ADJUSTING TO LIFE IN A PANDEMIC



               A Guide to Staying Safe as  States Reopen

                                Can I eat at a restaurant? Can I go shopping? Can I hug my friends again?

                                                                                     Experts weigh in.

JOE PINSKER




May marks a new phase of the coronavirus pandemic in the United States. Across the country, retail stores, restaurants, and other businesses are beginning to reopen. According to the nonprofit Kaiser Family Foundation, just over half of states had eased their public-health restrictions in one way or another as of the start of this week, with more states to follow soon.

This new phase, though, doesn’t necessarily mean that the ongoing risks of the pandemic have materially changed. “If your favorite watering hole reopens, that’s not a guarantee that it’s safe to go have a beer with your friend,” Andrew Noymer, a public-health professor at UC Irvine, told me. “That’s one possible reason that it’s reopening, but another is that the pressures to reopen businesses have been so enormous.” He said that if the U.S. were solely concerned with containing the virus, “reopening shouldn’t even be in the conversation” yet.

That said, many (but not all) parts of the country have at least gotten out of an “acute emergency phase” for the time being, according to Elizabeth Carlton, a professor at the Colorado School of Public Health. She now sees “a shift towards trying to come up with strategies that allow people to resume some parts of their old lives that are the least risky … We need to find a way to slow the spread of the virus that also allows us to maintain our mental and financial health.” The safest thing to do, if you can manage it, is still to stay at home, but now is the time when—unlike the past six weeks or so—people in some parts of the country can consider cautiously reintroducing some nonessential activities into their life after weighing the risks to themselves and others.


Basic Precautions

SHOULD I STILL STAY AT LEAST SIX FEET AWAY FROM OTHER PEOPLE?

Yes. “Reopening does not mean we all get to be close together again, as hard as that is,” Carlton said.

But “six feet is not a magical distance beyond which everything is ‘safe,’” Marr added. “The farther, the better.”

Similarly, the baseline measures that reduce the risk of spreading the virus aren’t all of a sudden unnecessary. You should still wash your hands regularly and thoroughly, use hand sanitizer on the go, avoid touching your face, wear a mask, and stay home if you’re sick but don’t require medical care.

Even as political leaders send different messages about the danger posed by the coronavirus at any given time, it’s at least clear that this suite of precautions will remain important for a long time—probably until there’s a vaccine or enough people get infected by (and then recover from) the virus to achieve population-level immunity.

HOW CAN I KNOW IF RESTRICTIONS WHERE I LIVE ARE LOOSENING TOO SOON?

Ideally, individual people shouldn’t have to determine whether the restrictions in their area are safe and sensible. But here we are: Many states’ reopening plans don’t even meet the standards laid out in guidelines from the White House.

This means that in many cases, you’ll have to try to make an informed decision about what’s safest for you and others. Marr laid out the basic calculus: “It depends on your own health, your age, preexisting conditions, how much risk you’re willing to tolerate, and the benefit that the activity could provide to you.” Another crucial variable: how much risk you might be introducing for everyone else around you.

With all that in mind, people who are in at-risk groups “should exercise an additional level of caution right now,” Carlton advised.

If an outbreak in your area gets worse, local authorities would hopefully respond accordingly, perhaps restoring stay-at-home orders. Carlton said that the onus to interpret data about local flare-ups shouldn’t be on the individual, though Noymer and Marr noted that people can keep tabs on the numbers of local confirmed cases and deaths; if there’s a big percentage change in either of those numbers, it’d be good to ratchet up your cautiousness. That said, Marr pointed out, if the case count rises significantly, that doesn’t just mean you should start being more careful now—“that means you should’ve done it two weeks ago.”


Social Gatherings

CAN I VISIT MY FRIENDS AND FAMILY? AND CAN I GIVE THEM A HUG?

To the first question: Yes, but cautiously, while maintaining social distance. All three experts thought that it would be much safer to socialize outdoors—on patios, lawns, driveways, and so on. If you do choose to risk an indoor visit, Marr said it’s a good idea to open the windows and keep the space well ventilated.

Outdoor areas are generally safer than indoor ones because they have better ventilation, more direct sunlight, and more room for people to space themselves out—none of which completely shuts down the transmission of the virus, but all of which seem to reduce it.

Even during outdoor gatherings, it’s best not to get too close to anyone you don’t live with. “Across household boundaries, there should be six feet of distance,” Noymer said.

