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GAO-20-545SP 1 (2020-05-13)

handle is hein.gao/gaobaebcn0001 and id is 1 raw text is: Science, Technology Assessment, GAO0 and Analytics SCIENCE & TECH SPOTLIGHT: SOCIAL DISTANCING DURING PANDEMICS What is it? Social distancing, also known as physical distancing, is the practice of maintaining physical distance from others and avoiding large gatherings, with the intent of reducing the rate of transmission of infectious diseases. COVID-19 has brought social distancing practices to the forefront worldwide as a means of controlling local spread of the disease. How does it work? Practicing social distancing reduces the rate of new infections by limiting person-to-person transmission. This in turn can flatten the curve, by reducing the peak number of patients to levels the health care system can better manage, ultimately saving lives (fig. 1). C, 0 guidelines are often conservative, recommending minimal personal contact except when necessary, such as within one's own household. Larger dropes Smaller droplets Medium droplets Source: Elsevier. Credit: Jianjian Wei, Yuguo Li. GAO-20-545SP Pandemic outbreak: With intervention Source: Adapted from similar diagrams published by the Centers for Disease Control and Prevention and the European Centre for Disease Prevention and Control. | GAO-20-545SP Reducing the rate of disease transmission through interventions, including social distancing and other measures, can alleviate the burden on medical facilities. The success of social distancing depends on factors such as the distance that infectious particles can spread from a contagious person. The Centers for Disease Control and Prevention (CDC) currently recommends a 2 meter (about 6 feet) separation between people, while the World Health Organization (WHO) recommends 1 meter (about 3 feet). The scientific basis for these recommendations comes from studies in fields such as fluid mechanics, epidemiology, and microbiology. For example, several studies estimated the velocity and distance traveled by droplets of different sizes expelled by sneezing, coughing, and breathing. These studies showed that sneezing and coughing can propel droplets more than 2 meters, with sneezing possibly propelling them further, and breathing less than 1 meter (fig. 2). However, these estimates of speeds and distances are not absolute maximums. Coughing and sneezing are complex phenomena that are challenging to characterize precisely. And the behavior of droplets after they are expelled depends on their size, along with environmental factors such as humidity and air currents, making it challenging to be definitive about how far they may travel. Partly as a result of this ambiguity, social distancing Droplets carrying infectious material can travel different distances, depending on factors such as size, humidity, and air currents. Microbiological studies on a variety of respiratory viruses have shown viral material can travel 2 meters or farther from an infected patient. Specifically for COVID-19, one study showed that viral material can be recovered from ventilation fans in a patient's room. However, it was not established whether the viral material could lead to disease transmission. How mature is it? Some modeling studies of historical outbreaks suggest that social distancing is effective in reducing the spread of infections. For example, studies examining the use of social distancing during the 1918 influenza outbreak and the 2003 SARS outbreak showed such a reduction in part due to social distancing. While it is clear that maintaining separation between individuals provides important protection, there is no definitive statement in the literature regarding effectiveness of specific distances. While a CDC guideline suggests that, historically, risk is highest within 1 meter of an infected person, the studies described above suggest a buffer of over 2 meters may further reduce risk. Still, several unknowns limit the ability to set specific guidance. For example, the risk from those droplets that travel long distances is unknown, as is the risk from viral material in aerosol form, which may persist for at least 3 hours in the air. Additionally, the amount of infectious material needed for COVID-19 transmission is not clear, nor is the effect of duration of exposure on risk, making it unclear how long two people standing 2 meters apart may safely interact. Social distancing practices, such as avoiding crowds and staying home, remain important, particularly as some infected people can shed virus before showing symptoms, according to WHO. GAO-20-545SP Social Distancing During Pandemics

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