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Measured risks: With easing of COVID-19 restrictions, weigh potential exposures to infection

After two months of mostly staying home, we all yearn to be with friends and family. Do things. Enjoy summer.

But how do we measure the risks of returning to activities without potential coronavirus exposure or spread? Should you go with friends to the lake? Meet relatives for a camping trip?

Spokane Regional Health District officer Dr. Bob Lutz acknowledges the pent-up demand to get on with life even if it’s 6 feet apart. Lutz and Anieca Ashley, a MultiCare infection prevention practitioner, said there are ways to evaluate activities with the easing of COVID-19 restrictions.

In weighing the risks of exposure to infection, think in terms of the space and time spent close to other people, Lutz said.

“The more time you spend in closer proximity to people, the greater your risk if that person is infected,” Lutz said. “We talk about the magic of 6 feet. Essentially, that’s if you are stationary and someone coughs or sneezes.

“It’s much less likely you’d be infected if you’re walking by another person and they cough unless it’s right into your face or immediate space.”

Ashley offered a similar equation for time, space and people.

“The time being how long will you be in an environment?” she said. “The space being what kind of space is it – outdoors or indoors with poor ventilation? And people, how many will be there? Do you know these people? Are they following good social distancing and wearing masks in public?

“A caveat with that is if you know your neighbors well, and you know they’re social distancing, your risk is lower than with people you don’t know and you don’t know how much they’re social distancing.”

Generally, an activity that’s outside with space is better.

“Being outdoors is a much more ‘quote, unquote’ safer environment because you have more air circulation, UV light, and you tend to have more space around you,” Lutz said.

“With UV light, we know that kills coronavirus. You have more space to move about generally, and being outdoors for recreation is to some degree a safer experience.”

In tighter public spaces, still be diligent about masks and distance, Ashley said. Indoor locations should be well-ventilated and clean.

“As we ease back into what are normal activities, social distancing and masks are still highly recommended,” she said. “Locally at least, a high percentage of positive tests are among people who are asymptomatic. They are not ill and have no symptoms, but they can still shed to other people.”

Trail running, hiking or cycling

Rating: Low risk.

Running or cycling on a trail by yourself or with household members carry a lowest risk.

“That’s less concerning than if you’re to go out with 10 people, but even then, just think about distancing,” Lutz said.

“If you’re going out with a group of five people, and you’ve not been around them, then it’s also maintaining physical distance.”

If you see others you’re about to pass on a trail, move aside and wait as a courtesy. Don’t gather in groups in the parking lot or at the trail head.

Ashley also puts these activities at a low risk, especially in uncrowded spots. If it’s a popular destination, space yourself a distance away from others, she said.

“We encourage masking, but for some people with biking and hiking, they have difficulty catching their breath if they wear a mask, so do social distancing and allow lots of space.”

Camping

Rating: Medium risk but manageable.

It’s still best to camp with your household family or a small group that’s followed protocols during the coronavirus pandemic.

Other than leaving for recreation, stay in your private campsite, Lutz added.

“I’m not there to camp with 40 of my closest friends I haven’t seen in two months. It’s camping with your immediate family, maybe up to five people who are following social distancing.”

Sleeping in tents only should be with immediate family members who have quarantined together. Around the campfire, spread those chairs out.

While the coronavirus isn’t transmitted by food, Ashley tells people to avoid sharing food or holding potlucks so they aren’t touching the same serving utensils or accidentally grabbing someone’s drink. Plus, a buffet table can get crowded.

Camping or family reunions with kids are trickier because children like play bunched together. Try to discourage contact sports, she said.

“We’d hate to see large groups get together like that and have problems. Avoid flag football. Baseball is not as bad. Anything that keeps them sort of distanced.”

Pool vs. lake or river

Rating: Mixed depending on where.

Generally, lakes and rivers are a safer bet than pools, with exceptions. “For example, lap swimming is very safe,” Lutz said. “You’re swimming alone and moving. That’s in contrast to if you’re in pool with lots of people, and kids are running around and screaming.”

Lutz was scheduled this past week to discuss with the city of Spokane’s park director when it’s safe to open public pools, play structures and splash pads – a decision pending as of early June.

Ashley said it’s known that the coronavirus isn’t transmitted through water, so the issue is really how crowded a location is.

“A swimming pool contains a certain number of people grouped together versus a river or lake area where you can spread out,” she said.

