How is the coronavirus likely to play out, how does it end, and does our behaviour make a difference? Here infectious diseases expert Dr Siouxsie Wiles walks us through the epidemic curve, with illustrations by Toby Morris.

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In a post last week, I showed you a picture of how the Covid-19 outbreak has played out in China. It was a graph of the number of cases reported each day, something we call an epidemic curve. It looked a bit like this. We can use the epidemic curve as a visual way to think about how Covid-19 could go, both here in Aotearoa New Zealand and globally.

But before we get to that, let me just explain epidemic curves in a little more detail. First, they have three parts: a start (phase one), a middle (phase two), and an end (phase three). Each of these phases is influenced by different things. Such as, how infectious is the virus or bacterium? How is it transmitted? Is it person-to-person, or from eating or drinking? If it’s person-to-person, are people infectious before they have symptoms and don’t know they are unwell? And if people do have symptoms, are they mild enough for people to go about their daily routine? Is everyone susceptible to the infection, or just some people? What resources do we need and have to contain the outbreak? The answers to these questions will influence the shape of the epidemic curve.

Phase one of the Covid-19 epidemic curve – containment

At the moment, Aotearoa and many other countries are in phase one for Covid-19. This is the start of the curve where cases pop up sporadically as people who have contracted the virus in one country travel to other countries.

Think of Covid-19 as several fires blazing away, with embers shooting off in all directions. Our goal is to stop those embers from turning into another blazing fire. It’s beginning to look like anyone who has travelled overseas recently should think of themselves as a potential ember and be on the lookout for symptoms.

Sticking with the fire analogy, it’s not unusual for embers to smoulder a little when they land. That’s why public health officials are actively looking for people who have been in close contact with someone with Covid-19. This is called contact tracing. Anyone at high risk of having contracted the virus is then put into isolation. Here in New Zealand, two of the five people who have tested positive for the virus so far are partners or relatives of those “embers”.

Covid-19 is now officially a pandemic. Do not panic. But do draft up a pandemic preparedness plan. Here’s Siouxsie’s step by step guide.

Our aim is to stay in phase one. The longer we can stay in phase one, the better we can prepare for phase two. If we can stay here for the next one to two years, then hopefully a vaccine will become available and we can avoid phases two and three altogether. One way to do that would be just to ban all international travel. No one in or out. Just to be clear, I don’t think this is the right approach to take. One to two years is a long time.

Alternatively, we could just make everyone who travels here, Kiwis included, go into isolation for two weeks. Again, I’m not sure how well this would work in practice. My advice to everyone, even if you haven’t travelled, is to be on the lookout for any of the symptoms of Covid-19. If you have a fever, or a cough, or shortness of breath, stay away from other people if you can. If you’ve a runny nose or sore throat this could be a really mild form of Covid-19 so I would also isolate yourself.

Phase two – community transmission

The way Covid-19 is playing out globally, we are going to enter phase two at some point. This will happen when people who don’t realise they have contracted Covid-19 go about their daily lives rather than stay isolated. More and more cases will be reported each day as the virus transmits from person to person out in the community and outpaces our ability to keep up with the contact tracing. The quicker and higher the numbers rise, the more likely the outbreak will overwhelm us, making it harder to control.

The data so far suggests all of us are susceptible to the virus. It’s clear from what’s happened overseas that many people with Covid-19 spent many weeks being treated in hospital before they recovered. This isn’t a trivial disease. China built two new hospitals in a matter of weeks to keep up with demand. Do we have the resources to do that if it came to it?

Flattening the curve

Our aim will be to keep phase two of the epidemic curve as flat as possible, keeping the number of cases reported each day as low as we can. If we can achieve that, it’ll mean we’ll be able to treat everyone who needs treating. We can all help with this by washing our hands regularly, avoiding touching our mouth, nose, and eyes, and staying away from other people when we are sick. This also means calling ahead if you feel sick and want to go to the doctor or hospital. The last thing we need is loads of our healthcare workers in isolation because they’ve been exposed to Covid-19. Forty-five staff from North Shore Hospital have been isolated as a precaution because of a probable case.

Another thing we are all going to need to start doing soon is minimising or avoiding contact with other people. This is called social distancing. If you are greeting people, don’t hug, shake hands, hongi, or kiss. Bump elbows or feet instead. Work from home if you can. Much as it pains me to say it, social distancing also means avoiding public transport (get on your bicycle!). Similarly, it means avoiding gyms, churches, cinemas, concerts, and other events and places where people congregate. At the community level we may need to close schools, universities, museums, and workplaces, limit public transportation, and cancel public events. This is what China did so effectively and what Italy is currently implementing in some regions.

