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    <p>A forward message from Dr. Benedict McWhirter with a reminder of
      why social distancing is so critical. <br>
    </p>
    <div class="moz-forward-container">Hope you all are doing well. <br>
      <br>
      -------- Forwarded Message --------<br>
      <br>
      
      Greetings all. 
      <div>Betsy Meredith used to be our Lane County Director of public
        health. She got us through the H1N1 epidemic a few years ago. </div>
      <div>I thought you’d like the science of this. </div>
      <div>Benedict </div>
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                    <div dir="ltr" class="gmail_attr">----------
                      Forwarded message ------<br>
                      From: <strong class="gmail_sendername" dir="auto">Betsy
                        Meredith</strong></div>
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                      <div style="font-size:12pt;font-family:helvetica,arial,sans-serif;color:#333333">I
                        hope you are all well, not going stir crazy, and
                        finding ways to sing and give praise during this
                        challenging time.  This is a little public
                        health update that is specific to those of us in
                        choirs and for any and all who are missing the
                        camaraderie of gathering with others outside our
                        immediate family.</div>
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                      <div style="font-size:12pt;font-family:helvetica,arial,sans-serif;color:#333333"><a href="https://urldefense.com/v3/__https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak__;!!C5qS4YX3!SSHxfuzaB1V-CiRkM8zaH5QZ0Z1dO8knEqqdhvGfcRAwLZSzt4Wd2w4aRksc3oR2cg$" target="_blank" moz-do-not-send="true">https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak</a>
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                      <div style="font-size:12pt;font-family:helvetica,arial,sans-serif;color:#333333">I've
                        also copied some information and advice that
                        helps to keep perspective on the measurable
                        importance of this prolonged social
                        distancing.  
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                        <div>This is a statement from an epidemiologist
                          at Dartmouth Hitchcock Medical Center.  (I
                          added the bold to a few of the key statements
                          and important visuals)
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                        <div>Please share widely. </div>
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                        <div>* * * </div>
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                        <div><span style="color:rgb(0,0,128)"><em>Hey
                              everybody, as an infectious disease
                              epidemiologist, at this point feel morally
                              obligated to provide some information on
                              what we are seeing from a transmission
                              dynamic perspective and how they apply to
                              the social distancing measures. Like any
                              good scientist I have noticed two things
                              that are either not articulated or not
                              present in the "literature" of social
                              media.</em></span>
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                        <div><span style="color:rgb(0,0,128)"><em>Specifically,
                              I want to make two aspects of these
                              measures very clear and unambiguous.</em></span>
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                        <div><span style="color:rgb(0,0,128)"><em>First,
                              we are in the very infancy of this
                              epidemic's trajectory. That means even
                              with these measures we will see cases and
                              deaths continue to rise globally,
                              nationally, and in our own communities in
                              the coming weeks. Our hospitals will be
                              overwhelmed, and people will die that
                              didn't have to. This may lead some people
                              to think that the social distancing
                              measures are not working. They are. They
                              may feel futile. They aren't. You will
                              feel discouraged. You should. This is
                              normal in chaos. But this is also normal
                              epidemic trajectory. Stay calm. This enemy
                              that we are facing is very good at what it
                              does; we are not failing. We need everyone
                              to hold the line as the epidemic
                              inevitably gets worse. This is not my
                              opinion; this is the unforgiving math of
                              epidemics for which I and my colleagues
                              have dedicated our lives to understanding
                              with great nuance, and this disease is no
                              exception. We know what will happen; I
                              want to help the community brace for this
                              impact. Stay strong and with solidarity
                              knowing with absolute certainty that what
                              you are doing is saving lives, even as
                              people begin getting sick and dying. You
                              may feel like giving in. Don't. Second,
                              although social distancing measures have
                              been (at least temporarily) well-received,
                              there is an obvious-but-overlooked
                              phenomenon when considering groups (i.e.
