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The COVID 19 Pandemic in Summer: How to Stay Safe


Ah, Summertime! It’s a time of year that traditionally brings us cookouts, beach trips and pool parties. Americans travel to the mountains and the sea. We eat out more, work less, socialize with friends and family and take more time to enjoy a few of the fruits of our labors. Officially, summer this year begins on June 20. It’s almost here!


But this is no ordinary summer.


The COVID 19 pandemic still rages across the globe. There have been nearly 8 million cases now and over 400,000 deaths. U.S. totals include over 2 million infected and 117,000 deaths—and cases in Georgia and Chatham County are still on the rise.


So what can we do with our usual summertime activities? Can we still go out to eat? What about travel? Or are we doomed to merely cowering indoors as we wait for the hurricanes to strike?


Here are a few guidelines that might make your enjoyment of summertime activities a bit safer, in this mask-wearing, sanitized alternate version of reality.


A couple of baseline things to understand: Infection with SARS CoV-2 has been estimated to take as few as 1000 viral particles. Since the viruses are invisible, that sort of inoculum can occur in any of a number of ways: An eye rub, inhalation of virus-laden air, etc. And it doesn’t have to be all in a single contact. The concentration of virus, coupled with the time or frequency of exposure, all conspire to provide enough of the viral load that can lead to infection. So the concept of total exposure is important. Biologist Erin Bromage has simplified this concept with a formula:


Successful infection = exposure to virus x time


Patients with influenza have been shown to release 33 viral particles per minute. Speaking increases that volume of release by a factor of 10, or up to 330 viral particles per minute. Singing does so even more. So for influenza, at least, being in an enclosed space and singing can get the viral particle load to over 1000 inside of 4 minutes (330 X 4 = 1320). We don’t know that exact number for COVID 19 yet, but if we presume that they are similar in their modes of transmission (and they are), one can see how being in close proximity to a COVID 19 patient can quickly get the infective viral counts up to a level which may lead to infection. This is especially true when one realizes that a single sneeze or cough can aerosolize up to 200 million viral particles into the surrounding air. That’s why we encourage people who are symptomatic, with coughing or sneezing, to stay home. One sneeze can infect a whole roomful of people! (https://www.erinbromage.com/post/the-risks-know-them-avoid-them)


One of the keys to the whole social distancing idea (and of the idea of universal mask-wearing, which has unfortunately become a political touchstone as people confuse the common-sense behavior of following scientific guidelines with an imaginary intrusion on personal liberties) is the idea of limiting the respiratory spread of the virus from person to person. It’s been shown that 90% of all transmission events of COVID 19 are from home exposures, the workplace, public transport, social gatherings (weddings, funerals and church services, for example) and bars and restaurants. Almost all of these events associated with outbreaks were indoors. Only a single event of transmission has been associated with an outdoor environment. Dr. Muge Cevik, an infectious disease specialist at the University of St. Andrews in the UK, has collected data from papers on disease transmission around the world. She has found that 9% of infected people are responsible for 80% of the transmitted infections. Most people are infectious during a window of time right around the onset of symptoms, and for a few days after. Dr. Cevik notes that the two principal drivers of the disease are close contact (the longer the exposure, the worse the risk) and crowding in enclosed spaces (https://www.bloomberg.com/opinion/articles/2020-05-15/will-i-get-coronavirus-at-the-grocery-store-unlikely).


Thus, a few general guidelines:


· If you are in a well-ventilated area, with few people, the risk of transmission is lower (i.e. outdoors and well-spaced)


· If you are in an enclosed space, with more people, the risk of transmission is higher (and goes up with the length of time you are there)


· People who are breathing heavily, coughing, sneezing, singing, etc. are more likely to transmit the virus


· If you are in a high-risk group (elderly, diabetic, overweight, etc.) seriously consider the risks of any social engagements before embarking upon them


· Wearing a mask dramatically decreases the risk of respiratory virus transmission, and should be encouraged for everyone in all public spaces


Specific Recommendations


The CDC just issued a set of guidelines to be used in situations when standard social distancing methods may be more difficult (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/activities.html). Other articles have been published that examine the risks of various activities and can give us guidance regarding how to mitigate our risks. Here are a few of the suggestions, summarized in bullet-point format:


Hosting Get-togethers

· Since the COVID 19 virus likes stuffy, enclosed areas, well-ventilated areas are better (open the windows!). If you can do things outdoors, that's the best location of all.

· When guests arrive, show them where they can wash their hands

· Arrange tables and chairs so that families can sit together, but groups are six feet apart

· Have people bring their own food—or if that is not possible, have only one server

· Make a list of who attends so that if someone later becomes ill, the rest may be contacted


Overnight Travel

· Try to use the stairs in a hotel, as opposed to the elevators (remember: avoid crowded, enclosed spaces)

· Ask the hotel what their disinfection policy is for frequently touched surfaces. If it is inadequate, do it yourself.

· Avoid common areas (dining areas, lounges, gyms, game centers) as much as possible


Using the Gym

· Wipe down machines before and after use—and use hand sanitizer

· Wear a mask during low-intensity workouts

· Try to do any vigorous exercise outdoors

· Don’t share resistance bands or weight belts, since these are not usually disinfected between use

· Limit the size and the number of your indoor exercise classes


Riding Public Transportation

· Avoid lengthy trips

· Try not to touch ticket machines, rails, turnstiles or restroom surfaces

· Try to have at least a row of seats between yourself and others

· After you leave the station, use hand sanitizer

· When you arrive at your destination, wash your hands

· Consider wearing a mask

· Don’t touch your face!


Flying on an Airline

Here's a common misconception: Commercial aircraft are not merely sealed metal tubes. The air filtration systems on commercial aircraft are quite efficient and are excellent at filtering out viral particles which might be airborne. Modern Boeing aircraft exchange the entire air volume of the inside of the plane with outside air every 4-5 minutes, and the cabin air is filtered through a HEPA filtration system 25-30 times per hour. HEPA filtration systems capture 99.97% of all particles which are 0.3 micrometers in size or greater (by comparison, an N95 facemask excludes 95% of such particles). Moreover, the air nozzle above each passenger comes directly from the HEPA filter. Your greatest risk of exposure, therefore, comes from surfaces—and from those seated directly around you. So here are a few flying guidelines:


· Generally, a window seat in mid-cabin is best

· Wear a mask (Delta, American, Hawaiian, Allegiant, Spirit, United, Jet Blue, Southwest, Frontier and Alaska now require it)

· Pack your own food and drink

· Wash and sanitize your hands frequently

· Avoid touching surfaces

· Use electronic check-in to minimize face-to-face interactions

· When traveling with a group, designate one person as the “contact person” with the staff at check-in to minimize the group’s interaction with others


Going to the Beach

· Try to stay at least six feet away from folks you don’t know

· Use individual containers or packaging for food and drink (don’t use shared food containers)

· Use hand sanitizer after contact with any public surfaces


Eating in Restaurants

· Curbside service and take-out is lowest risk

· Eat outside if possible

· No buffets!

· Limit tables to no more than 10 people (smaller is better)

· If eating indoors, try to keep tables spaced at least 6 feet apart

· Use frequent hand-washing and/or hand sanitization, particularly after touching common surfaces and before eating

· Ideally, servers and other employees should all wear facemasks

· Limit face-to-face interactions to less than 10 minutes, if possible

As the COVID 19 lockdown eases up, let’s all enjoy the warm weather and brilliant sunshine—but we must also remember that the pandemic is not over. Take care of yourself and the people you love this summer by using these simple guidelines. Stay safe!

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