Read more

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Moving into phase three

We move into phase three when the outbreak is either brought under control or everyone has been infected and there are no more susceptible people left to infect. Vaccination is one way we can stop people being susceptible, or at least enough people that the disease stops spreading from person-to-person – that’s what herd immunity is all about.

Given we are one to two years away from a vaccine, bringing Covid-19 under control is obviously the goal here and what China has achieved. But if there are still susceptible people in a population and we stop taking all the right measures then we will see cases flare up again.

That’s why what happens on the global scale is so important. Any “fires” left blazing threaten us all. At the moment, many of the new cases being reported in China are people who have contracted the virus while travelling outside of China. They are essentially back in phase one but with all the understanding of why it’s so important to stay there. And all the expertise and public knowledge to make it happen.

While the coronavirus responsible for Covid-19 likely started out in bats, so far, it’s not clear how it got from bats to people. SARS jumped from bats to humans via civet cats. With SARS once we managed to stop all human-to-human transmission, the disease then ran its course in those infected, and we haven’t seen SARS since.

Hopefully, if we can stop all human-to-human transmission of Covid-19 that’ll be the end of this coronavirus too. But it’s clear that we’ll all have to play our part to make that a reality.

Read all Dr Siouxsie Wiles’ explainers on the Covid-19 outbreak here.

The idea of women late in pregnancy ‘nesting’ – preparing the home for the arrival of their newborn – is ingrained in popular culture and reinforced by health-care professionals, but in fact has no scientific basis.

We’ve been led to believe women have a biological urge to tidy, clean and prepare the home for their baby, just like mice, rabbits and pigs prepare their nests to provide a safe environment for their litters.

But a UK review of the evidence finds there’s no basis to the idea that women’s hormones drive them to nest. Instead, the researchers argue this is a myth that reinforces gender inequalities of who does housework. The myth also sets women up for a lifetime of tidying, cleaning and sorting.

The latest myth to be busted

This is the latest study to shatter our long-held expectation that women are biologically predisposed to do more care work.

First we were told women were better multi-taskers. But this was false. Then, we were told men can’t see mess. But that wasn’t true either. Now we are told women aren’t biologically disposed to nest.

So, what is happening here? It turns out all these myths about gender are just another way to get women to do the drudgery of housework.

The history of creating more work for women

This pattern is nothing new. The advent of the multi-burner stove meant cooking moved from single pot meals cooked over an open hearth to an elaborate range of multiple-course meals.

The result? More work for women.

The innovation of a washing machine, which allowed clothes to be washed mechanically, meant people expected clean underwear and socks every single day.

The result? More work for women.

Today, more women have a university education than ever before, surpassing men for the first time in history. More women are in paid work and hold more prestigious jobs than ever before. Yet they still shoulder the load when it comes to housework.

Why are we stuck in the past when so much has changed?

The challenge for women is that the gender revolution in housework that started in the 1970s has at best slowed and at worst stalled.

Men have increased their housework contributions and men and women today are more egalitarian, expecting to share domestic and economic chores more equally now than in the past. But even though women have made major strides in the labour force, they still can’t get their partners to share most of the household chores.

The reason: housework is drudgery. But someone has to do it to ensure the household functions. So, it gets dumped to those who have less power, have less time or are socialised into doing it.

The solution is structural

A lack of child care, parental leave and flexible work available to men freely and without consequence means these gender divisions when it comes to housework are structural.

Housework is also about time. The way global markets are structured, plus rising inequality, means investing time in employment is more highly valued than investing time at home.

So we need policy supports – parental leave that allows fathers to step in equally to mothers, childcare costs that don’t drain the family savings or flexible work and part-time work that is not relegated to mothers – to allow people more time to manage the home when the demand spikes.

In countries without these supports, like the United States and Australia, we see mothers carrying a larger share of this burden.

In countries where these policies are more generous, we see men and women sharing the domestic and economic load more equally.

So, what do we do in the meantime as we are waiting for governments and employers to catch up to the modern family?

We name and shame these myths that trap and entangle women through the guise of biology.

Leah Ruppanner is an Associate Professor of Sociology and Co-Director of The Policy Lab at the University of Melbourne. 

This article is republished from The Conversation under a Creative Commons license. Read the original article here.