My name is Matt Salter, and I’ve been a Physician Assistant since 2007. I live in a small, tight-knit town in Vermont. I participate in several community forums and am compelled to educate and inform those around me. Due to my education and training, I understand complex issues related to this new strain of coronavirus and need to make sure that people in my community and beyond get accurate and timely information, to influence their behavior.
My primary concern, however, is helping people understand why social distancing works. If I am able to get through to one person and they change their behavior, then I am glad I used my time to make this statement.
It concerns me greatly that misinformation about COVID-19 is shared as fact, and that individuals who have no background in medicine, or public health are offering their opinions and debating recommendations made by medical care and public health practitioners.
We have been told to stay home unless we have a pressing need for groceries or medical care. We have been told to practice social distancing.
Social distancing is:
- Keeping a minimum of 6 feet from people you do not live with
- Working from home if possible
- Only leaving your house or property when absolutely necessary
- Only shopping when you must, and buying enough food for 7-10 days
- Visiting friends, neighbors, and family outside your family unit ONLY via electronic devices
- Exercising outside alone, or with your family unit
Social distancing is not:
- Visiting with people outside your family unit, no matter who they are
- Traveling far from your home
- Going to meetings, gatherings, work functions
- Going to the playground or the ice cream shop
- Going hiking, biking, skiing, etc. with others outside your family unit
- Having neighborhood get-togethers
- Browsing in any store
- Running any errands that aren’t truly urgent
To begin, let’s look at South Korea, as well as a small Italian village named Vo. They have essentially succeeded in defeating COVID-19.
Very early on, Vo closed down the village and tested almost all of its 3300 inhabitants. Nobody was let into or out of the town. They proved that strict social distancing and 14-day quarantines, along with many COVID-19 swabs (in order to find people who test positive for COVID-19 without showing any symptoms) were the paths to defeating the virus. The village is now free of COVID-19 infections.
South Korea was ahead of infection trends from the very beginning. They listened to science and predicted this virus would hit hard. They ended up testing residents early on and did around 20,000 tests per day (population 51,000,000). South Korea mobilized its government, used a top-down approach, and used strict social distancing and quarantine measures along with widespread testing to combat COVID-19 with great success. This is how we know, for sure, why social distancing works.
Now Vermont. Thus far, we have failed to take this virus seriously and are playing catch up, much like the rest of the United States. We were very late to the game with testing and are, to this day, nowhere near where we need to be in terms of the number of daily COVID-19 tests performed. The limiting factor in testing is currently the turnaround time from the swab test to results.
Yes, we are now testing people with less severe symptoms and more testing sites are popping up, but it still takes time to process these samples. We test about 20 people per day, 6 days a week at our small operation at Evergreen Family Health, and the results are trickling in, taking 2-5 days or so. Hardly a dent in this battle, but it’s something, I suppose. As a state, we have tested 3,700 people as of March 29. That is 0.59% of our population. This is not a good number. Our testing system is failing.
Now that we have established that Vermont is way behind in terms of testing, what are we left with? How else can we change the course of COVID-19?
We CANNOT rely on early widespread testing; that ship has sailed.
What did the other successful countries do that we aren’t doing?
Social distancing. Knowing what this means, we must now commit to it fully.
I will be the first to admit that heavy-handed, military-motivated measures such as those used in South Korea won’t fly here in the US… or would they? New Rochelle, New York offers one example of success in the US related to a very early response.
Both South Korea and Vo took drastic measures to stop the spread of COVID-19. Isolation, widespread testing, and social distancing. And they were successful.
We have attempted a different approach. We have focused on strict community-supported social distancing, quarantines, and strict isolation of persons with any symptoms that could be related to COVID-19. The Vermont state government issued a “Stay Home” order on March 24, but if we don’t do what is recommended, then what is the point?
Social distancing will allow us to accomplish a lot. It might not be immediately apparent, but strict social distancing now will save lives in the future. This means staying home, in your house, on your property, only with those you live with. Your family unit. Social distancing and keeping your family unit completely separate will absolutely decrease the spread of COVID-19 and associated deaths. If we stop moving around, the virus stops moving around.
Correct social distancing has absolutely nothing to do with whether or not you have symptoms. Somewhere between 30 and 70% of infected persons have NO symptoms, and many of those persons will NOT develop any symptoms. Even so, you can quite easily spread the disease without having symptoms. The problem comes when those you spread the virus to begin to show symptoms. A small percentage of people who have COVID-19 will become very, very sick.
Social distancing is NOT easy. We, at least most of us, are not meant to stay in one place. I love to travel, move around, play outside, and be social. Most medical providers, myself included, preach about getting up and moving around, getting outside… all day long I tell my patients this. Now here we are, a bunch of medical providers telling people to stay inside, stay away from others, limit interaction with nature to your own property, and do it alone or with your housemates. It’s difficult, to put it lightly.
There are thousands of medical providers, MDs, PAs, NPs, nurses, EMTs, Paramedics, etc all saying exactly the same things. Stay home. Please. Practice social distancing. Please.
Reach out to your neighbors, friends, and family members. Teach rather than scold. Support rather than berate. Please listen to your healthcare providers. We are risking our lives every time we see patients now.
You each have likely chosen a provider to turn to when sick or injured, and to work with to become as healthy as possible. Now is the time to trust us, listen to our advice, and reach out with questions, for help, or with any thoughts. We are telling you why social distancing works. Please listen.
Our current situation is going to get much worse before it gets better. The more focused we are now at doing our part, the quicker normal life can resume, and fewer members of our community will fall ill and die.
Guest Author: Matt Salter
Matt Salter has been a board-certified Physician Assistant working at Evergreen Family Health in Williston, VT. After growing up in the Hudson Valley region of New York, he attended St. Michael’s College in Colchester, Vermont, then graduated from Albany Medical College in 2007. He has extensive experience in Orthopedic Surgery and Sports Medicine as well as 4+ years working in the Emergency Department at the University of Vermont Medical Center. He enjoys an active lifestyle in Essex Junction with his two sons.
