Wednesday, June 17, 2020

As America Reopens, Here’s How to Assess the Risk of Shopping and Dining Out

In most parts of the United States, you can now grab a drink with your friends at a bar, eat inside a restaurant, get your hair washed and cut in a salon, and try on clothes in a store.

Manicures and pedicures are generally allowed, as is working out in a gym and even getting a massage to soothe your stressed-out muscles.

It sounds like a dream come true after all those months cooped up at home — but at the same time, for many of us, something feels off.

Sure, we want the economy to reopen and do the things that used to bring us joy. But then we remember that the virus hasn't actually disappeared. In fact, in some parts of the country like California, Texas, Arizona and Florida, the number of people infected is still rising each day.

We also remember that in just five months, this virus has killed more than 116,000 Americans and infected more than 2.1 million.

And so we wonder: Is it really safe to be out and about? If I care about my own health and the health of my family and neighbors, should I be resisting the urge to patronize businesses in person even if my local government says I can?

The Los Angeles Times spoke with epidemiologists and physicians about what has changed since stay-at-home orders were first put in place, what remains the same, and what we can do to be responsible citizens as we move into the summer months.

And just so you know, this article is not going to address the risks associated with attending protests. Why? Because the risks you're willing to take to get your hair cut or eat at your favorite restaurant may not be the same as those you might take to fight systemic racism. That's a whole other story.

The first thing to remember is that the coronavirus is no less deadly or contagious now than it was three months ago, when the country all but shut down.

"It's still the same virus that has caused an average of 1,000 U.S. deaths a day and 4,000 around the world," said Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins University. "I'm worried that people have accepted where we are as the new normal. This is not normal."

And it's not like we are nearing the end of the pandemic either, said Carolyn Cannuscio, director of research at the Center for Public Health Initiatives at the University of Pennsylvania. Far from it.

Studies suggest just 5% of the U.S. population has been infected with the virus thus far. To get herd immunity, 60% to 70% of the population will need to be infected.

"If you think about how many people have died in just the first few months of this crisis, we still have a lot of suffering ahead of us," Cannuscio said. "We should try to do all we can to contribute to slowing the pandemic to give us more time to establish effective treatments."

Even as coronavirus infections and fatalities continue to grow, some experts say it is safer to venture out into the world today than it was when most stay-at-home orders first went into effect.

"I would say it's a lot safer," said Gerardo Chowell, a professor of mathematical epidemiology at Georgia State University. "We have a lot more information about the enemy."

Back in March and April, we still did not know that the virus spread primarily through the droplets expressed when we cough, sneeze, shout or sing without wearing masks. We also didn't know about the potential for asymptomatic transmission, or the potential for presymptomatic transmission, he said.

"Now, assuming that the population at large has this information, we have the power to protect ourselves," he said.

Specifically, several studies have shown that wearing facemasks can drastically reduce the spread of the virus.

"Back in April, it was not yet clear how useful this tool was," he said. "Since then, the science has been overwhelming."

So, even if you live in a state where the virus is circulating more now than it was in March, we now know that your chances of becoming infected are relatively low if you are careful about wearing a mask, social distancing and washing your hands.

One of the reasons we all stayed at home for three months was to slow the outbreak's spread and give hospitals time to prepare for a surge in COVID-19 patients as the numbers of infections inevitably ticked up.

"We didn't eliminate the virus, but we pumped the brakes on it," said Dr. Armand Dorian, chief medical officer for Verdugo Hills Hospital of the University of Southern California in Glendale.

In the past few months, most hospitals have put that grace period to good use, Dorian said. Among other things, they've stocked up on personal protective equipment for medical professionals and obtained more ventilators.

Now, doctors know to consider therapeutics like dexamethasone, remdesivir, anti-inflammatories and rheumatoid arthritis medication. They've learned to have patients lie prone on their bellies and to not intubate them right away.

"Three years from now we'll look back at this treatment and say it was so primitive, but it is massive leaps from where we were a few months ago," Dorian said.

"I don't think we've had enough advances in treatment to make me feel this is an un-concerning infection," she said. "I still think this is a disease we want to prevent."

Where does this all leave us? Is it OK to go out to eat? Get your hair cut? Go shopping for something besides groceries?

All the experts say that to make the most responsible decision, you'll have to consider many factors.

by Deborah Netburn, Los Angeles Times | Read more: (paywalled)
Image:AP Photo/Mark Lennihan
[ed. See also: How Exactly Do You Catch Covid-19? There Is a Growing Consensus (WSJ).]