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As fears over COVID-19 grow and health authorities worldwide urge or even force people to isolate themselves, “social distancing,” or shakai kyori senryaku in Japanese, has become a buzz phrase online.

But what does that really look like and what is the cost of the draconian restrictions that are being placed on citizens in some of the hardest-hit countries?

At its most basic level, social distancing refers to measures taken to increase the physical space between individuals in a bid to reduce the chance of transmission.

Authorities around the world are asking — and sometimes demanding — that citizens avoid public spaces, cancel large events and close stores. Japan, for its part, has closed schools and recommended telework or staggered commuting times to reduce rush-hour crowds. Professional baseball and soccer leagues have put their seasons on hold and sumo matches are being held without spectators.

Europe, in particular, has seen many countries shut down events and put a halt to day to day business. In a sign that the focus of the pandemic is shifting to the continent from Asia, World Health Organization chief Tedros Adhanom Ghebreyesus on Friday even labeled Europe “the epicenter” of the outbreak. Spain, Italy and France, where the virus is spreading fast, have ordered nonessential businesses to close.

And although Japan has not gone that far, it has sought to reduce mingling among the population.

In a bid to rein in the number of infections, Prime Minister Shinzo Abe requested late last month that elementary, junior high and high schools nationwide close starting March 2. Although some critics remain concerned about the social impact of the move and its effectiveness, others have called the decision “wise.”

Mitsuyoshi Urashima, professor at Jikei University School of Medicine in Tokyo, pointed to the risk of infections in children being missed, noting the possibility that those with mild symptoms are not seeing doctors.

In such cases, “it’s possible that children could unwittingly bring home the virus and pass it on to their family members,” Urashima wrote on the Forbes Japan website on Feb. 29. “From a crisis-management point of view, I think the closure of schools is an inevitable measure, as we have yet to grasp the full picture of the virus.”

Indeed, there have been few reports of children developing severe symptoms, according to the Japan Pediatric Society.

One result of the government’s active promotion of social-distancing measures has been the emergence of new types of “remote” socialization, including reports of people shunning bars and enjoying drinks with friends over video chat from the safety of their own homes.

A Japanese panel of experts on anti-coronavirus measures said March 9 that mass infections tend to occur in crowded, poorly ventilated spaces, where people have conversations in close range of one another. The experts urged the public to steer clear of such situations.

Lisa Sedger, who heads the Viruses and Cytokine Biology research group at the School of Life Sciences at the University of Technology Sydney, told The Japan Times that social distancing is “the best way to reduce infection rates in the current situation when we do not yet have proven anti-viral drugs or a vaccine.”

She said there have been examples of self-isolation and social distancing working in Asia, including in the Chinese city of Wuhan, where the outbreak began. She said the number of daily cases there had started to decline “after 14 days or so of harsh quarantine.”

Sedger contended that the benefits of social distancing outweigh the economic sacrifices in the long term, considering that it can save lives while reducing the costs to the health care system and the impact on business productivity because of “people being away from work due to illness.”

But what is the appropriate escalation and timing of social-distancing measures?

To get it right, Japan and other countries need to carefully calibrate their responses based on their monitoring of the outbreak, since the restrictions do have a “massive societal and economic cost,” according to professor Eyal Leshem, director of the Institute for Travel Medicine and Tropical Diseases at the Sheba Medical Center in Israel.

“It is critical,” Leshem said, “to collect and model these surveillance data in a conservative way and escalate social-distancing recommendations before the medical system is overwhelmed with critical patients.”

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