Process for reopening complicated
Detailed directives scarce since there is ‘no playbook’
When the country was largely under lockdown, at least the rules were mostly clear.
Essential workers ventured out; everyone else sheltered in. Bars and restaurants were closed except for dining out; hair salons and spas were shuttered. Outings were limited to the supermarket or drugstore.
Now states are lifting restrictions, but detailed guidance about navigating the minutiae of everyday life is still hard to come by — and there’s never going to be a ready solution to every problematic circumstance you may encounter.
“Ramping down was easy by c o mp a r i s o n , eve n though it felt hard at the time,” said Dr. Preeti Malani, an infectious disease expert who is chief health officer for the University of Michigan. “We basically flipped a switch.
“Reopening is much more complicated. There is no template, no playbook. We can’t just say, ‘ Follow these 10 rules, and you’re good.’ ”
Even in the absence of detailed directives, however, there’s scientific consensus about a general approach that can reduce the spread of the virus as the world around you reopens.
As you tiptoe toward normalization — whatever that is, given these times — try to follow three precautions: avoid contact, confinement and crowds. And make realistic choices.
You need to continue with social distancing. That means wearing masks, washing hands well and often, and keeping a distance of at least 6 feet from one another. No hugs, at
Contact:
least not in the usual way, and no handshakes.
Try to make sure that public spaces you frequent are maintaining mitigation measures: spreading out tables at a restaurant, limiting or spacing out patrons in shops and parks, and conducting frequent cleaning and disinfection. The virus is spread most efficiently from person to person, but the Centers for Disease Control and Prevention nonetheless recommends frequent cleaning of hightouch objects and surfaces such as tables, doorknobs, light switches, countertops, handles, phones, keyboards, toilets and faucets, ATMs and gas pump handles.
Any 15-minute face-toface conversation between people who are within 6 feet of each other constitutes close contact, said Dr. Muge Cevik, an expert on infectious diseases and virology at the University of St. Andrews School of Medicine in Scotland.
The longer the conversation and the closer the physical proximity between the participants, the greater the risk of the virus spreading if one person is infected.
Indoor activities in confined enclosed spaces, even large ones, are more conducive to spreading the virus than events held outside, especially if the air inside the building is being recirculated or the windows don’t open.
Many infections have been traced to public transportation vehicles such as buses and vans. Some experts have raised questions about the safety of enclosed public spaces, such as office buildings, indoor restaurants and nightclubs.
“When there’s stagnant air, the droplets could persist longer than you would expect, and there will be a lot of contamination on surfaces,” Cevik said.
Confinement:
A flow of fresh air dilutes the virus, she added.
In recent guidance to businesses that are reopening, the CDC told employers they must make sure ventilation systems are working properly and take steps to maximize the circulation of outdoor air by opening windows and doors and using fans.
Large groups are risky no matter where they are gathered. Even outdoors, crowds mean more people, more contacts — and more potential sources of infection. And ultimately, preventing infection is a numbers game, where less is more.
“It’s a really different way of thinking that most people in the world aren’t used to,” said Dr. Barbara Taylor, an infectious disease specialist at the University of Texas Health Science Center at San Antonio.
“It’s all math.”
Crowds:
Many bars in Texas are outside, she noted, and are therefore relatively low risk. But the number of patrons in a space still matters.
“You can create a scenario where you have everybody 6 feet apart, but if that scenario involves 500 people, that is inherently more risky than if that same scenario involves 30 people,” Taylor said. “There’s more potential for one of those 500 people to have COVID-19 and be spreading it.”
Another concern about drinking holes: As people become inebriated, they let their guard down and lose their inhibitions.
The CDC ranks dining options from lowest- to highest-risk situations. The lowest risk is a drive-thru, delivery, takeout or curbside pickup of food. Restaurants with the highest risk have indoor and outdoor seating with no additional spacing between tables.
Every individual ultimately must make a personal decision about the level of risk he or she is comfortable with, weighing their own age and health status, life circumstances and general level of risk aversion or tolerance.
People at high risk for developing severe disease if they become infected with the coronavirus will want to take the greatest of precautions. That group includes those 65 and older; residents of nursing homes and long-term care facilities; and people with compromised immune systems, with chronic lung or kidney disease or heart conditions, or who are severely obese.
But young, healthy adults and children should also consider the protection of people around them, including family members, colleagues or friends who are vulnerable because of chronic disease or other life circumstances, Taylor said.
Choices: