I’ve posted here twice before on my friend William Dale’s work in geriatric oncology, once on March 26th, and then again on April 3rd. In the second post, I took issue with William’s insistence on using the phrase “physical distancing” rather than “social distancing.” It’s not that I disagreed with him on the superiority of “physical distancing” over “social distancing”; “physical distancing” is obviously the superior term. But I worried that at that relatively early stage of the game, the change of terminology might dilute efforts at inducing people to engage in distancing. Better to have a single term and really hammer it home than change semantic horses in mid-stream.

This was, I suppose, less a disagreement than a recognition of the need for a division of labor: good cop and bad cop maybe, or nuance-maker and rhetorical bludgeon wielder. I think you can guess which one of us was playing which role. I’m increasingly convinced, however, that the time is right to make the move from “social distancing” to “physical distancing.” People are now familiar enough with the general idea that we can start introducing the nuance that William rightly advocates. Of course “start to make the move” is a bit misleading: without William’s tireless efforts at advocacy (and efforts like his), there would be no move to make. But over the last several weeks, I’ve gotten the sense that “physical distancing” has started to catch on, whether through William’s efforts, or that of other like-minded advocates and activists.

The turning point for me was hearing New Jersey’s Governor Phil Murphy using the two terms as synonyms during a press conference (unfortunately, I don’t remember exactly when).* This news item from about a month back nicely conveys the simultaneous use of both terms: it reports on violations of social distancing orders in New Jersey while using the term “physical distancing” in the title. If New Jerseyans can get the point despite the change in terminology, anyone can. The problem with the New Jerseyans who aren’t social distancing is no longer a matter of semantics or messaging; it’s the expression of a distinctive regional ethos. People here conduct themselves in public during a pandemic in the way that they drive: if recklessness and disrespect for the rights of others are a way of life in the one case, they’re bound to be so in the other. Another set of bad habits that will have to change if we’re to survive COVID-19.

With that background, here’s a clip from an interview William did a few days ago on ABC7 TV in the Los Angeles area–3.5 million people getting the message for 44 seconds. (The video was shot on a cell phone by his wife Tamra, watching at home. I’ll replace it once an “official” clip becomes available.)

And here’s an interview with William at Targeted Oncology, “Managing Risk of COVID-19 in Geriatric Patients with Cancer.”

A note on the term “social distancing”: I’m a social scientist, so I don’t like using the term “social distancing” because it can easily lead to social isolation, which is very dangerous for older adults. We have to do physical distancing, but it is equally important to maintain emotional connections. I continue to remind patients that physical distancing is important, but they need to have their support network in place. Their support system is the counterbalance to all the infection risk precautions that we’re telling people to take, which can lead to isolation. Their vulnerability is an important reminder to younger individuals who may be asymptomatic carriers that they should take steps, such as physical distancing and mask wearing, to not pass COVID-19 to older family members and friends. It is up to all of us to do this on their behalf, and they need to do even more to protect themselves.

There’s a lot to learn here about the integration of social and medical perspectives, but I’ll let the interview speak for itself.

*I just happened to attend a New York Academy of Sciences webinar in which two of the three speakers (Gabriel Leung and Vernon Lee) referred consistently to “physical distancing,” not “social distancing.” (I don’t think the third speaker, Jennifer Dowd, happened to use either phrase, but I’m not sure.) Leung’s presentation explicitly echoed some of the same themes as William’s on the need to integrate social and medical aims in responding to the pandemic. More on this webinar in a future post.