A friend of mine is looking forward to a neighbor’s barbecue this weekend now that Pennsylvania has eased COVID-19 restrictions and is allowing small gatherings.
As we have moved away from stay-at-home orders, most of us feel like getting on with our lives. But instead of rushing into potential danger, this is a good time to pause and think about our individual choices, values and risks.
Small gatherings are legal now in most states. But, as many states are experiencing an uptick in COVID-19 cases, we need to be careful not to confuse the fact that something is legal with the question of whether it's a good idea.
Consider risk of exposure
Assessing risk in any area is difficult and subject to all sorts of confounders, including lack of data about the real risk involved as well as our perception of that risk. For example, some people don't swim in the ocean because they fear shark attacks. But in reality, shark attacks are very rare and the drive to the beach is probably riskier than swimming in the water.
Right now, the opposite phenomena is happening when it comes to COVID-19. Folks are taking greater risks because the perception is that the pandemic's prevalence is much less than it was just two months ago. The reality is that the presence of COVID-19 is about the same as it was the day the stay-at-home orders were implemented.
If that does not feel very reassuring, it shouldn’t.
We have learned a lot about the virus in the last two months, including how social distancing, masks and hand washing are effective at decreasing transmission. If we didn’t know it before, we’ve realized there is an economic imperative to returning to work. This should be done as carefully as possible.
At the same time, we still need to be careful and thoughtful about the choices we make in our personal lives.
I was taught a long time ago, in the context of educating patients about sexually transmitted infections, that people often have a difficult time understanding the implications of their behavioral choices. One way to explain the risk of sleeping with multiple partners is to explain to a patient that when they have sex with one person, the risk equates to having sex with everyone their partner recently slept with.
If the patient had three partners, and each of those partners also had three partners, it's easy for most people to calculate that those three hookups are actually like nine. And any one of those people might have recently contracted an infection from someone else.
Sexually transmitted infections are readily treatable. COIVID-19 often is not. A small barbecue of just 25 people could quickly turn into COVID-19 exposure from hundreds of people depending on who the attendees at the barbecue have been in contact with.
Exposure to COVID-19 involves behavior that is far more socially acceptable and ordinary than sexually transmitted infections, which, in part, explains why nearly 130,000 Americans had died from the disease as of July 2.
Take precautions, stay safe
Given the current amount of COVID-19 in many communities, some people who hit July 4 barbecues may have been exposed. Transmission at such an event wouldn't be out of the realm of possibility.
The choices that we make will affect not only our own lives, but that of so many others. Each one of us needs to use careful judgment. Our behaviors should match our values and our goals. If our values are to spend time with friends and family members, to contribute to a healthy economy and to remain healthy it will require adhering to difficult choices.
For the foreseeable future, the best choice may require limiting contact with others, wearing masks and practicing social distancing.
This July 4, choose to remain safe.
Neil Skolnik, M.D., is associate director in the Family Medicine Residency Program at Abington Jefferson Health.