We’re going to start this post with some positive news and happily share that the COVID-19 curve that we discussed in detail here has finally started to flatten in some places. Not all countries are experiencing the same decrease in the number of new cases though, some of them are still on the rise.
Despite this, some countries are thinking about opening up or have already opened up. Restrictions are being lifted, people are having pool parties, and some bars are serving drinks just as before, i.e. no special COVID-19 guidelines and no restrictions. Let’s have a look at whether it’s time to do so. And if not, why not? Spoiler alert - it’s not. But don’t stop reading just yet. We will also touch on the subject of wearing masks and social distancing. Is it time to let all this “nonsense” go or should we keep doing it?
Back to the basics
As we discussed in our previous post, we now know that SARS-CoV-2 can be transmitted through respiratory droplets and also via various surfaces. What this means is that if people around us cough, sneeze, speak, and breathe - yes, breathe! - we are at risk of being infected. The chances of infection are defined by a simple equation:
Infection = Number of Viral particles X Time.
These respiratory droplets are subjected to laws of physics which dictate that the biggest/heaviest droplets will fall down to the ground relatively quickly, while the smaller/lighter ones will hang in the air for longer periods of time. In the following paragraphs we will discuss possible scenarios of how people can get infected using this formula.
What is the worst case situation? Imagine yourself in a small room without proper ventilation at a dinner table with 10 other people, at least one of which is infected with COVID-19. Dinner lasts for a few hours, you share some jokes and some laughs (which produce more viral particles than normal breathing), someone sneezes once in a while, someone coughs - all in all a regular gathering of friends in the pre COVID-19 era. Maybe you even have a sip of wine from someone else’s glass. Since we are drawing the worst case scenario here, the chances are extremely high that you will get infected as a result of this dinner.
Now let’s go through this example and try to establish what can be done to minimize the risks. All of these tips are fairly straightforward and self explanatory, but it’s easy to forget that we need to follow them.
Big four. Location - People - Masks - Symptoms.
Location. Try to avoid small, enclosed spaces with limited ventilation. If viral particles are present in the room and the air doesn’t move much, you will come in contact with some of them just by breathing. Whether it’s going to be enough to actually get infected is another question. Remember the equation, Number of Viral particles X Time. If you take a few breaths, leave the room and walk into a fresh air environment, maybe the virus won’t “stick”. But are you willing to take the risk?
Every sneeze and cough may release approximately 40,000-4,000,000 more viral particles than a normal breath.
People. The best possible strategy is to self isolate yourself in your household and limit interactions with other people as much as possible. Clearly, it is not an option for the majority of people, because most of us need to go to work, take kids to school, go grocery shopping, and run a wide range of errands accumulated over the last few months of the confinement. What are our options then? Well, limit interactions with others as much as possible. Try to stay at least 2 meters away from other people and wear a mask. It goes without saying (even in normal life, with no regard to the coronavirus pandemic) that you need to do your best to avoid being sneezed or coughed on. Every sneeze and cough may release approximately 40,000-4,000,000 more viral particles than a normal breath. Yes, this is 40 thousand to 4 million more viral particles! It means that if an infected person sneezes or coughs directly on you, you will receive a required-to-be-infected dose in a single breath. Even if a sneeze or a cough isn’t directed straight at you, many of the smaller particles will still hang in the air for a while. And if you are standing next to that area for a longer period of time, the chances of getting infected go up.
Symptoms. Another important thing to remember is that if a person doesn’t have COVID-19 symptoms, it doesn’t mean in the slightest that it is safe to be in close contact with them. Whatever that contact may be, shaking a hand, a hug, or a cup of coffee. If someone has visible and now well-described symptoms of being affected with COVID-19, of course it is an easy decision for the person to stay self isolated (or seek medical attention) and for others to keep their distance. But if no visible symptoms are present, it is equally important to follow the guidelines. We know from recent studies that 20-40% of people who are currently infected or had an infection in the past, were asymptomatic. Twenty to forty percent is an enormous number! These asymptomatic people could probably lead normal lives without taking all the necessary precautions because they thought - as in many reported cases - “Well, I don’t have it, I feel perfectly fine”. If you are in contact with an asymptomatic carrier, you increase your chances of getting infected. Unfortunately, now having drinks in a small local bar with a few friends who all “feel perfectly fine” doesn’t seem all that harmless anymore. Lack of symptoms doesn’t translate into lack of virus.
Lack of symptoms doesn’t translate into lack of virus.
