  112. Berg, Madeline. "No, Netflix Is Not Spoiling Its Own Shows To Fight Coronavirus". Forbes . Archived from the original on 2020-03-27. Retrieved 2020-03-30.
  113. Sayej, Nadja (2020-03-25). "'It feels like wartime': how street artists are responding to coronavirus. The pandemic may have closed museums and galleries down but artists have found other ways to comment on the crisis". The Guardian . Street art. Archived from the original on 2020-03-29. Retrieved 2020-03-30.
  114. 1 2 Solis, Jorge (2020-03-16). "The #StayTheF***kHome movement just wants you to, well, you know". Newsweek . Culture. Archived from the original on 2020-03-27. Retrieved 2020-03-30.
  115. Ao, Bethany (2020-03-19). "Social distancing can strain mental health. Here's how you can protect yourself". The Philadelphia Inquirer . Archived from the original on 2020-03-26. Retrieved 2020-03-24.
  116. "Stress and Coping". Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. 2020-03-23 [2020-02-11]. Archived from the original on 2020-03-29. Retrieved 2020-03-24.
  117. Willis, Olivia (2020-03-22). "Coronavirus: Social distancing and isolation can take a toll on your mental health, here's how some people are coping. Managing mental health in the time of coronavirus". ABC News . Archived from the original on 2020-03-28. Retrieved 2020-03-24.
  118. 1 2 3 Treadwell-Deering, Diane E. (July 2020). "Coronavirus (COVID-19): Helping Kids With Autism Cope". Retrieved 2020-07-26.
  119. 1 2 3 Farmer, Sam (2020-05-08). "Coronavirus and social distancing through an autistic lens". The Hill. Retrieved 2020-07-26.
  120. 1 2 Thom, Robyn; McDougle, Chris (2020-04-24). "Strategies to support teens and young adults with autism spectrum disorder during COVID-19". Harvard University . Retrieved 2020-07-26.
  121. 1 2 Becker, Niels (2015). Modeling to Inform Infectious Disease Control. CRC Press. p. 104. ISBN   978-1-49873107-2.
  122. "Ending coronavirus lockdowns will be a dangerous process of trial and error". Science. 2020-04-14. Retrieved 2020-04-20.
  123. Lu, Marcus (2020-03-28). "The Math Behind Social Distancing". Visual Capitalist. Retrieved 2020-04-16.
  124. page 6
  125. Hawley, Dana M.; Buck, Julia C. (2020-08-01). "Animals Use Social Distancing to Avoid Disease". Scientific American . Retrieved 2020-09-24.