Sadly, this means no hugs. “There are so many friends I would love to hug right now, but it’s a no,” Carlton said.

CAN GRANDPARENTS SEE THEIR GRANDCHILDREN?

The idea of children being physically close to an older person they don’t live with made the three experts uneasy. “I know grandparents and grandchildren want to cuddle,” Marr said, but “I know I would feel horrible if we visited with grandparents and it turns out my kids ended up getting them sick, and then they died.”

So the answers are maybe and only really carefully. It’d be prudent for grandparents to stay at least six feet away from grandkids, and for visits to take place outdoors. Making exceptions to those guidelines is riskier when older adults are involved than it is with people who aren’t especially vulnerable to COVID-19.

CAN I GO ON A WALK OR HAVE A PICNIC WITH A FRIEND?

“Going for a walk with a friend in a park is probably better than hanging out in your friend’s living room,” Noymer said. Even though being outdoors is generally safer, the usual caveats apply: Don’t get as physically close as you usually would, and wear a mask.

For picnics, bring your own blanket and food—“not because food is a source of transmission,” Carlton said, “but because you [don’t want to] be touching the same items.”

Noymer and Carlton recommended keeping a six-foot distance during walks, though Marr thought being a little closer would be okay, so long as you’re walking side by side and not constantly turning to face each other.

HOW BIG OF A GATHERING CAN I HAVE?

This still isn’t the time to throw a house party, Marr advises. She thinks 10 or so people seems like a good cap for the number of people who can participate in an outdoor gathering (six feet apart, of course).

“I think more in terms of density than absolute number,” Noymer said. People should be physically spaced out, so the number also depends on the size of the space you’re meeting up in.

CAN I ATTEND A RELIGIOUS SERVICE?

“Going to a crowded church, temple, mosque, or whatever is not a great idea right now,” Carlton said. She was particularly concerned about the risks to any older attendees, and recommended finding a safer way to congregate than gathering in close quarters indoors.

Virtual services seem most prudent, but Marr thought that spaced-out, outdoor services would be okay. But she cautioned that singing might come with a higher risk of spreading the virus than talking does. Religious services “probably raise my concern more than many other things we’ve talked about, because of the singing,” she said.

CAN I EXPAND THE “BUBBLE” OF PEOPLE I INTERACT WITH CLOSELY?

It’s much safer not to, but, depending on your tolerance for risk and your need for social contact, you could consider it. The safest bubble, of course, is one that only includes you, but the people you live with are your de facto bubble-mates—meaning you get closer than six feet to one another, spend time indoors together, and break other rules that apply to interactions during a pandemic—and that’s fine.

“Part of the stay-at-home guidelines was essentially, ‘Your bubble should be your household,’” Carlton said, “and what we’re potentially shifting to is, ‘If you’re an extremely small household and really struggling with social isolation, it may be okay for you to have closer contact with a limited number of individuals.’” Restricting your bubble to just your household is still ideal, but Carlton said it’s “probably not terrible” to carefully incorporate very limited others.

Keep in mind that each person you add to your bubble brings not only their own risks, but the risks of everyone else they may be exposed to. So if you do add people to your bubble, choose them cautiously—but better to leave your bubble as is, if you can bear to.

IF I GO ON A DATE, CAN I GET CLOSER THAN SIX FEET FROM THE OTHER PERSON?

You probably shouldn’t. “If you want to kiss somebody at the end of the date, that’s inadvisable—sorry,” Carlton said. She and the other experts recommended staying a sensible distance apart on a first date. If you eventually end up starting a relationship, you’ll have to figure out when you’re comfortable becoming a part of each other’s bubbles.

A woman runs past a set bistro table outside a restaurant amid the novel coronavirus pandemic in Atlanta, Georgia, on April 27, 2020. Some Georgia restaurants reopened on April 27 for limited dine-in service as the state loosened more coronavirus restrictions. (Chandan Khanna / AFP / Getty)

                                                                                             

Dining, Shopping, and Services

CAN I EAT AT A RESTAURANT?

Probably, as long as the tables are sufficiently spaced out and the workers wear masks. Even better if the restaurant has outdoor seating.

You should wear a mask when you go, though of course you’ll have to remove it when you eat, and a restaurant with a bunch of customers not covering their faces is not ideal. “This isn’t a zero-risk scenario and high-risk populations should proceed with caution,” Carlton said. Moreover, the risks to restaurant workers are higher than those to diners, mainly because workers spend more time on the job than diners do eating.

