EUSM publishes research showing how early implementation of social distancing measures in Saint-Louis saved lives

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The Washington University School of Medicine published the study on September 1.

The Washington University School of Medicine released a study this month concluding that the first health orders issued by public authorities in St. Louis likely averted thousands of hospitalizations and deaths, saving the city from a crisis. much more important.

The study, led by Washington University professor of medicine Dr. Elvin H. Geng, found that a delay of just two weeks in implementing social distancing measures would have resulted in a “total increase nearly six times of deaths, “using a model of the COVID-19 pandemic in accordance with Saint-Louis demographics and policies. Such a short delay could have created a situation resembling that of a more severely affected area, such as New York City.

The study also concluded that, among several behavioral theories, immediacy is the most crucial element in creating a successful public health procedure.

Medical anthropologist and University of Washington professor David Ansari, who was not part of the study, said the research was not just another part of academic group thinking, but was rather very relevant for an effective public health policy.

“I think we can generalize from these results and see that, if certain measures had been put in place even earlier, it could have had a very different effect, which would have resulted in saving lives and protecting people against this truly dangerous pandemic. “said Ansari.

If the response were delayed by a week, the study calculates that the number of deaths as of April 15, 2020 would have reached a median projection of 219 instead of the number actually observed, 115. As a result, large cities like New York and Boston can learn from St. Louis, where county and city officials acted quickly by issuing health orders before the severity of the pandemic became apparent.

“When an epidemic takes off, at that point, it is important for leaders to have the courage to make a decision that might be unpopular and to do so before it becomes obvious,” Geng said. “There are cases in America where we have done it [issuing health orders] too late. New York City did it too late. There were tons of people saying we had to shut things down, and New York waited and waited until the hospitals filled up, by then it was too late. By the time it is obvious, it is too late.

The state of Missouri, its more rural counties in particular, also lagged behind St. Louis, underscoring the disparity between health orders in different regions.

“I think there was [a disconnect]”Geng said.” The severity of the epidemic is worse in rural areas than in urban areas. Part of the reason is that people living in urban areas were more likely to change their behavior over time. . “

“I think Missouri would do much better in terms of numbers, both in terms of infections but also in terms of deaths, if approaches similar to those implemented in St. Louis and surrounding communities were followed. “said Ansari.

Ansari also argued that disparities in vaccination rates between St. Louis and Missouri overall had an even worse impact than disparities in public health orders. At the time of publication, Missouri has 26 counties with vaccination rates below 30%.

Ansari explained that the unvaccinated population of Missouri affects the vaccinated population both by allowing the virus to continue to spread, as well as having a demoralizing effect on the vaccinated population.

“We have to have a certain threshold in the general vaccinated population in order to achieve a certain level of safety,” he said. “Knowing that a significant part of the state is not even approaching that threshold, I think it takes a kind of psychological toll, more broadly. “

An emerging area of ​​research focuses on why people or do not follow public health orders or get vaccinated. Dr James Stellar, professor of behavioral neuroscience at the University of Albany, argues that emotion plays an important role in these decisions.

“The emotional brain circuits that you carry with you influence your cognitive decisions and often in ways that you don’t understand,” Stellar said. “Here, I think what happened is people became tribal. “It’s my tribe telling me not to do this. [This logic] often happens unconsciously.

Because of this emotional element, Stellar argued that some public health decisions are best made at the local level, as people are more likely to listen to someone they feel they know and trust.

“If these orders come from above, they could have the opposite effect. People will think, ‘Oh, it’s just the government pushing me,’ ”Stellar said.

Another conclusion of the study is that local decisions matter as much, if not more, than those taken at the national level. However, Ansari admitted that large-scale national planning also brings some benefits.

“I think it’s important to respond to needs and resources in a local context, but at the same time, if we had a cohesive approach that was nationally driven in this country, we would have been much better in terms of where we are with the pandemic now, ”Ansari said.

Geng said that the fight against anti-science and contempt for public health is “a lasting struggle.” However, he maintained the importance of scientific research centers, such as the School of Medicine, in the production of knowledge.

“People generally believe what they believe, and if you look on the Internet, you can find evidence to support anything you want to believe,” Geng said. “I’m not totally hopeful that a study based on an epidemiological model will change a lot of opinions. On the flip side, I still think science has a role to play in society and hopefully we’ll get to a point in the future where we can have these conversations. “

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