How to stay safe in a reopened world
As Massachusetts begins to reopen public life after the COVID-19 closure, many people are wondering how safe that will be. Phase I of the opening, which began on May 18 and expanded on May 25, allows residents to begin to venture out to hair salons, public gardens, some office buildings and houses of worship. Hospitals and doctors’ offices are allowed to provide high-priority care for certain patients and retail stores can now do curbside pick-up.
Gatherings are limited to 10 people or fewer, except for religious services, which must be at or less than 40 percent of their capacity.
While the state may be opening up, the virus is still with us and it is important that people remember all of the rules they have been following up until now, said David Pombo, MD, Medical Director of Infection Prevention for Cape Cod Healthcare.
“Everything is going to depend on physical distancing to avoid large groups in close proximity,” he said. “You can go out as long as you wear a mask and are not going to large events where people are in close contact.”
Large crowds aren’t going to be safe for quite a while, he said. That is especially true because some of the new information is indicating that the severity and rapid growth of infections, especially in larger cities, were tied to the gathering of people at conventions, churches, sporting events or festivals. Not only did those infections spread faster, but they were also more severe in nature.
Dr. Pombo likes the term “precision physical distancing” rather than social distancing because it gives people clearer guidelines, such as staying six feet apart. He said grocery stores are safe as long as they limit the number of people in the store. And, hospitals are also very safe, he added.
“I think it is quite safe to go out,” Dr. Pombo said. “Being out isn’t the issue. Being close to people is the issue.”
The most important things people can do is follow all of the prior recommendations, including:
- Wear a mask that covers your nose and mouth.
- Limit the number of people you see.
- Stay at least six feet apart from another person.
- Don’t touch your face.
- Wash your hands frequently for at least 20 seconds.
- Call a doctor, get tested and self-quarantine at the first sign of COVID-19 symptoms.
As the weather warms up, it is reassuring to know that going outdoors is very safe, according to Dr. Pombo.
“When you are outdoors, the number of air exchanges for any given hour is huge,” he said. “The number of air exchanges per hour determines the safety indoors too. So, if you can be somewhere where there is a lot of ventilation, you are relatively safe.”
The major route of transmission of the virus is respiratory droplets, he said, and density matters. If you are further away from other people, the density decreases with the square of the distance. For example, if you are four feet away, you have 1/16 the density than if you were one foot away. For six feet, the density drops to 1/36.
For those who want to begin socializing with friends and family, an outdoor picnic would be a very safe way to gather, Dr. Pombo said, as long as each family unit brings their own food, beverages and utensils, and maintains a safe distance from one another.
The exception is those who are at extremely high risk due to being immunocompromised or elderly. Those folks should continue to stay in quarantine for their own safety, he said. Anyone who is experiencing any symptoms of illness should also stay home.
Go Out But Be Safe
Nobody knows what is going to happen once people become more mobile, but Dr. Pombo believes that life will not be back to “normal” for a long time.
“It depends on how quickly the general population becomes exposed to this,” he said. “The numbers I’ve seen indicate that until 70 percent of the population has become exposed to the virus, there is still a chance of having big flare-ups. Herd immunity would require 70 percent of the population, and right now we are in the single digits.”
Because of that, the four phases planned for Massachusetts make a lot of sense from a safety perspective, Dr. Pombo said. The incubation phase is four to five days and then it takes another week to 10 days before people become very sick. In other words, the consequences of our behavior today won’t show up for about two weeks.
Under Governor Baker’s guidelines, as businesses slowly open up, they are required to have a plan for protecting employees and customers. Dr. Pombo believes that people should trust most businesses to do the right thing.
“I think business people are going to do what they can to keep their customers safe,” he said. “You kind of need to trust businesses to have a safe plan in place, because the vast majority of them are not going to be the contrary type. They’re going to be people who want to be safe and just get on with things.”
The bottom line is that you simply have to be careful and pay attention to conditions in any public places. If people are not following the recommendations, the best thing to do is avoid those places.
“Unless you can stay six feet away and you’re with a group of less than 10, you shouldn’t go there,” he said.
To keep up with the current guidelines, Dr. Pombo recommends that people visit the CDC’s Coronavirus 2019 “Communities, Schools, Workplaces and Events” page and the CCHC COVID-19 information site for the most up-to-date information.