CORONAVIRUS UPDATE: As experts learn more about the novel coronavirus, news and information changes. For the latest on the COVID-19 pandemic, please visit the Centers for Disease Control and Prevention.

By now, everyone has heard about social distancing. It’s a simple term, but what it means and why it’s necessary is causing some confusion. It may seem drastic, but experts agree that social distancing plus precautions like handwashing and wearing a mask in public are the best ways to “flatten the curve” and have the best outcome possible for the COVID-19 (coronavirus) pandemic.

What does it mean to “flatten the curve”?

“The ‘curve’ refers to the number of people who will contract COVID-19 over a period of time,” says Soma Mandal, MD, of Summit Medical Group in Berkeley Heights, New Jersey. “’Flattening the curve’ refers to all the measures that are being taken right now to reduce the number of cases. The efforts to ‘flatten the curve’ are to avoid overtaxing our health care capacity [in terms of] number of hospital beds, emergency room availability, available doctors and nurses to take care of patients, and availability of adequate equipment to treat patients.”

Shuhan He, MD, is on the front line of the COVID-19 pandemic as an emergency medicine physician at Mass General Hospital in Boston. He likens flattening the curve to the toilet paper rush (and subsequent shortage).

“When everyone tries to buy toilet paper at once, there is no toilet paper left,” he says. “That is a peak in the curve. But when everyone buys it at a slow, regular pace, there is always enough to go around. That is a peak that has been flattened.”

Essentially, as coronavirus transmission slows, the number of people infected at one time decreases, and makes it possible for everyone to receive better care. This includes other medical emergencies like heart attacks, strokes, and anything else that might require hospitalization and the resources that come with it.

What are the differences between social distancing, self-isolation/quarantine, full isolation, and lockdown?

While this terminology is not exclusive to the COVID-19 pandemic, these words come up more frequently as mandates and recommendations for flattening the curve emerge.

Dr. Mandal outlines the different definitions:

Social distancing: Avoidance of public gatherings and maintaining a distance of 6 feet from other people.

Self-isolation/quarantine: Separating a person or group of people who have been exposed to a communicable disease but are not yet symptomatic. This is done to prevent the spread of a communicable disease. In terms of coronavirus isolation precautions, the quarantine period is currently 14 days.

Full Isolation: Separation of a person or group of people who are reasonably believed to be infected with a communicable disease and potentially able to spread that disease to others. Isolation can be voluntary, or can be mandated by the federal, state, or local public health board.

Lockdown: In this current health crisis, lockdown refers to preventing people from leaving a certain area. This can be mandated at the federal (national lockdown), state, or local level. Depending on the level of the lockdown, all services except essential services are shut down.

Is social distancing a recommendation or a requirement?

Whether it is a requirement or a recommendation depends on the state, city, or even country. Some cities have shut down bars, restaurants, night clubs, and other places people gather socially. Many areas have closed schools to slow the spread among children, who often have milder symptoms but can still infect other people.

In places where social distancing isn’t mandated yet, it is strongly urged. “If more people do not practice social distancing, then we may be forced into a lockdown, at which point it would be mandatory,” says Dr. Mandal.

Social distancing works when the vast majority of people are practicing it.

Do I need to practice social distancing even if I don’t have symptoms and don’t think I have been exposed to anyone with COVID-19?

Yes! People with COVID-19 can be contagious before they show coronavirus symptoms. That means that you may have come into contact with somehow who is spreading COVID-19 and doesn’t show it, or you could be infected yourself and not know it. Some people, particularly younger adults, are never symptomatic but can still spread the infection.

Social distancing also keeps healthy people healthy. You may not have come in contact with the virus yet, but staying home lessens the chances that you will and helps prevent spreading it to others if you do.

What are the guidelines for social distancing?

When you’re social distancing, you should not:

Socialize in person with people outside of your household.
Have physical contact with anyone outside your household, including handshakes, hugs, etc.
Make outings that aren’t essential. The only places you should go are grocery stores (only as needed, try to consolidate trips), essential medical appointments, to pick up medication, and to work (only if necessary—working from home or taking a leave are preferable). If you don’t absolutely have to go out, don’t!
Go without a mask. When you do go out and will be in contact with other people, you should wear a cloth face covering.
Have play dates inside your home or other peoples’ homes.
Have friends and family over to your house or visit their houses. This is especially important when it comes to seniors or other vulnerable people.
Attend events—concerts, plays, or any other event, big or small.
Attend celebrations—birthday parties, weddings, or anywhere there will be a gathering.
Attend religious services.
Spend time in large or small groups of people. If you must be in a group, make it less than 10 people, and all members must maintain a social distance of at least 6 feet from everyone else and wear masks.
Visit public spaces—the gym, libraries, sporting events (adult and children), malls, museums, theme parks, resorts, anywhere else people gather and objects are shared/touched by multiple people.
Go to play areas—this includes indoor playgrounds and outdoor play equipment.
Take public transit if it is possible to avoid it.
Participate in community classes such as those offered through recreation centers or private lessons.
Travel. Essential trips only, postpone vacations and any other non-essential travel.
Eat out. Take-out, drive-thru, and delivery are debatable. While preferable to dining in a restaurant, there is still contact between your food, drink, and other people. At this time, it may be best to cook for yourself.

If you don’t absolutely have to leave the house, don’t. And don’t let anyone into your house unless it is essential either. It sounds extreme, but it’s much better to use social distancing now to slow the spread of the virus, than to do it as a reaction to widespread infection. The more people who practice social distancing, the better it will work.

Even with these restrictions, there are still a lot of things you can do while practicing social distancing. If you can do it in your house without contact with other people, go for it, have fun!

What should you do if someone in your house is infected with or has been exposed to COVID-19?

Before anyone gets sick or is exposed, the Centers for Disease Control (CDC) says to make a plan. If someone is already sick or has been exposed to COVID-19, taking care of them at home requires special considerations.

The infected, or potentially infected, person should:

Stay home except for receiving medical care. (Call ahead before going to the doctor.)
Isolate themselves inside the house, in a designated room away from other people and animals. If possible, they should use a separate, designated bathroom as well.
Wear a face mask when around other people and animals, such as in the room or sharing a vehicle.
Sneeze into a tissue, discard the tissue in a lined trash can, and then immediately wash hands with soap and water for at least 20 seconds (or use a 60% alcohol or higher hand sanitizer if handwashing is not possible.)

Everyone in the house should:

Wash their hands frequently.
Avoid sharing personal items such as utensils, towels, drinking glasses, bedding, etc. These items should be washed after use.
Clean all “high touch surfaces” daily. These include but are not limited to doorknobs, countertops, toilets, faucet taps, phones, and other devices, etc.
Monitor their symptoms (particularly look for fever, cough, or shortness of breath.)

By being vigilant about practicing social distancing, it will help make sure that hospitals are able to care for both COVID-19 patients and anyone else needing emergency or intensive care services.

Social distancing is crucial right now. It won’t be forever. The more distance you put between yourself and others, the less dire of an impact COVID-19 will have. Now is the time for people around the world to work together toward the common goal of keeping each other safe and healthy.