With that in mind, it’s probably good to reflect on whether the enjoyment of being in a restaurant truly outweighs the risk to yourself and others. After all, you can still get restaurant food and support local businesses with far less risk by getting takeout or delivery instead. Whatever you choose, leave a generous tip if you’re able to.

CAN I GO SHOPPING?

Shopping for essentials like groceries and medication has been allowed over the past couple months, and as more stores reopen, the same guidelines for safe shopping apply: Wear a mask, go somewhere else if a store or mall is crowded, and turn around if the air in a space feels stuffy.

If you follow those guidelines, the risks of shopping aren’t exceptionally high, but, like with restaurants, the upside to doing it on the premises doesn’t seem worth much risk at all. Curbside pickup, a service many stores are starting to offer, is safer for all involved.

CAN I GET A HAIRCUT?

Cautiously. Since haircuts mean close physical contact and often conversation, there are real risks here. If you choose to go, both the haircutter and the haircuttee should wear a mask, though you may have to remove yours temporarily if the elastic is in the way of the scissors. (Marr says it’s fine to keep up the banter while wearing a face covering.) While you won’t be able to keep six feet between you and the person cutting your hair, it’s important that other people in your vicinity aren’t any closer than that. (Also, I’d add, tip well if you can afford to.)

All that said, people will probably be understanding if you just grow your hair out or do a so-so job lopping it off yourself. Less chic, but less risky.

CAN I GO TO THE DENTIST?

If you have an urgent dental problem, yes. If you have a routine cleaning coming up, that’s a tougher call. The experts were not thrilled about the fact that patients can’t wear a mask while someone is fiddling around with their mouth, but had confidence in dentists’ procedures for minimizing the risk of infections of any kind. This one seems like it could go either way, so perhaps the deciding factor is how long you’re comfortable postponing your cleaning.


Work & Travel                                                                        

IS IT SAFE TO GO BACK TO WORK IF MY WORKPLACE IS REOPENING?

This is tough to answer comprehensively, because it has to do with the specific conditions of your workplace. But the three experts suggested a number of things to look out for as indicators of safety.

In general, Carlton said, you want to be able to maintain distance on the job, and should be wary of any employer who seems to be okay with pre-pandemic levels of crowding. Workplaces are also safer if everyone is wearing a mask and if there is a sick-leave policy in place that encourages workers who have symptoms to stay home. It’s encouraging if your local government has provided specific guidelines for how businesses can safely operate; you can consult those to see how your workplace’s practices compare. Lastly, Carlton recommends that people in at-risk groups have conversations with their employer and their doctor about whether it’s safe for them to return to work.

Marr said that factories will be safer if workers can keep distance between them and if they all wear masks. In offices, desks shouldn’t be close together, barriers between desks are helpful, close interactions should be kept to a minimum, and having your own office is safer.

The idea of working as a restaurant server right now gave Noymer pause. “I’m not going to give you a guarantee that it’s safe to go back to work in a job like that, even though I may give a qualified yes on the question of whether it’s safe to go as a diner,” he said.

But the experts suggested a handful of restaurant-specific tips: Have people write down their orders to cut down on face-to-face interaction with staff, make sure everyone on staff is regularly washing their hands (especially after clearing dirty dishes), and don’t transfer condiments from one table to another.

CAN I USE PUBLIC TRANSIT?

“I would use public transit if it’s the only available option to get from point A to point B,” Carlton said. “If you're able not to use public transit, you're in some ways making it safer for those who need to use it.”

The experts were in agreement that if you do get on a subway or bus, you should wear a mask, distance yourself from others, and use hand sanitizer when you disembark. But driving in a car is safer than public transit when it comes to the risk of exposure.

CAN I DRIVE OR FLY TO OTHER CITIES?

If you urgently need to go somewhere, perhaps to see a loved one who’s dying, then by all means go. If you can drive, that’s probably safer than flying, because it’ll expose you to fewer other people.

That said, airlines have started requiring passengers to cover their face, and “if everyone's wearing masks, I would feel much more comfortable,” Marr said. Planes don’t seem to be so much riskier than cars that you should necessarily drive 12 hours instead of taking a 90-minute flight. (And besides, Noymer noted, on a long drive you’d probably need to stop for food, restrooms, and probably gas, which present more opportunities for exposure.)

