The new coronavirus has forced most of us to shut down our public lives. In response to this dangerous virus, staples of our society like schools, libraries, retail stores, and restaurants shuttered to varying degrees. Then, in mid-April, the U.S. government released its recommendations for a phased reopening of the public sphere. Local governments are in charge of implementing their reopenings based on factors like the availability of testing, how crowded hospitals are, and whether COVID-19 cases are steadily going down. But starting to reopen doesn’t automatically mean the state in question has a firm grip on the new coronavirus. States like Texas are continuing to roll out their reopenings despite a rise in COVID-19 cases and hospitalizations, for instance.
A lack of cohesive messaging across the country has left many wondering just how risky it is to do things that seemed so basic mere months ago. If grocery shopping is okay, does that mean retail shopping is low-risk? If restaurants are opening, is it really safe to go back? Can we enjoy the beach this summer or not? Please, someone, just tell us what to do!
How are health experts thinking about risk right now?
While a clear-cut answer would be nice, the truth is that some behaviors are riskier than others.
To get clarity on some of the most common questions people have about what is and isn’t safe right now, SELF contacted three health experts to weigh the risks of different scenarios: Eleanor J. Murray, Sc.D., assistant professor of epidemiology at Boston University School of Public Health, Tara C. Smith, Ph.D., professor of epidemiology at the Kent State University College of Public Health, and Brandon Brown, M.P.H., Ph.D., an epidemiologist and associate professor in the Department of Social Medicine, Population, and Public Health at the University of California, Riverside. (Responses have been edited for clarity and length.)
SELF: How risky is it to go shopping right now, whether it’s grocery or retail?
Tara C. Smith: It depends on the area. What we’re seeing is basically a patchwork of outbreaks across the United States. Your risk of going shopping in rural Montana is likely going to be a lot less than your risk in New York City. So it’s dependent on what your current area is seeing with cases and how well you can trust those numbers—if they’re doing a lot of testing or not—and what local ordinances are. As the pandemic has evolved, it seems that transmission from inanimate objects, like touching your groceries, is probably pretty low risk. Wash your hands after you’re done touching everything. It’s easy to do and it lowers your risk of getting the virus.
Eleanor J. Murray: If you’re going clothes shopping, then you might want to minimize the amount of clothing you try on. Do you just know your size? Can you wash clothes after buying them but before wearing them? (Though the virus doesn’t seem to last that long on fabric.) It’s probably better to frequent a smaller retailer that doesn’t have as many people coming in because there will be fewer people, and fewer people touching the objects. If it’s crowded, that would be a lot of potential for contamination.
Brandon Brown: While shopping malls are now open, I will not go yet myself for any nonessentials in case we see a second wave of infection due to easing restrictions. Groceries, on the other hand, are essential for living, and many grocery stores still enforce wearing masks and keeping a physical distance both inside and outside, including limitations on how many people can be inside at one time.
How risky is eating at a restaurant? How can people mitigate that risk?
Smith: Restaurants are relatively high-risk. Outdoors, maybe a little less so, especially if they’re doing spacing between tables and there’s good airflow outside to reduce the level of virus you might be exposed to.
Murray: Across the board, outside is better than inside. That’s the message for summer. In some places, it gets so hot that outside is really uncomfortable and people are going to want to go back inside. Usually, people spend at least an hour at a restaurant, so that’s a lot of time to be exposed to particles that are potentially coming from somebody near you. There’s also worry that air conditioning systems might help to spread the virus indoors. You want to be looking for restaurants that are not just doing the minimum. Not just putting tables six feet apart, but maybe 10 feet or 12 feet.
Brown: Takeout or delivery from a restaurant has lower risk than eating in. Eating in a restaurant is risky. We cannot control the physical distancing of others. The server may be exposed to COVID-19 by one customer and then subsequently inadvertently spread it to other people. We touch items that others also touch: menus, cups and dishes, utensils, tables, and chairs. By definition, if we are eating, we cannot wear masks. We cannot decrease this risk to zero, but disinfection between customers is key. Employees should be provided with effective masks and gloves, have paid leave available if they are sick, and be provided with protection if they take public transportation to and from work. Hand sanitizer can be made available to guests, as well as temperature checks.
What about who you’re at a restaurant with—is it safer to only go out to eat with people from your household (if you live with others), versus people outside of it?