Masks. Our knowledge about the virus has vastly increased since the beginning of the pandemic. In late February 2020 the CDC’s recommendations did not include wearing a mask as a preventive measure to avoid an infection. However, in early June 2020 we now know that wearing a mask may significantly reduce the spread of the virus. In all the situations described above, your safety and the safety of your loved ones would increase if you all wore masks. At the very least, if your mask is clean and not contaminated, it couldn’t hurt you. If the best case scenario where people stay home and limit their interactions with the outside world is not possible, wearing a mask may prevent you and others from spreading the infection. Grocery stores, banks, pharmacies, and gas stations - some of the places where social distancing isn’t always possible - wearing a mask is. So please do it. It can be inconvenient to wear a mask, glasses get foggy, it pulls on your ears, you may look funny, it’s all true. Just remember that if you hate wearing a mask, you are really not going to like the ventilator.
Grocery stores, banks, pharmacies, and gas stations - some of the places where social distancing isn’t always possible - wearing a mask is.
Deconfinement, the smart way
It is absolutely clear that the economy needs to be revived. So it’s just a matter of time when all the businesses will reopen, and when people will start pouring into bars, restaurants, and coffee shops to spend all that money saved over the confinement period (of course only those people who were fortunate to keep their jobs) and to enjoy the long forgotten pleasure of paying 10 times the price for a cup of coffee that they can make in their own kitchens. However, as we mentioned before, confined spaces are not good for us but they are good for the virus. Multiple articles suggest that some of the most prominent viral outbreaks happened at restaurants, business offices, religious establishments, and also at weddings, birthdays, and funerals. What do most of them have in common? Almost all of these events assume presence or a large number of people, some of whom may be infected but asymptomatic. In addition to that, some of these events are restricted to small and confined places (churches, small restaurants, workplaces) and probably not everyone would be willing to wear a mask at a wedding (although the industry is catching up). This is a recipe for disaster if one has ever been written.
What can and should be done? One possibility is to restrict major indoor events and large gatherings of people in general. For example, France did just that and in addition they cancelled their most profitable League 1 football season. As opposed to other European leagues who have chosen to carry on with their seasons, to the delight of the fans and stakeholders but to the understandable confusion and anger from some of the players.
Restaurants who care about safety of the patrons and their own staff should probably limit the number of people that can be served at the same time, restrict their service only to the outdoor areas, and implement rigorous sanitary precautions. Will these measures completely eliminate the possibility of spreading the virus? Obviously, not. But as we are not going for the perfect solution but for the most reasonable one, these steps appear to be dictated by common sense.
Let’s assess the risks
One of the main take home points of this article is that enclosed spaces are dangerous. If you are considering an indoor gathering in a poorly ventilated space with a lot of people for an extended period of time - maybe you should think again. Many restaurants, bars, and cafes fall into this category. It appears that even if everyone follows social distancing guidelines in such an enclosed environment, people may get infected. It’s important to remember the formula, exposure to the virus over a prolonged period of time may be dangerous, even if people are located far away from each other. If there are no guidelines, if your restaurant operates in a pre-COVID manner, consider ordering a contactless take out or even be adventurous and try a different establishment.
Confined spaces with limited ventilation are not good for us but they are good for the virus.
Our economy can’t stay shut down forever. It’s easy to say that we should first solve all the health related issues and only then we should start thinking about opening things up and getting back to a normal life. Unfortunately, our society is not built in a sustainable enough way for us to be able to afford it. However, we should not just blindly lift all the restrictions and make it seem like the world is the same as it was in 2019. Precautions need to be taken, restrictions need to be put in place if necessary, and most importantly, we all should try to be responsible and remain vigilant. Pretty Light Science will keep providing scientific news in an easy to digest manner so that you could stay on top of it. For now, please wear a mask, avoid touching anything outside of your house that doesn’t necessarily need to be touched, and wash your hands.
Works Cited
https://ourworldindata.org/coronavirus
https://www.theguardian.com/world/2020/may/25/americans-defy-covid-19-social-distancing-rules-to-celebrate-memorial-day-holiday#maincontent
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/what-you-can-do.html
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html#studies
https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e1.htm?s_cid=mm6915e1_w
https://www.cnbc.com/2020/04/22/love-is-in-the-air-as-weddings-innovate-despite-coronavirus.html
https://www.bbc.com/news/world-europe-51690657
https://www.theguardian.com/football/2020/apr/28/french-football-season-cancelled-with-no-games-until-at-least-august-prime-minister-coronavirus
https://www.bbc.com/sport/football/52283194
https://www.theguardian.com/football/2020/may/04/footballers-must-be-allowed-to-refuse-return-to-playing-says-sordell
https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article
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