Guidelines as St. Louis Reopens
On Monday, St. Louis City and County eased their restrictions on business and personal activities due to COVID-19. This is a relief to many individuals and businesses, whose lives and livelihoods have been dramatically affected by this pandemic. It also comes with anxieties and risks given the imperfect information we have about the virus, its transmission, and its dangers.
Here’s what we do know with a reasonable degree of certainty: the longer you're exposed to the virus and the greater the concentration of exposure, the greater your risk of infection and perhaps a more serious one at that. Also we know the virus can be present and is transmissible in asymptomatic, presymptomatic, and minimally symptomatic individuals. Thus, indoor areas (particularly poorly ventilated ones) with larger numbers of or in close proximity to people (especially those with cavalier attitudes to social distancing or whom you do not know well) will likely increase your risk.
We also know that masks work, when properly fitted. N95 masks block both large and 95% of small particles when the wearer inhales. Simple surgical masks filter out larger particles in the air and reduce others' exposure to your saliva and respiratory secretions. However, both of these masks are currently in short supply and are generally reserved for health care providers.
Cloth masks also help reduce the spread of COVID-19 by asymptomatic people by reducing or eliminating the amount of virus spread when talking, sneezing, or coughing. They are cheap and easy to make (instructions can be found here), or they are available for purchase online. They should be worn in public settings, indoors or outdoors. But they should not be used as a substitute for social distancing.
Knowing these things, our strong suggestion is to avoid socializing indoors.
Being outdoors can offer many advantages. It can help boost both your mental health and your physical health. By reducing your stress and increasing your exercise, you can help strengthen your immune systems as well. But how do you safely go outside right now? Here are some best practices to follow:
- When outside, try to maintain 6 feet from others you may encounter and wear a mask.
- Areas with more open space are preferred to crowded spaces like a busy park or trail.
- Remember the length of time you’re exposed makes a difference. Quickly passing someone is better than walking behind or lingering near them.
- On walks, cross the street as you approach someone or head in another direction if possible.
- Try to avoid touching common areas such as handrails or park benches.
- Don’t touch your face and wash your hands before eating/drinking and as soon as you return home.
- The best option still is to avoid social gatherings. Especially if you’re over 65, we recommend being outdoors with household members only.
- For those under 65, if you decide to gather with non-household members:
- It’s safer to be outdoors than indoors. You still run the risk of being exposed, but you’ll potentially be exposed to a smaller quantity of the virus since it dilutes in the breeze.
- Keep the gathering to 10 people or less (per STL County restrictions) and maintain a distance of 6 feet. All parties should wear a mask. If it’s not possible to social distance, limit the time spent together to a short period.
- Don’t share food or drinks.
- If your children are itching to meet with friends, encourage them to meet with friends outside rather than go over to their houses.
- Delivery or curbside pickup is still the best option for restaurants. If you’re tempted to eat outside at a restaurant, check out the restaurant’s practices first. Make sure the wait staff are wearing masks and you can properly social distance from other patrons or people passing by. It’s also best to wear a mask until your food or drinks arrive.
As a summary, I would like to end this newsletter with the thoughtful “personal statement” of a healthy, middle-aged patient as it pertains to COVID-19: “I am willing to work and socialize in small groups locally in well-ventilated areas or outdoors with people I believe are conscientious and responsible, with proper distancing and masking precautions. I am willing to take some calculated risks but as an exception rather than the rule. I will adjust my behavior according to local reports of activity in the area.”