“Anything outdoorsy is a lower risk compared to what’s contained in a cement enclosure.”

Silverwood

Rating: Higher risk; take precautions.

“There is an inherent risk with lots of people you don’t know coming together in close proximity,” Lutz said. Likely, fewer people at Silverwood will be wearing face coverings, he said.

“Remember, it’s a function of space and time. If you’re on a ride, obviously they’re short and they’re outdoors.”

But he added to be safer, don’t touch something and then touch your face. Seek out hand sanitizer stations and carry some. Wash your hands often.

Ashley suggests still wearing a mask and to use hand sanitizer.

“You’re touching a lot of things that other people touch” even with heightened cleaning standards, she said. Adhere to waiting-in-line restrictions for social distancing.

Golfing

Rating: Low risk.

Lutz said golf is another example of an outdoor activity that’s relatively low risk, but rides in carts should be same household members only.

This falls into the category of being in a wide-open space and somewhat an individual activity, Ashley added. “This activity has lower risk, but the more people you add to it, the higher the risk.”

Boating/fishing

Rating: Low risk in small numbers.

A boat with a small number of people also has the element of being outdoors with lots of wind, Lutz said, but don’t pack a vessel full.

“If you’re in a power boat and you’ve got air moving about you, that’s OK because that air is rapidly moving past you in contrast to being in a canoe or just rowboat with only two or three people,” Lutz said.

Ashley joked that her husband thinks being in a boat is the safest place to be. He’s a park ranger.

“It’s a really low risk because you’re usually in a boat with one or two people,” she said.

Cabin with friends

Rating: Higher risk; take precautions.

Lutz said this scenario is safer if you’re in a cabin with household members versus adding people you haven’t seen in two months for time in tight quarters.

To add space, have someone put up a tent outside. Spend as much time as possible on a porch or outdoors. If everyone’s inside, bring out the masks even if it’s a bit awkward, he said.

“I’ve been encouraging people to wear face coverings if physical space is not possible,” he said. “That is a good measure of what’s called source control. I’m trying to control my source of respiratory droplets.

“If I’m outside with a 10-feet distance between us, I’d say, ‘Let me see your face.’ ”

Car trips

Rating: Mixed with cautions.

“Car trips are concerning because you’re in a very confined space for potentially a long period of time,” Lutz said. “If you’re with members of your household you’ve been with, go for it. But with others, I’d be concerned about a long period of time spent in a confined car.”

Steps to mitigate that include opening windows, covering sneezes and coughs, and if someone feels ill, they don’t go.

Ashley also thought a car trip carries risk but can be safe with immediate family or people known if spaced apart.

“It’s hard if eight people want to go to be in a small space,” she said. “I’d distance and bring two cars to allow for spacing.”

Public restrooms

Rating: Decent risk.

“Like like everything else, wash hands before, wash hands after, don’t touch your face,” Lutz said.

Ashley said this is a challenging category, but it’s also unhealthy to delay going to the bathroom.

“People are at least conditioned to carry hand sanitizer,” she said. “While all these facilities are required to ‘up’ their cleaning, you can bring disinfectant wipes and hand sanitizer just as extra precautions. Obviously, wash hands.”

Hotels

Rating: Moderate risk; clean extra.

Lutz said hotels have practices in place for cleaning and sanitizing, but he still encourages an “overabundance of caution” if staying in a room.

That includes bringing your own disinfectant wipes and using them on frequently touched items such as the TV remote, door handles, coffee machines and telephones. He said the Centers for Disease Control and Prevention reported recently the biggest risk of contracting coronavirus is from being around another person rather than contact with the virus on a surface.

“But it’s still a risk,” he said. “Wash your hands more frequently, and don’t touch your face.”

Ashley suggested that when you enter a hotel room to remove the top bed cover under the assumption that only sheets are laundered. And she’d also bring those disinfectant wipes. Lutz said there are no guarantees in any space, so it’s about good hygiene, social distance and masks.

Such steps protect those who can’t fight COVID-19 off themselves, Ashley added. Otherwise, “Ease back and enjoy life,” she said. Her daughter asked recent advice for her grandson’s birthday party with a few guests.

Ashley’s daughter invited only those who have socially distanced. The cake slices were prepared ahead and put on individual plates with no shared utensils. Hand sanitizer and wipes were handy. But the focus was on celebrating.

“You don’t want to make it neurotic,” she said. “You still want it to be fun.”

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