Cases of coronavirus infection continue to spread. In response, the Centers for Disease Control and Prevention published a number of recommendations to mitigate the transmission of COVID-19. Many local governments have followed suit, placing limits on public gatherings as part of what’s known as “social distancing.”
In California, for instance, Gov. Gavin Newsom (D) ordered that gatherings of 250 people or more should be postponed or canceled at least through the end of March. Similarly, New York Gov. Andrew Cuomo announced an indefinite ban on all gatherings of 500 or more.
These numbers aren’t based on any one set of data; they’re general estimates meant to put the kibosh on major events that could spread the new virus in an explosive fashion. That doesn’t mean that a gathering of, say, 249 people is free and clear from risk of exposure or that hosting an intimate dinner party is automatically a good idea.
“There is no specific number of the people to say, ’All right, yes, you can go to a gathering where there are only five or 10 people, for example,” said Muhiuddin Haider, a clinical professor of global health at the University of Maryland. “The major principle is that we are trying to reduce the transmission.”
So if you want to do your part to slow the spread of the coronavirus, you might be wondering what is and isn’t safe to do. Here’s a look at how careful you really need to be and what plans you should cancel.
Right now, we don’t have any vaccine or antiviral medication to treat COVID-19 if people do get the disease. “So what we do is try to keep people away from one another and try to keep it from spreading in a variety of ways,” said Georges Benjamin, executive director of the American Public Health Association.
Those measures, known as non-pharmacological interventions, include handwashing, using hand sanitizer and social distancing.
“We know that, at least for this disease as has been described so far, every person who is sick right now appears to infect about two other people, on average,” Benjamin said. The goal, then, is to try to break that cycle. “That includes a more aggressive concept of social distancing.”
For people who have already been exposed to the virus, that’s isolation or quarantine.
For the rest of us, we should be keeping away from other people as much as possible. Because most people have not been tested for the virus, there’s no way to know who is potentially both infected and infectious. “In some cases, there are people out there who look perfectly well but are terribly infectious,” Benjamin said.
The idea of social distancing is to separate everyone enough so that the chain of infectivity is broken.
“A lot of this stuff is important but not essential,” Benjamin said. So, in general, if you do need to go out into the public, try to limit it to important reasons. And if you are wondering what’s considered essential or important, here are answers to some of those questions.
International travel is pretty much off the table right now, but what if you need to fly domestically for work or personal reasons? Deciding whether or not to go is best approached by asking yourself a few questions, according to Pamela Aaltonen, professor emerita of nursing at Purdue University and past president of the American Public Health Association.
First, she says, consider how essential the travel really is. You should also find out what’s currently known about the number of cases at both ends of the travel (including layovers). Of course, “this is very challenging now because we’re not yet doing widespread testing,” Aaltonen said.
If it’s reasonable to use an alternative means of traveling, such as by car, that would be the preferred option. And if you’re part of a high-risk group ― you’re older in age and/or have a compromised immune system ― or the party you’re traveling to includes a high-risk individual that you don’t want to potentially expose, it’s probably best to call off the trip.
If you must travel, Aaltonen says you should wipe down arm rests, seat back tables, light switches and vent knobs before touching them.
If your employer hasn’t instituted a work-from-home policy or you need to get around town to run errands, transportation can be another tricky situation. Public transportation exposes you to many people and germs. But for many people, there is no other option.
“Try to keep as much distance from one another as you can,” Aaltonen said, noting 6 to 10 feet is ideal. It also helps to travel at non-peak hours, if possible. “Minimize touching surfaces on public transportation,” she added. “Carry wipes or hand sanitizer if available (these are in short supply in many areas of the country) and use on frequently touched surfaces if you, too, are going to touch these surfaces.”
And though it might be a tough habit to break, Aaltonen said you shouldn’t shake hands or hug anyone you know along the way.
Benjamin said this is a risk-based decision. If you need food or medication, there’s really no getting around it.
However, if you’re over the age of 60 or are immunocompromised, consider having someone run these types of errands for you.
If that’s not a possibility (and you are not under isolation or quarantine, of course), try to go during off-peak hours when fewer people are around.
