Deciding risks we are willing to take as coronavirus shutdowns are lifted
SAN JOSE, Calif. — As an infectious disease expert, Dr. George Rutherford knows all about the horrors of COVID-19.
But there’s one risk that the University of California, San Francisco professor, wearing a mask, is willing to take: hugging his 2-year-old granddaughter.
For two months, we’ve been diligent about staying home. But, as Bay Area residents start to venture out with parts of the state gradually loosening lockdown restrictions, how do we navigate this new landscape of peril and promise? We can’t stay isolated and fearful forever.
The new normal looks like this: Social lives carefully built around “risk reduction,” rather than the strict and absolute safety of isolated sheltering.
“We need to balance our needs with what we know about coronavirus,” said Stanford University communications professor Jeff Hancock, founding director of the Stanford Social Media Lab, who is studying compliance with stay-at-home orders.
“Abstinence doesn’t work. Plans that are practical and recognize basic human needs will be more successful than those plans that don’t,” he said. “Do we need a vacation in Costa Rica with lots of friends? No. Do we need intimate and social moments? Yes.”
Risk isn’t binary, experts agreed. All-or-nothing approaches both have bad consequences.
Emerging research shows that the most dangerous settings are large gatherings of mixed social groups, where people who don’t know each other are close, sing, chat and commingle.
Think San Francisco’s Outside Lands festival, where music lovers from far-flung locales are crowded together for hours. Indoor and confined areas, such as bars and restaurants, are much worse than more solitary outdoor recreational activities, such as golf or hiking.
And time matters: brief moments of contact are better than hours.
What’s safe will mean different things to different people.
UCSF’s Rutherford would consider hosting cocktails on the back porch with friends, with safe distancing. Tennis? Yes. A small, discreet and formal wedding? Probably. A neighborhood crafts fair? Unlikely. An indoor rock concert? No way.
When out and about, “wearing masks is the most important thing,” he said. “That is the game changer. We can control transmission. We need to keep it as low as possible throughout the summer.”
UC Berkeley’s Dr. John Swartzberg would love to hug his grandchildren, ages 10 and 13. But he and his wife are in their 70s. And their son and daughter-in-law, both physicians, are potentially exposed to COVID-19 at work.
So they have family picnics in the backyard, in the fresh air, safely distanced and using their own utensils. This weekend’s lunch with close friends, their first gathering since March, will look the same.
“There is a risk. But it is a minuscule risk because there’s adequate social distancing and it’s outdoors,” said Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley. “It is a price we are willing to pay.”
Scanning the skies for birds, Santa Clara Valley Audubon Society director Matthew Dodder and two friends ventured out together for the first time Thursday, separated by the span of a country road, sharing sights of a lazuli bunting, hawks and 60 other species.
“It was emotional. Zoom isn’t the same. Human nature draws us together,” Dodder said.
What wasn’t shared: spotting scopes or car rides. When the club’s larger outings restart, he said, groups will be small. They’ll visit wide open wetlands, lakes and ponds, rather than narrow wooded trails.
“With friends, when we were chatting, we just naturally drift toward each other, but then remember,” he said. “With a large group of people, that’s harder.”
When cyclist David Schorow rides with friends, single file, along Alameda and Contra Costa County roads, they’re 25 to 50 feet apart. Future rides with his club Western Wheelers also will be safely stretched out — and they’ll be different from pre-pandemic rides, with no printed route sheets or a convivial post-ride meal.
Pastors of most synagogues, mosques and churches are discussing how to limit the size of services when health officials give the OK to resume. They will separate members and require masks while also continuing to provide online worship for vulnerable members.
Can there be “self-service” communion? It’s under consideration.
Bay Area counties are still restricting many outdoor activities that encourage gathering and close-contact sports, with high-touch equipment, like playgrounds and climbing walls off-limits.
Jamie Kalb, captain of the Palo Alto Feral Cows Ultimate Frisbee club, has been doing footwork and conditioning drills to stay in shape. Future games will be different, players said. Can you block a toss when you’re standing 6 feet away? That’s hard — and requires a major change in the game.
“A Frisbee is something you touch. It’s a shared surface,” said Mike McGuirk, executive director of Bay Area Disc Association, who only tosses with members of his household.
Baseball involves close contact and shared balls. So does basketball. Golf is safer. Surfing is very safe.
Palo Alto’s Lawn Bowling Club may consider new national guidelines: Wear masks. Sanitize hands. Only handle your own bowls. Leave an empty rink between games. Use a clean towel after each game. Keep a safe distance. And definitely no spitting or licking of fingers.
“Distance and time. That’s what matters,” said Swartzberg. “Can you maintain social distancing? How long are you in close proximity?”
“I’m walking through a neighborhood art festival with a mask on, the risk is minimal,” he said. “But if I stop and talk to the artist for 15 minutes, that is not prudent.”
In a provocative and widely circulated Medium post, Tomas Pueyo, a Stanford Graduate School of Business alum with a degree in public management and a specialization in behavioral psychology, published a data-driven article analyzing the economic costs and benefits of social gatherings in the time of COVID-19. The calculations give a blunt assessment of how we prioritize what’s worth the risk.
“If we establish based on our health care system that the cost (of hospitalization) is only $10,000 per infection, then we should allow the opera, theaters, cinemas and big conferences and congresses,” which add more to the economy because of their high revenue, he wrote. “But we shouldn’t allow events like big fairs or music concerts since their value (revenue) drops below the $10,000 per infection (threshold).”
Based on his modeling, the opera — with more expensive seats, fewer attendees and lower risk — has a value of $33,000 per infection. A big, boisterous and crowded music concert has a much lower value of $400 per infection.
Until there is a vaccine or more effective treatment, our new reality and its daily assessment of risk will be a more complicated, nuanced and ever-changing place, Swartzberg said. But it’s inevitable — and important.
“We’re social animals. We can’t stay isolated. We already know there will be very significant mental health fallout from this pandemic,” Swartzberg said. “If you want to prevent death from infection, people won’t have money for food and will starve to death.
“It’s not perfect and it will never be perfect,” he said. “We’re threading the needle through a very small hole.”