If you don’t have to leave your current location, though, you should stay put. “This isn't the summer to get too far away from your home-base radius,” Noymer said. There’s a risk that you’d catch the virus if you went somewhere else, just as there’s a risk that you’d spread it. Moreover, if you do have to go to the hospital (for whatever reason) during a pandemic, you probably would want to navigate a health system that you’re familiar with instead of one in another area.

Carlton recommended a simpler kind of trip for those hoping to get away this summer. “There's nothing wrong with getting in your car, driving someplace beautiful [nearby], and going for a hike, as long as there aren't a lot of people around,” she said.

                                                                                                                                                                     

Recreation

CAN I GO TO A BEACH, LAKE, OR POOL?

Yes, but only if you’re able to keep your distance from everyone else there, both in and out of the water.

None of the three experts were concerned that water could carry the virus and get someone infected—the risk comes simply from being near other people. “I don't see it being any more hazardous than being close to someone out of the water,” Marr said.

“Probably the places to worry about most are less on the beach itself than the places where people cluster,” Carlton said, noting that distance may be harder to maintain at public bathrooms or ice cream trucks. (Pools, too, can get crowded easily.)

CAN I GO TO THE MOVIES?

If the theater is at all crowded, that’s dangerous, given that moviegoers sit in an enclosed room for an extended period of time. Consider going to a drive-in if there’s one in your area, Marr suggested. If you do choose to go to an indoor theater, choose one that is generously spacing out its seating, and wear a mask.

Relatedly, all three experts advised against going to indoor concerts. Noymer was open to the idea of outdoor shows with proper spacing between audience members.

CAN I TAKE MY KIDS TO A PLAYGROUND?

The experts were divided on this one. Carlton said this was “not a great idea,” given that children are quite bad at distancing and that playground structures are large, constantly-touched surfaces.

Marr and Noymer were less concerned, but recommended having kids wear a mask, gently breaking up any extended up-close conversations with other children, and washing their hands afterward.

CAN I SEND MY KIDS TO SUMMER CAMP?

This was another question without a consensus answer.

Marr said that she feels okay about day camp if kids will be spending a good deal of time outside and if any room they’ll be in won’t be unduly crowded. “I would be hesitant about overnight camp because of the close sleeping and eating quarters,” she said.

Noymer said he’s “not super comfortable with summer camp,” whether overnight or not. “If I had a kid, I would want to keep my eye on her this summer.” He added that households in which someone is in an at-risk group might want to be extra cautious about this, because a child could bring the virus back home with them.

Carlton didn’t feel like there’s enough information yet about how the virus spreads among children to weigh in definitively.

These concerns foreshadow the uncertainties people will have about sending their children back to school whenever classes resume. Carlton said that hopefully, after more research is done, there’ll be a clearer answer to questions like these in the coming months.

WHAT CHOICES ARE THESE EXPERTS MAKING THEMSELVES?

As the three experts answered these questions, they occasionally mentioned what they’re planning to do themselves.

Marr’s plans for her summer indicate how she’s weighing various risks. First, she’s currently comfortable sending her kids to camp if it’s open. Second, her family is plotting a trip from Virginia, where they live, to Montana; they’re considering renting an RV so that they don’t have to fly or stay in hotels. And third, Marr has a ticket she booked pre-pandemic for a flight in late June to visit family and she said she might actually go. A few weeks ago, she thought she definitely wasn’t going to, but she’s open to it now that her fellow passengers may all be required to wear a mask.

Carlton and Noymer’s cautiousness is illustrative too. Carlton, for example, said she’s putting off haircuts and dentist appointments till it’s safer to go. “I’m scrubbing my son's teeth with extra vigor every night,” she said.

Noymer, likewise, said he’s being relatively conservative. “Part of it is that seeing my friend in person as opposed to seeing them on a video call is not the hill I want to die on,” he said.

Another part of it is how he thinks about the evolution of the treatment of COVID-19. "As more and more people have this thing, doctors will get better and better at figuring out what works and what doesn’t—trial and error is an amazing process for honing procedures,” he said. “I trust them to slowly but surely figure out what works in most cases, and so I feel like if I could get COVID a year from now, I'll receive a more refined course of treatment than if I get it today. … I just feel like, the later, the better.” (This logic also contributes to an argument for doing all you can not to infect others right now.)

That doesn’t mean Noymer is completely sealing himself off from the world—he still goes out to get groceries, he recently brought his car in to replace a flat tire, and he figures he’ll get a haircut eventually. But it does mean he’s erring on the side of staying in. “You won’t find me at the beach,” he said.












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