While many students are disappointed about their semesters cut short, epidemiologists at the School of Public Health say that the decision to close Yale’s campus for the remainder of the spring semester is the correct one, especially when considering past epidemics.
Av Harris, Director of Communications and Government Relations for the Connecticut Department of Public Health said to the News that measures implemented by institutions such as Yale help enforce social distancing, which is necessary to combat COVID-19. The statement comes after President Salovey’s email to the Yale community on Saturday night, announcing that all classes and final exams will take place online for the rest of the spring semester.
“We support any kind of change that institutions can enact in order to promote social distancing,” wrote Harris. “It is going to be disruptive to the lives of millions of people but we as a society, country, and state, need to respond to the most serious pandemic we have seen in a hundred years. Ultimately it is about saving lives and making sure the healthcare system is not overwhelmed.”
Harris’s statement corresponds with the actions of Gov. Ned Lamont, who signed an executive order on Thursday that banned gatherings of more than 250 people in Connecticut. At his most recent press conference on Sunday evening, the governor signed another order that will cancel classes at all public schools in Connecticut from March 17 to March 31.
Dr. Kaveh Khoshnood, an epidemiologist and Director of Undergraduate Studies at the Yale School of Public Health, echoed Harris’s statements and said that Yale’s decision to close its doors to students was the correct move. He added that the response of the United States government and shutdown of schools across the country should have come sooner.
“We are at a phase in the epidemic where the numbers are going up and one of the most effective tools we have is social isolation,” said Khoshnood. “Historically, if you look at quarantine in terms of outbreaks, school closures have had significant effects.”
Khoshnood estimated that the virus has a basic reproduction number of 2 to 4 (the number of people, on average, one sick person will infect in an entirely susceptible population) and a case fatality rate of 1 to 2 percent. Khoshnood warned that if millions of people become infected, this will pose a serious problem for the United States. But he also pointed out that the current case fatality rates tend to exaggerate the deadliness of COVID-19. These projections largely represent only a subset of people with the worst symptoms who end up in the hospital.
Other experts, such as Dr. Nicholas Christaki, Professor of Sociology and Natural Science, underscored the importance of looking to the past for lessons about how to address the current COVID-19 outbreak. Although the transition to online platforms for universities and the cancellation of public school classes across the country may be unprecedented, he reminded readers that the practice of social distancing in the face of a global pandemic is not.
In a series of tweets, he wrote that the 1957 flu pandemic “was first recognized in [the] USA in June in RI, but other outbreaks soon occurred in CA. By September, it was everywhere. And it recurred when schools re-opened in fall of 1957.” He went on to describe that community mitigation measures such as social distancing will similarly be crucial to “reduce the intensity of the COVID-19 epidemic.”
Responses to the 1918 H1N1 influenza outbreak also serve as a reminder of the history of social distancing to combat a pandemic. In St. Louis, all schools, libraries, churches, and other public places closed just two days after the first reports of cases in the city. The government also promptly banned gatherings of more than 20 people. Although these measures seemed extreme to many residents, a 2007 paper in the Proceedings of the National Academy of Sciences revealed that per capita flu-related deaths in St. Louis were less than half of those in Philadelphia, where social distancing measures were absent.
A 2006 study posted on the Center for Disease Control and Prevention website drew similar conclusions about social distancing during the 1957-1958 H2N2 influenza epidemic. Researchers modeled that in this outbreak, closing all schools to keep children and teenagers at home would have reduced the attack rate by 90 percent.
While drawing on lessons from the past, Khoshnood looked to the future.
“This is the time for public health to take the lead and engage with the community at large,” he said.
As of Monday morning, 3,782 people in the United States have tested positive for COVID-19.
Sydney Gray | sydney.gray@yale.edu