Below is published CDC email dated June 1st, 2018, acknowledging my research paper titled, “Social Distance: Homonym for Prejudice and Pandemic Mitigation”

Dear Mr. Guy:

Thank you for sharing your in-depth and well-researched paper on the use of the term “social distance” from a sociology perspective and on the use of the term “social distancing” from a public health perspective as it pertains to pandemic influenza (flu) community mitigation and non-pharmaceutical interventions (NPIs).

CDC appreciates that, through your extensive literature search, you have highlighted that the terms “social distance” and “social distancing” have different meanings given the discipline, context, and circumstance in which they are used. As you discovered in your research, navigating the landscape between recommended public health measures during flu pandemics and their legal, moral, and ethical implications for community settings has always been important to the practice of public health. More information about social distancing measures for schools, workplaces, and mass (large) gatherings – the evidence base, implementation issues, and research gaps – can be found on pages 31-36 in Chapter 3 in Technical Report 1 (https://stacks.cdc.gov/view/cdc/44313) that supplements the Department of Health and Human Services (HHS)/CDC Community Mitigation Guidelines to Prevent Pandemic Influenza – United States, 2017.

As you have seen, the 2017 guidelines include CDC recommendations on the use of NPIs at all times and during flu pandemics. NPIs that CDC recommends at all times and in all settings include: staying home when sick; covering coughs and sneezes with a tissue; washing hands often with soap and water; and routine cleaning of frequently touched surfaces and objects. NPIs that CDC might recommend for use during (severe, very severe, or extreme) flu pandemics include: staying home if exposed to a sick household member; using a face mask when sick and out in crowded community settings; implementing preemptive, coordinated school dismissals early in a pandemic; limiting face-to-face contact in schools and workplaces to help reduce person-to-person transmission; and modifying, postponing, or cancelling mass gatherings.

As you well-documented, the concept of “social distancing” as a public health measure began at least in the early 1900s with the advent of the 1918 flu pandemic and, over the years, it has become a commonly used and accepted term in the public health and emergency preparedness and response communities, including in national and international frameworks, guidelines, and action plans. The underpinning of this strategy is to ensure physical distancing between sick persons and well persons to slow down the transmission of disease. Because persons who are sick with influenza may be contagious just prior to exhibiting symptoms and when symptomatic, these measures may be used during a severe pandemic as part of a suite of strategies to mitigate the spread and impact of the pandemic. As such, CDC will continue to affirm the importance of pre-pandemic planning and preparedness for the early and simultaneous implementation of multiple NPIs, including potentially social distancing, during a pandemic response to help reduce flu transmission in community settings.

Over the last 100 years, 4 flu pandemics have occurred – in 1918, 1957, 1968, and 2009 – and they killed close to 1 million people in the United States alone. This year, CDC and many national and international public health organizations are commemorating the 100-year anniversary of the 1918 flu pandemic and the lessons learned for pandemic flu planning, preparedness, and response (https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/index.htm). One important lesson learned is that community mitigation measures and NPIs, like social distancing, can help slow the spread and reduce the impact of pandemic flu in community settings.

Thank you for your sincere interest in and commitment to public health. If you have additional questions, please contact CDC INFO at 800-CDC-INFO (800-232-4636), TTY: 888-232-6348 or via email.

Center for State, Tribal, Local, and Territorial Support (proposed)