It’s been about two months of quarantine for many of us. The desire to go out and enjoy the summer is real. But what is certain? We asked a panel of infectious disease and public health experts to assess the risk of summer activities, gatherings in the yard, a day at the pool, sharing a vacation home with another household .
A big warning: your personal risk depends on your age and health, the prevalence of the virus in your area and the precautions you take during these activities. Additionally, many regions continue to restrict the activities described here, so check your local laws.
And there’s nothing like a zero risk exit right now. As states allow businesses and public spaces to reopen, decisions about what is safe will be made by individuals. It can be helpful to think about the risks as the experts do.
“We can think of the risk of transmission with one simple sentence: time, space, people, place,” said Dr. William Miller, epidemiologist at Ohio State University.
Here’s her rule of thumb: more time you pass and the closest space the more you are infected, the higher your risk. Interact with more people increases your risk, and inside places are riskier than outdoors.
Dr. Emily Landon, hospital epidemiologist and infectious disease specialist at the University of Chicago Medicine, has her own shortcut: “Always choose the exterior rather than the interior, always choose masking or not, and always choose more space for fewer people on a smaller space. ”
Our experts shared their thoughts by phone and by email.
Go to an activity: Backyard gathering; Restaurant; Worship service; Beach or pool; Outdoor party; Public toilets; A friend using your bathroom; Holidays with another family; Haircut; Mall; Hotel; Camping; Nightclub; Outdoor sports
1. A BYOB backyard gathering with another household: low to medium risk
Getting together in a spacious outdoor area with only a small group is not too risky. But our experts say that security here depends on who you invite and what their behavior has been. “If you have a gathering with another household that [has] after social estrangement, it would be a low-risk activity, “says Dr. Judith Guzman-Cottrill, a pediatric infectious disease specialist at Oregon Health & Science University.
What changes the risk? To reduce risk, avoid sharing food, drink or utensils – make it a BYO party all. Dr. Andrew Janowski, a pediatric infectious disease expert at the University of Washington in St. Louis, notes that the food itself is not the risk, but touching shared dishes or utensils could be.
Beware of alcohol, says Dr. Abraar Karan, a doctor and public health researcher at Harvard Medical School, as it can make people careless about social distancing. It also increases the chances that people will want to use your bathroom. “Once you move into the house with other people, the risk profile increases,” he says.
Some experts suggest wearing a face cover, but Landon points out that you can’t realistically mask yourself while eating and drinking. She suggests that an alternative to a meal would be a lawn tournament in the yard: “Children can play together, but always with their masks.” It could also be fun for adults.
2: Eating inside a restaurant: medium to high risk
Eating indoors “is always one of the riskiest things you can do,” Landon warns. The problem is, says Miller, “people tend to linger in restaurants. So even if the spacing is correct, the exposure time is longer. ” In addition, he says, speaking “seems to lead to some release of the virus”.
Karan notes that an epidemic in Guangzhou, China has occurred in a windowless restaurant with poor ventilation, and the air conditioning seems to have blown droplets between the tables.
What changes the risk? Janowski says the level of risk depends on the restaurant adapting to the pandemic. Restaurants should reduce and space out seats, require waiters to wear masks, and provide easy access to handwashing stations.
They should also provide single-use options for condiments so you don’t have to touch shared ones, says Janowski. And they should close all self-service areas like soda fountains or buffet tables.
If you go to a restaurant, look for outdoor seating. Landon says she would only go with family members because “I don’t want to have to take my mask off near a bunch of other people.”
3. Attending a religious service indoors: high risk
Worship services involve people from different households who meet inside for an extended period of time. “All the ingredients are there to get many people infected in no time,” said Kimberly Powers, epidemiologist at the University of North Carolina at Chapel Hill. She reports church-related epidemics: in one, 35 out of 92 people who attended a service in a rural Arkansas church developed COVID-19.
Singing – whether benches or choir – is high risk, several experts noted, citing a study of a choir practice in Washington State where more than half of the participants were infected.
What changes the risk: If people are far from society, wear masks and avoid singing, it can reduce the risk, says Karan. Also avoid shared worship items like hymns, Janowski adds.
The risk decreases if places of worship adapt, says Guzman-Cottrill. “My ward started having in-person services last week,” she says. The church had pre-registrations to limit attendance to 25 people. Participants had to be in good health, wear face covers, and sit at least six feet apart.
4. Spend the day on a popular beach or swimming pool: low risk
As long as you can stay socially distanced, it could be a pretty safe activity, say our experts.