Murray: Unless you’re at a restaurant where the table itself can seat you and your friends at least six feet apart, you probably want to just stick with your household members.
Smith: The risk increases if you’re bringing in people you haven’t been with versus people in your household. You’re not going to be masking up the whole time, you’re going to have to take them off to eat and talk and things like that.
What would you be looking for in terms of restaurant crowding?
Murray: If you go to a restaurant and it looks like it might be a little crowded, turn around and go somewhere else. If you’re in a restaurant and it starts to get crowded, the best thing you can do for yourself is say, “I need to leave now,” pay your check, and go. We know that the risk is not just about physical proximity, it’s about the time spent in physical proximity. So if it starts to look crowded, you’re better off leaving sooner rather than later.
Smith:It may depend on local ordinances. In theory, restaurants should be less crowded anyway, but I don’t know what they’re doing about group gatherings or people waiting for a table. There could be potential for the virus to be transmitted in lots of other restaurant areas besides sitting at the table.
How risky is going to an outdoor area like a beach?
Brown: This depends. If you go to the beach on a holiday weekend with perfect weather, you can expect it to be crowded with little room for physical distancing.
Smith: Even if you’re outside, still try to stay away from other groups of people as much as possible. If I were going to be around a bunch of people, I’d still want to be wearing a mask. In windy conditions, the air would in theory disperse the virus, but if you have a lot of crowding on a particular beach and you have someone who is infected and shedding the virus, that could possibly spread the virus to people who are downwind. I don’t think we have any great data on that yet.
How risky is going to someone’s house or having people over at your house?
Brown: At this time, I would consider having friends and family from outside your home coming inside to be risky, even with masks. Unless everyone has been tested, we do not know who could be harboring infection, and even if there are no symptoms, we can spread the virus. When you invite someone inside, it may be more difficult to keep a physical distance in rooms, hallways, etc. Another issue is that when inside, people are often touching surfaces (doorknobs, tables, chairs), so this can lead to potential transmission from someone who has the virus. So the backyard (if you have one) is a safer space to have guests compared to inside.
Smith: Bathrooms are potentially an issue too. We do know that the virus can live in stool. Presuming it would be aerosolized if someone flushed, it could be on different bathroom surfaces. We don’t really know how long that would live there, but you’d want to go into any bathroom assuming potential for contamination. Wash your hands really well, which hopefully you’d be doing anyway.
Murray: It’s about how much space you have and how much you trust those people in terms of their ability to respect your personal risk tolerance. And do you respect their tolerance? If it’s not somebody who you can tell, “Please don’t do that, it’s too risky for me,” they probably shouldn’t be coming into your space. We’re not going to see the full impact of places opening up and whether it was a good or bad decision for probably a month. You want to really start slowly. Start with something like having people over to sit in your backyard in a spaced out place or meet in a park. Gradually, as you see what’s happening in your state over the next several weeks and months, then maybe start stepping up the types of interactions you’re having.
Even if you engage in one risky behavior, that doesn’t mean it’s safe to loosen other social distancing measures.
Both Murray and Smith stress that every time you come into contact with someone, loved ones and strangers included, you’re also coming into a sort of extended contact with everyone else that person has seen in recent weeks. You’re potentially exposed to the virus from every person who’s stepped too close to your server or your cashier recently as well as whoever your friend gave a quick hug to before meeting up with you. “Our risk does increase as we bring in people who have larger networks because they are more likely to be exposed to someone who may be incubating the virus,” Smith says. The reverse is also true: The more you start to see people, the more you’re exposing each of them to possible transmission from the other people you’ve seen. States reopening various businesses and allowing certain activities doesn’t change that basic, unfortunate reality.
Depending on your risk factors and those of the people you live with, you may decide to start having short, socially distant interactions with people who don’t live with you. Remember that each of those additional interactions does carry a risk. The fact that you’re around other people while doing something essential like grocery shopping doesn’t somehow negate or justify the risk of something nonessential like going to a mall to shop for clothes. Make sure you’re weighing the risk with relevant information, like local spread of the virus, and staying on top of your area’s safety requirements.
Many of us are longing for life to get back to “normal.” I know I am. Unfortunately, life won’t be normal for quite some time, possibly ever. In the meantime, we have to make smart choices to keep ourselves, our loved ones, and our communities as safe as possible.
Photo: Getty Images