Stopping the spread of the Coronavirus
The New England Journal of Medicine just published a paper on the stability of SARS-CoV-2 (the cause of COVID-19) outside the human body.
aerosols > 3 hours
plastic > 72 hours
stainless steel > 72 hours
copper 4 hours
cardboard 24 hours
After a bit more than an hour the amount of virus in an aerosol decreases by about half. The amount of virus on plastic and stainless steel decreases by half about every 6 hours. The temperature, humidity and type of plastic would be expected to affect the results.
Doremalen, Bushmaker, and Morris (2020) NEJM (DOI: 10.1056/NEJMc2004973)
UV light, alcohol, heat, or soap and water can be used to inactivate the virus. Wiping the grocery cart with alcohol wipes is clearly a good idea. Discarding plastic packaging and then washing hands with soap and warm water is also wise.
One inexpensive way to slow down the spread of the virus is to hang our laundry out to dry in the sunlight. UV light does destroy pathogenic viruses and other types of germs. Some towns and cities will have to rescind ordinances about clotheslines, but exposing laundry to sunlight would help disinfect things for people who have a place to hang it out.
Laundromats worry me as a source of viral spread. Soap and hot water can inactivate the virus but the clothes could still get contaminated again in the laundry carts and on the folding tables. Sometimes laundromats can be crowded. Sick people will still need to have clean clothes and people spread the virus even before they have any symptoms.
Sunlight will fade expensive clothes and the bright colors of the guest towels, but it would be great if everyone could hang out blue jeans, family towels, T-shirts and used face masks.
Wilson "The plague...": people fleeing from plague. Credit: Wellcome Collection. Attribution 4.0
Pandemics are nothing new. During the early modern period bubonic plague had a high mortality rate and no real cure. People did not know about the involvement of fleas in spreading plague. When the plague struck England many of the nobility and wealthy would flee to the countryside carrying the plague with them. Middle class people were commonly quarantined in their houses for 40 days after the last death in the household. Poorer families could be taken to pesthouses on the outskirts of town until they died or recovered. If a servant to a better-off family fell ill they could be sent to the pesthouse outside town to decrease the risk to the rest of the household. Food and financial support were supposed to be provided, but quarantine could be financially devastating to middle class families.
According to the conclusion of a paper by Kira Newman on the 1636 Plague quarantines in England:
Government implementation of quarantine was remarkably effective. Despite a lack of early preparations, economic stress, and public opposition, parishes managed thousands of infected and exposed individuals in a system that, for many, helped ensure compliance. Pesthouses gave parishes a secure place to put individuals for the full duration of quarantine and insured that they would receive care. The coordination of parish officials provided daily support to the needy. To save money, the parish devised strategies to minimize expenses and to bring in some returns. Policies like having watchmen assigned to areas rather than individual houses had little public opposition. Others, like giving aid in the form of loans, may have been less popular.
However, quarantine could never be uncontroversial. The flight of the wealthiest from London and Westminster left only the more socially vulnerable to be quarantined. Plague policy was financially sensitive to the poorest but costly in the short and long term to the middling sort. Most significantly, government implementation of quarantine was not always as fair and equal as official public documents purported it to be.
The government used quarantine directly as a punishment to control individuals found breaking other parts of the books of orders. Though this was not publicized, popular narratives continually included grievances about the cruelty and inequity of quarantine and the militaristic nature of its implementation. Quarantine was depicted as uncharitable and unchristian because it prevented family and friends from supporting the ill by conventional means. In response to the perceived inequity of quarantine, individuals, most often the middling sort, broke out of their houses, hid the sick, bribed parish officials, and violated the books of orders in other ways.
Similar public arguments against quarantine continued to arise throughout the rest of the seventeenth century. During 1665, the last great outbreak of plague in London, individuals printed dozens of pamphlets and published numerous books meticulously detailing the points against shutting up the infirm and exposed. In the end, opposition to plague policy died out only when plague itself did.
Shutt Up: Bubonic Plague and Quarantine in Early Modern England
Kira L. S. Newman Journal of Social History (Vol. 45, No. 3)
The government response to plagues looked good on paper, but popular literature describes quite a few failures to apply Plague laws properly. The playwright Thomas Dekker described incidents from the outbreak of plague in 1603:
I could draw forth a Catalogue of many poore wretches, that in fieldes, in ditches, in common Cages, and under stalls (being either thrust by cruell maisters out of doores, or wanting all worldly succour but the common benefit of earth and aire have most miserably perished. . . . .
Neither will I speake a word of a poore boy (servant to a Chandler) dwelling thereabouts, who being struck to the heart by sicknes, was first caryed away by water, to be left any where, but landing being denyed by an army of browne bill-men that kept the shore, back againe was he brought, and left in an out-celler, where lying groveling and groning on his face (amongst fagots, but not one of the set on fire to comfort him (there continued all night, and dyed miserably for want of succor.
Nor of another poore wetch in the Parish of Saint Mary Overeyes, who being in the morning throwne, as the fashion is, into a grave upon a heape of carcases, that kayd for their complement, was found in the afternoone, gasping and gaping for life:
Dekker The Wonderfull Yeare 1604
According to the CDC plague had a mortality rate of 66% before antibiotics became available in 1941. The mortality rate is around 10% now. Testing and isolation of the patients can effectively stop human to human transmission.
The data from South Korea suggest a mortality rate of less than 1% for the current epidemic of COVID-19. As epidemics progress the mortality rates tend to decrease. Strains of the pathogen that cause severe symptoms are less likely to be passed on since an infected person who is bedridden has fewer opportunities to infect others (especially if they have an adequate supply of masks and other protective equipment).