Water itself is not a risk. “The sheer volume of water will dilute the virus, making water a very unlikely source of infection,” said Janowski.
What changes the risk? The key question is how close are you to others? “Can you make sure you can stay six feet [or more] someone outside of your designated family? “Asks Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center.
Watch out for crowds at entry points and bathrooms. Maintain a social distance both on land and in water.
Landon says his biggest concern with swimming pools and beaches is children. At the pools, “they make friends with everyone,” she says. “If you want to be able to see Grandma for Sunday lunch, because that’s what’s really important to your family, then you don’t want your kids to run with other people’s kids. “
She says a beach is better than a pool in terms of space. Go early in the morning or late afternoon when the crowds are low and look for beaches that mark out places where people can set up their areas.
5. An outdoor celebration such as a wedding with more than 10 guests: medium to high risk
Family celebrations are generally a summer tradition, but they are currently very risky. Many marriages have been postponed, and for good reason.
“Outdoors reduce the risk, but as people celebrate and drink, it seems like they can’t distance themselves that easily,” said Abraar Karan, the Harvard doctor. “These types of events end up being a large crowd where people have long face-to-face conversations. “
The larger the guest list, the higher the risk of one being infected, says Kimberly Powers, the UNC’s epidemiologist.
What changes the risk? The danger varies considerably depending on the size of the gathering and the proximity of the gatherings.
If you are planning to hold a celebration, make it a small one, mostly with local guests. “Bringing people from other communities” is a high risk, says Landon at the University of Chicago. “If people have to travel by car, by plane from other places, you really ask. “
And really think twice before inviting your loved ones, especially older family members or those with underlying illnesses. People may feel pressured to attend, even if it is dangerous to their health – and even more so if you insist that you will try to make it safe, says Landon. One of the largest groups of deaths from the virus in Chicago occurred after a funeral in which one of the participants passed it on to many family members.
6. Use of public toilets: low to medium risk
The toilets were designed to prevent the spread of disease, says Landon: “There are all kinds of things you can catch from other people’s poop, and you almost never do it because they are installed with all the hard surfaces that can be cleaned. “
The risk depends on the number of local COVID-19 cases and the cleanliness of the bathroom, says Janowski at the University of Washington, noting that a bathroom has multiple high contact surfaces.
There is not yet enough data to know if there is a risk of flushing by aerosolizing the virus. Landon says other viruses, such as norovirus, can be aerosolized by rinsing, but norovirus doesn’t often spread this way until the bathrooms are cleaned. The CDC says it “is unclear whether the virus found in feces may be able to cause COVID-19. “
What changes the risk: Miller says the main risk comes from toilets that are small, busy and poorly ventilated – like “these toilets at a gas station near the highway where the toilets are outside.”
Choose a bathroom that looks clean and is full of supplies like paper towels, soap, and toilet paper. Avoid grouping in a line to go to the bathroom or stay there for a long time, if you are less than six feet from others. Wash your hands after you leave and disinfect them if you need to touch surfaces after that.
7. Letting a friend use your bathroom: low risk
Landon doesn’t think this is a big risk: “What happens in the bathroom is going to be sucked out of the bathroom ventilation and you can clean all hard surfaces very easily. “
Miller agrees, “You can turn on the fan, leave the door open afterwards (so the air can circulate), and clean the bathroom later. And if you use the bathroom after that, just wash your hands. “
What changes the risk? Your friend may be infected but asymptomatic, says Janowski. “It would be reasonable to decontaminate the bathroom after a friend has used it, including cleaning the very sensitive surfaces of the door, toilet and sink. “
8. Going to a holiday home with another family: low risk
Experts said that if the two families have quarantined and limited their exposure to the others, this is pretty safe. “If a family is very active or if the parents have more exposed jobs, the risk increases,” says Miller.
Landon thinks this arrangement might be a good idea, especially if the house is “in the woods where you’re not going to have a lot of contact with other people,” she said.
What changes the risk? Landon suggests talking with the other family beforehand, to make sure you share the same expectations regarding the precautions everyone will take during the two weeks before arrival and during your stay. Make sure no one has any signs of illness – if they do, they should stay at home. Miller recommends cleaning the main areas of the house upon arrival. “And the more people can reduce their exposure in the days leading up to the trip, the better,” he adds.
9. Hotel stay: low to medium risk
The consensus is that staying in a hotel presents a relatively low risk, especially once you are in your room. It is best to limit your time in common areas such as the lobby, gym, restaurant and elevator, where the risk of exposure is higher.