                              families) in transmission dynamics. While
                              social distancing decreases contact with
                              members of society, it of course increases
                              your contacts with group (i.e. family)
                              members. This small and obvious fact has
                              surprisingly profound implications on
                              disease transmission dynamics. Study after
                              study demonstrates that even if there is
                              only a little bit of connection between
                              groups (i.e. social dinners,
                              playdates/playgrounds, etc.), the epidemic
                              trajectory isn't much different than if
                              there was no measure in place. The same
                              underlying fundamentals of disease
                              transmission apply, and the result is that
                              the community is left with all of the
                              social and economic disruption but very
                              little public health benefit. You should
                              perceive your entire family to function as
                              a single individual unit; if one person
                              puts themselves at risk, everyone in the
                              unit is at risk. Seemingly small social
                              chains get large and complex with alarming
                              speed. I<strong>f your son visits his
                                girlfriend, and you later sneak over for
                                coffee with a neighbor, your neighbor is
                                now connected to the infected office
                                worker that your son's girlfriend's
                                mother shook hands with. This sounds
                                silly, it's not. This is not a joke or a
                                hypothetical. We as epidemiologists see
                                it borne out in the data time and time
                                again</strong> and no one listens. <strong>
                                Conversely, any break in that chain
                                breaks disease transmission along that
                                chain.</strong></em></span>
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                        <div><span style="color:rgb(0,0,128)"><em>In
                              contrast to hand-washing and other
                              personal measures, social distancing
                              measures are not about individuals, they
                              are about societies working in unison.
                              These measures also take a long time to
                              see the results.
                              <strong>It is hard (even for me) to
                                conceptualize how 'one quick little get
                                together' can undermine the entire
                                framework of a public health
                                intervention, but it does. I promise you
                                it does. I promise. I promise. I
                                promise. You can't cheat it. People are
                                already itching to cheat on the social
                                distancing precautions just a "little"-
                                a playdate, a haircut, or picking up a
                                needless item at the store, etc. From a
                                transmission dynamics standpoint, this
                                very quickly recreates a highly
                                connected social network that undermines
                                all of the work the community has done
                                so far.</strong></em></span> </div>
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                        <div><span style="color:rgb(0,0,128)"><em>Until
                              we get a viable vaccine this unprecedented
                              outbreak will not be overcome in grand,
                              sweeping gesture, rather only by the
                              collection of individual choices our
                              community makes in the coming months. This
                              virus is unforgiving to unwise choices.</em></span>
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                        <div><span style="color:rgb(0,0,128)"><em>My
                              goal in writing this is to prevent
                              communities from getting 'sucker-punched'
                              by what the epidemiological community
                              knows will happen in the coming weeks. It
                              will be easy to be drawn to the idea that
                              what we are doing isn't working and become
                              paralyzed by fear, or to 'cheat' a little
                              bit in the coming weeks. By knowing what
                              to expect, and knowing the importance of
                              maintaining these measures, my hope is to
                              encourage continued community spirit,
                              strategizing, and action to persevere in
                              this time of uncertainty.</em></span> <span style="color:rgb(0,0,128)">
                            <em></em></span></div>
                        <div><span style="color:rgb(0,0,128)"><em><br>
                            </em></span></div>
                        <div><span style="color:rgb(51,51,51)">**************************</span>
                        </div>
                        <div><span style="color:rgb(51,51,51)">One thing
                            I am grateful for at this time is the way
                            people are reaching out to one another -
                            especially virtually.  Who knew a Zoom
                            account was an essential?!</span>
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                        <div><span style="color:rgb(51,51,51)"><br>
                          </span></div>
                        <div><span style="color:rgb(51,51,51)">Sending
                            love and prayers for all</span></div>
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                        <div><span style="color:rgb(51,51,51)"><br>
                          </span></div>
                        <div><span style="color:rgb(51,51,51)">Betsy
                            Meredith</span> </div>
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                          </span></div>
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                          </span></div>
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                          </span></div>
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                            </em></span></div>
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                -- <br>
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                  <div dir="ltr"><span style="font-family:garamond,serif">___________________________________<br>
                      Benedict T. McWhirter, Ph.D.</span></div>
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