Experts: Stay home to lower virus risk

‘Flattening the curve,’ or slowing spread of coronavirus, can help reduce worst effects

The number of cases of the novel coronavirus has started creeping up in Connecticut while it balloons in other states.

Before, travelers were bringing the virus home. Now, it’s starting to spread through communities. With this shift, health officials have changed their approach from containing the few numbers of cases to mitigating its inevitable spread.

When the cases were more isolated, health departments identified and quarantined people who tested positive as well as those who interacted with the patient, said Richard Martinello, a Yale School of Medicine associate professor of infectious diseases.

“When there are very few people who are sick, that works very well,” said Martinello, who also is the medical director of infection prevention for Yale New Haven Hospital.

As the spread picked up pace, however, the strategy has changed to mitigation. In this phase, it is more important for everyone to know how to prevent themselves from getting sick and how to recognize if they are starting to get sick.

“Because our society really doesn’t have vast resources, we focus on making sure we are paying attention to those who are sick, and making sure they’re not getting anyone else sick,” he said.

Connecticut is following the lead of other states by taking more extreme measures for social distancing: closing schools, canceling large events and telling people to work from home when they can.

Without these efforts, the number of cases spike in a short window as the virus quickly spreads through a community. The spike would far exceed capacity at hospitals and other healthcare facilities, making it difficult to treat everyone while also providing care unrelated to COVID-19.

As a family practitioner in Westport, Dr. Steven Benaderet was shocked when he peeked at his social media after the town’s school district closed due to fears about a form of the respiratory illness coronavirus.

There were posts from parents about what they should do with their children, and what activities might be available for them.

“I thought ‘You’re missing the point,’ ” said Benaderet, who is also regional medical director of Northeast Medical Group, which is part of Yale New Haven Health.

The idea is to limit the amount of time people spend in close contact with each other, thus preventing anyone who might unknowingly infected from passing it to others. This, experts said, can help slow the spread of COVID-19 — a phenomenon known as “flattening the curve.”

Benaderet said “flattening the curve” means spreading out the amount of people infected with COVID-19 over time, to better allow hospitals and health care workers to properly treat the influx of cases. Other experts echoed the need to decrease contact with others — also known as “social distancing” — to keep the virus from spreading at an out-of-control rate.

Benaderet compared curtailing the spread of the illness to fighting a rash of house fires.

“If there are 100 house fires in Westport on one given night, there wouldn’t be enough firefighters to fight them all, and someone’s house would burn down,” he said. “But if there are 100 fires in a year, then there is a system in place to respond to that.”

Similarly, Benaderet said, if there are thousands of COVID-19 cases in a week, that’s a much heavier burden on the health care system than if there are thousands of cases over the course of a year or even a few months.

People have pointed to Italy, where thousands of cases and hundreds of deaths have overwhelmed the health system and forced a national shutdown, as a worst-case scenario.

If the United States in general, and Connecticut in particular, don’t do something to slow down infection rates, experts worry that the same thing will happen here.

“You could have people who are seriously ill and need to go to the hospital, and there won’t be enough (resources) to handle it,” said Patrick Kelly, a distinguished fellow in nursing and health studies at Fairfield University.

That’s already happening to some degree, said Dr. Alis Pose, chief quality officer for Optimus Health Care, which provides affordable health care for uninsured and underinsured people at its 31 locations throughout southwest Connecticut (including Bridgeport, Stamford, Stratford and Milford).

She said she is concerned about the impact of a spike in COVID-19 cases, particularly since the centers are already running low on masks and alcohol disinfectants. “We’re already in our reserves,” Pose said.

The clinics are trying to limit the staff ’s exposure, and handle cases as best they can by screening everyone who comes in to see if they have a temperature of 100.4 degrees or higher. Those who are aware that they have a fever and/or a dry cough — two prime symptoms of COVID-19 — are asked to call before they come to the centers, so staff can be prepared.

Optimus also is limiting the dental services it provides, to help limit exposure. But Pose is still worried about that the centers will get overwhelmed. She has worked in France, which has also been hit hard by COVID-19, and is in contact with people there and in Italy.

She’s heard stories about shortages of intensive care unit beds and of patients being treated in gymnasiums when proper facilities aren’t available.

“I hope we’re not going to get there, but I don’t know,” Pose said.

Like Benaderet, Pose said the best way to keep health systems from getting overwhelmed is to slow the spread by avoiding others.

“No parades. No parties. No crowded restaurants. No crowded grocery stores,” she said.