“It is not only desirable but highly recommended that we reduce our contact with humans.”- Muhiuddin Haider, clinical professor of global health at the University of Maryland
Other errands, such as going to the gas station to ensure you have a full tank of gas in case of emergency, are also pretty essential. But your dry cleaning should really wait.
Considering that the goal right now is to limit our exposure to large crowds and places where many people congregate, entertainment and nonessential activities should really be avoided completely. Movie theaters, restaurants, football games ― all these hold a large number of people. “So the probability [of exposure] is very high, particularly when we don’t know who has been tested,” Haider said. “It is not only desirable but highly recommended that we reduce our contact with humans.”
If you have a fitness routine that you’d like to stick to, you might wonder if the gym is a safe space. After all, it’s easy to assume that most regular patrons are in superior health and at less risk of falling seriously ill.
“Certainly, it is helpful to be healthy if one contracts the virus, since you’re likely to have a better recovery, but this virus infects healthy as well as unhealthy persons,” Aaltonen said.
The problem here is that even if you are healthy, you can become infected but show no symptoms and then spread the virus to others unknowingly. Aaltonen suggested asking yourself some of the same questions as when deciding to travel. Are there high-risk people living in your household or that you come into contact with at work? How essential is it really for you to be in the gym?
Again, if you do decide to go, you should ask the staff about what sanitation measures they’ve instituted and wipe down all the equipment before and after using it. If possible, though, you’re better off with an at-home workout routine until we have a better handle on the virus.
Again, people need to make a risk-based decision when it comes to children’s activities. “A small party might be OK,” Benjamin said. “But kids are little incubators.”
So far, there haven’t been any cases of children falling very ill due to exposure to coronavirus. But as evidenced by flu season, they tend to spread germs easily to parents, grandparents and other people in the household.
“That’s the thing ― you’ve got to decide whether or not it’s important,” Benjamin said. “A birthday party can probably be rescheduled. Obviously, you have to properly educate your kid and make sure they understand why.”
His personal recommendation? As you can probably guess, it would be to err on the side of caution.
Each school district will weigh a few important factors when deciding whether or not to close, according to Haider. That includes how many cases have been identified in the area, how many people have died (if any) and the estimated possibility of getting the virus. “Again, since our population is not all tested, we live in uncertainty,” Haider said.
Many school districts have decided to err on the side of caution and shut down so that children remain at home. However, not all have. If that’s the case for your kids, you may be wondering if it’s safe for them to continue attending school or if you should pull them out.
“It is better to keep the kids at home, or at least maintain a certain distance from the larger crowds to reduce the probability of transmission,” Haider said. However, he noted that’s easier said than done, as many working parents can’t take time off to care for children at home, and 22 million children rely on school-provided meals each day.
If it’s reasonable for your family, however, keeping your kids out of school for the next few weeks will help to protect them and prevent transmission in general.
Things can get particularly hairy if you have a major event like a wedding planned for the upcoming weeks. Postponing a wedding last-minute can definitely be a headache.
“It demands radical change in our lifestyle.”- Muhiuddin Haider
Whether to reschedule will come down to the number of guests, their ages and health status, the location of the wedding and more. “I would certainly think about scaling things down if you want to get married in the next four to six weeks,” Aaltonen said. If you’re not comfortable with scaling back the activities, you might as well postpone, she said.
“The science behind doing this now is pretty urgent. Because again, not having the medications, not having the vaccine... the goal is really to try to flatten the bell-shaped curve of people [who are infected] so that not as many people get sick at one time,” Benjamin said. If we can do that, he added, then our health system should be able to handle treating those who really need it.
As tempting as it is to try to maintain the same lifestyle during this pandemic, the hard truth is that we all need to make some sacrifices now to protect each other. “It is not an easy time for us,” Haider said. “It demands radical change in our lifestyle.”
With so much uncertainty surrounding a rapidly spreading and potentially life-threatening disease, it can feel overwhelming. But Benjamin’s final words of wisdom should be reassuring: “People need to be informed, but not afraid.”