What changes the risk? Bring disinfectant wipes to wipe the TV remote control and other common surfaces. You might also want to remove the bedspread as it may not be cleaned after each guest, suggests Miller. Ask about hotel cleaning policies, as many have new COVID-19 protocols. “Watch out for elevators!” Use your little one or ring finger to press the buttons, “says Miller.
Other suggestions: Order room service rather than eating out, avoid the exercise room, and wear a face covering in public areas.
10. Getting your hair cut: medium to high risk
A haircut involves “close contact and prolonged breathing for several minutes,” notes Karan. “This is the main mode of transmission that we know to occur. And cloth masks are certainly not perfect for this. “
Janowski says this is one of the most risky scenarios on this list, as there is no way to keep six feet from someone who cuts their hair. “All it takes is [having] an asymptomatic but infected worker and suddenly many clients are at high risk of infection, “he said.
What changes the risk? Landon believes that the risk is not very high if you and your hairdresser wear masks, and COVID-19 is not very common in your area. Look for a salon or hair salon that has (and applies) policies to protect its employees, such as wearing protective equipment and sanitizing their hands, she said, “By protecting their employees, they are protecting you too.” “
And make sure your hairstylist or stylist is a business, says Karan: “Stop chatting at close range like this is something we all like to do with our barbers normally. It is not the moment. “
11. Shopping in a mall: the risk varies
The degree of risk this represents depends on the type of shopping center, overcrowding and the time you spend there, agreed our panel. “High density crowds lead to a substantial increase in risk,” says Miller. “The main mitigating factor is that people don’t mix in the same place for long. “
What changes the risk? Outdoor shopping centers are preferable to indoor centers. And empty shopping malls are better than crowded ones. Avoid the food court and go for the goal, not the hobby, says Landon: “As much as you like retail therapy, you should browse online before you go. Know what you are going to pick up or try. Wear your mask. Come in, look at it. Make your decision and go out. ”
Be vigilant while you are there to avoid close contact. “Maintain your space,” says Miller. “Try to go during off-peak hours. Bring a hand sanitizer, Guzman-Cottrill explains, and use it frequently, especially if you touch common surfaces like handrails or elevator buttons.
12. Going to a nightclub: high risk
There is a consensus among experts that going to a club is a very high risk activity. Crowds, ultra-close contact, chanting, sweating, and the alcohol that releases inhibition are a powerful cocktail of risk factors. By drinking, people become less obedient to the rules, says Miller, and they can breathe more heavily while dancing – “which means more viruses are cleared,” he says. If there is an infected person in the mixture, the virus can spread easily.
“This is a very high risk situation for an epidemic, as we have seen recently in South Korea,” said Abraar Karan, referring to an epidemic linked to several discos and bars. “Don’t go to bars or clubs right now. “
What changes the risk? Nothing makes it a good idea right now. If you want to dance, organize a dance party at home with the people in your inner circle. If it was a small outdoor gathering, dancing under the stars – six feet away – would be much less risky too.
13. Camping: low risk
“When it comes to summer activities, it’s the least risky from a virus perspective,” says Rebecca Katz of Georgetown. You are outside and isolated. Miller agrees. But, he says, if you’re going with a group, make sure you can trust your comrades. Did they distance themselves from society and follow directions? Otherwise, they could be asymptomatic diffusers of the virus.
What changes the risk? Of course, risks can come in, depending on the details. “Are you camping in a secluded outdoor location with your family?” Katz asks – this is the low risk scenario. It’s more dangerous if you’re in a crowded campground with shared restrooms and picnic areas, she says. “Sleeping in tents with others [not in your household] can certainly be a configuration for the transmission, “adds Karan.
Conclusion: the activity itself is low risk, but the people you will be in close contact with during the trip may increase the danger.
14. Exercising outdoors: low risk
Unless you play group sports, exercising outdoors is a great way to let off steam while staying socially aloof. Our experts agree that sports like golf and tennis are safer than contact sports like basketball and football. “I would personally avoid contact sports until we have a better sense of the risk of transmission here,” said Karan.
And run? “If you’re not on a congested path where people are grazing, then I think it’s a great form of exercise right now,” says Powers.
What changes the risk? The more people involved in the activity, the higher the risk. It is possible to spread the virus when you are close to others – even if you are asymptomatic – so it is better to wear a mask if you cannot remain socially distanced.
The risk depends on the sport. A game like basketball is difficult, says Landon. “You touch the ball and you will breathe each other’s faces,” so she suggests playing only with the people in your household. Tennis has a much lower risk: “You are far from each other. It is a definite social distancing, “she said.