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America is “Re-opening” But Are You Ready?

America is “Re-opening” But Are You Ready?

The COVID-19 pandemic isn’t over yet. Learn how to manage the pressure to resume normal activities.

Updated on June 29, 2020 at 1:00pm EST.

In the midst of the coronavirus pandemic, most states have started reopening their economies, leading to a great divide.

Some people want—and need—to get back to their more normal routines. They’re drained from the prolonged stress and anxiety of isolation. Many are even experiencing “caution fatigue,” meaning they’ve become desensitized to the repeated warnings about COVID-19 or the risk of infection.

Meanwhile, on the flip side, others remain worried about their health and a surge in new COVID-19 cases. Those who are remaining vigilant amid the “re-opening” might feel angry or scared. They may even feel pressure to relent and accept more risk.

This growing divide is especially evident when it comes to face masks or coverings. In some parts of the country, people feel awkward about wearing a mask in public because others aren’t. In other areas however, people who go out in public without their face covered may be verbally abused for not masking up. 

Despite differing opinions on how to handle the reopening, at least one fact remains: The pandemic doesn’t just disappear because your governor opens up beaches, salons and bars.

“We should make no mistake,” says Luis Ostrosky, MD, a professor of infectious diseases at McGovern Medical School at UTHealth in Houston, “we’re living an historic pandemic, and we’re right in the middle of it.”

Remember, you’re in charge
Your neighbors might be ready to get back to normal, but it’s okay if you’re not.

It’s important to understand that decisions to re-open businesses and get people back to work are driven mainly by economic concerns. These financial worries are valid and important, but health officials are also warning that as cities get back to business as usual, we can expect a resurgence of new COVID-19 cases—as effective treatment options and a COVID-19 vaccine are all still under investigation.

“Just because something is open doesn't mean that you should do it,” cautions Tom Inglesby, MD, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.

During stay-at-home orders, there were precise rules to follow. Things aren’t as clear cut during this gradual and evolving re-opening. So, as restrictions are eased in your community, you must assess your own personal risk tolerance for COVID-19. Are you or those in your home at high risk for serious illness, and how much risk are you able and willing to tolerate emotionally and physically?

You make your own rules—even if you’re facing pressure from friends, family, or co-workers to socialize and resume day-to-day activities. What works for a neighbor who’s decided it’s fine to resume playdates and dine at friends’ homes might not work for you—and that’s okay.

Re-opening isn’t an “all-clear”
As states reopen, it’s critical to continue to wear masks and practice social distancing and good hand hygiene, Ostrosky advises. Areas where people have strictly adhered to those practices are not experiencing the same level of increased transmission seen in other regions in which people have not strictly followed these guidelines, he adds.

“The problem is many people are taking re-openings as an all-clear and unfortunately, masking and social distancing have become political and ideological in the U.S,” Ostrosky says, noting that there really there should be no controversy behind these guidelines from a scientific standpoint.

“We need to come together as a country, as a society,” he says. “There’s no way out of this unless we all do this.”

There are plenty of activities that can still be done safely, Ostrosky points out, as long as you take the necessary precautions, including wearing a mask, distancing yourself from others and practicing hand hygiene. He notes however that staying at home as much as possible and minimizing elective social interactions is still the best move. If you interact with others, wear a mask at all times within six feet of other people and always have hand sanitizer on you, Ostrosky adds.

Consider your level of exposure
Being in a group of people not social distancing or wearing masks increases your risk, as does engaging with new people, according to the Centers for Disease Control and Prevention. Complicating matters, mounting research suggests some people with COVID-19 who don’t develop the most commonly reported signs of the disease—including fever, coughing, shortness of breath and other respiratory symptoms—may be spreading the virus unknowingly.

It’s also becoming increasingly clear that others who are carrying SARS-CoV-2 (the coronavirus that causes COVID-19) may not develop symptoms for several days or not have any symptoms at all, making the infection much more difficult to contain.

When considering your approach to the re-opening of your hometown, think about your “social bubble,” or the people with whom you’re interacting. Is your social circle contained, and are you confident that the people you want to interact with have been following the “rules” up to your standards?

Some people are making pacts with neighbors and forming exclusive social “pods” for engaging in activities.

Exactly where you live plays a part as well. Some states have seen a dramatic decline in cases, while others have seen pretty substantial upticks, Inglesby points out.

“So depending on where you live, your risk may be different from what it was two months ago, or it may be the same in some places,” he says. Even within a state, there are counties with fewer confirmed cases of the disease than others.

That said, it’s important to stay up-to-date on COVID-19 in your area and specifically whether the virus is currently spreading in your community. The higher the level of community transmission where you are, the higher the risk of someone getting COVID-19 during a gathering.   

In general, you’re most at risk when you have close, prolonged contact with people in enclosed areas. When it comes to COVID-19, close contact is defined as being within 6 feet of an infected person for at least 15 minutes, starting from two days before symptoms develop or a test result comes back positive, according to the CDC. That’s why activities where there are crowds can be a problem—it can be hard to properly distance yourself and there are just more sources of infection.

When deciding how to act during the reopening, you’ll need to weigh risks with benefits to your health. For example, brief outdoors activities with a few people, such as meeting up in a park or a backyard barbeque, are much better than indoor get togethers.

Higher risk would be spending longer periods of time indoors with other people that are not part of your immediate family, says Inglesby. “Then you're breathing in the air that they’re exhaling if you're at close distance,” Inglesby explains.

Rely on science
As states reopen and public opinion about what’s safe—and what isn’t—varies, try to remain focused on yourself and your family members and base your decisions on the advice of health officials and your healthcare provider (HCP).

“Never get into anybody’s face about wearing or not wearing a mask,” Ostrosky says. “Take care of yourself.”

If you do have the opportunity to discuss your view with others who may be living by different rules, bring up the science behind why masks work—it keeps germs from the mask wearer from spreading to others. “Wearing a mask is a sign of respect for each other,” Ostrosky says.

One person acting responsibly for the greater good can make a difference, according to Inglesby.

“We can make choices about where we go, how we operate more outside the home, what events we attend. So yes, there's a lot that we can do as individuals,” he says. “And we've seen historically that action taken by individuals has made big differences in past outbreaks in other parts of the world.”

Medically reviewed in June 2020.

Sources:
National Institutes of Health. “To Beat COVID-19, Social Distancing is a Must.”
Centers for Disease Control and Prevention. “Symptoms of Coronavirus.”
World Health Organization. “Coronavirus disease 2019 (COVID-19) Situation Report – 73.”
SA Lauer, KH Grantz, Q Bi, et al. “The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.” Annals of Internal Medicine. 2020;M20-0504. doi:10.7326/M20-0504.
Centers for Disease Control and Prevention. “Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020.”
Government of Iceland. “Large scale testing of general population in Iceland underway.”
Centers for Disease Control and Prevention. “Contact Tracing for COVID-19.”
Centers for Disease Control and Prevention. “Personal and Social Activities.”
Centers for Disease Control and Prevention. “Deciding to Go Out.”
Rand Corporation. “The Health and Economic Impacts of COVID-19 Interventions.”
Centers for Disease Control and Prevention. “Considerations for Events and Gatherings.”

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