Thinking Like Epidemiologists

For the past couple of weeks all of us living in Southwest Florida have experienced a massive disruption in our lives. We’ve been asked to forgo routine pleasures like sharing a meal with friends or a walk on the beach, to protect those among us who are at greatest risk for acquiring COVID19.

Many of us have questioned the restrictions placed on our lives and wonder how doing something to enhance our personal health like walking on the beach or going to the gym and working out, can put the public’s health at risk.

Part of our confusion is that we are not “thinking like epidemiologists,” a phrase I often used in my Introduction to Epidemiology class that I taught to all new Public Health Education majors.

Epidemiologists think about diseases and health problems differently than average folks and clinicians (doctors, nurses etc.) do.

Average folks like you and me look at disease risks very personally. We look at the germ, how it is spread, and if we are at personal risk. We then take actions to reduce our risks, and go about our lives. If we get sick, we might do something like sleep in a different bedroom so our coughing and sneezing doesn’t keep our spouse up.

Clinicians do everything they can to provide optimal care to their individual patients. They will order tests and prescribe the best drugs possible to help their patients. Cost is not the primary factor in their work, providing optimal care is.

Epidemiologists combine information about clinical care with diagnostic, treatment and management strategies designed to combat problems at the community level.

Rather than focusing on doing everything possible, regardless of the cost, to treat an individual patient, epidemiologists focus on community medicine that seeks to provide the best care possible to the greatest number of people in the community.

A big part of “thinking like epidemiologists” involves understanding community-level risk-reduction strategies that focus on reducing disease transmission in the community. This is why one of the steps Governor DeSantis took to prevent the spread of COVID19 in Florida was to work with local officials to close the beaches.

I’ll have to admit that during my initial reaction to the beaches on Marco Island being closed I wasn’t “thinking like epidemiologists.” I thought; “How am I going to infect anyone by running along the beach and keeping my distance from anyone else crazy enough be out there at 6:15 am in the semi-darkness.”

It took my mind a day or so to shift back into my “thinking like epidemiologists” mode, and realize that while I was practicing social distancing, and being careful not to touch railings, bathroom door knobs, bike racks etc. at the beach, others were not doing that.

Pictures showed many people on the beach sitting closely together, laughing and touching, kissing and shaking hands. They were sharing drinks and food, playing with balls and other toys, and ignoring the social distancing recommendations.

Unfortunately, these wonderful, ordinary things that bring us simple pleasures also can be the same behaviors that unknowingly pass this virus on to those among us who are most vulnerable and susceptible.

So, while I really miss the beach and the gym, I support the Governor’s decision and have shifted my focus and started “thinking like epidemiologists“ again.

Instead of going to the beach and the gym, I’ve been riding my bike and kayaking the backwaters. Much to the delight of my wife I’ve cleaned up the backyard, weeded the garden, and spread mulch around her beautiful plants.

I know it is tough, you feel fine, and would really like your life back; so would I. However, the more we pull together now, the quicker we can stop this disease from spreading and start reopening restaurants and bars and sending people back to work and our kids back to school.

We can do this together if we all start “thinking like epidemiologists.”

Dr Rich Blonna is a Professor Emeritus in the Department of Public Health, William Paterson University and a candidate for the City Council of Marco Island.