behaviour

I’m still being asked a lot of questions about the virus situation here in SA. Microbiology is my passion and I’m happy to be asked, happy to answer. But maybe I can save us all some time and effort by answering some of the more commonly asked questions on here.

I’m not saying that this is the only way to do things, or necessarily even the best way of doing things: everyone will have their own approach and that’s fine. But this is the way we’re doing things, based on science, our knowledge and the changing situation around us. And yes, things are constantly changing, so it’s therefore reasonable to assume that our approach will change when required as well.

You’ll notice a common theme, one that I have eluded to many times before: it’s all just one risk individual assessment after another. Basically: how much do I need to do this and how much risk is there of me getting the virus from doing it?

Where you can, avoid risky situations: close proximity to others, indoor spaces – especially poorly ventilated indoor spaces and especially spending a prolonged length of time in those sorts of spaces. Apply that approach to your daily life (it’s really not as arduous as you might think) and generally you’ll end up doing things right.

Questions.

Are we in the clear in Cape Town now?
No. We’re not. The focus over the last couple of weeks has definitely moved to Gauteng, but this isn’t a light switch. You don’t just flick one place on and another goes off (and actually, that’s not even how light switches work, is it?). The situation in Cape Town still awful and no, you shouldn’t let your guard down. Right now, wherever you are in the country, it’s safest to assume that the virus is everywhere and alter your behaviour accordingly.

Should I be wearing a mask?
Yes. Wearing a mask is cheap, easy and has huge benefits, especially for those around you in that it limits the distance that any virus you breathe out, can go. And sure, I know that you don’t have the virus, but science has shown that asymptomatic transmission (passing the virus on even though you don’t feel ill) is a huge factor in the spread of Covid-19.
There is no downside to wearing a mask.
The Disaster Regulations say you must wear a mask when you are in a public place. And good luck with getting into any private establishment (shops, restaurants etc) without wearing one.

Should I be shopping?
Not unless you need to. Certainly not for pleasure. Shops are generally indoor spaces and you really should be avoiding those wherever you can. If you can order online, do so. If you can’t, then get in and get out as quickly as possible. Groceries are one thing, but I promise that you really don’t need to get those shoes or buy that new vase right now. Do that quick mental assessment: the risk is likely the same for grocery shopping and shoe/vase shopping, but only one is necessary. See how easy this is?

Should I be going to bars and restaurants?
In my humble opinion: hell no. Just because these places are open for business, doesn’t mean it’s a good idea to go there. People with masks off (for eating and drinking), inside space, prolonged period of time, and often speaking loudly because of background noise/music. These are all high risk behaviours/situations. Put them all together and it’s a recipe for disaster. By all means support your local restaurants, but do it via delivery or pick-up.
Sit down meals are not a good idea right now. Sit down meals are actually a very bad idea right now.

Don’t we all?

And haircuts?
I would love to have a haircut. But again: just look at how you have a haircut: someone stands right next to you (right over you, even) in a small space for a good length of time. This is not a safe situation. This is an easy call. And it’s a strong no from me right now.

Cinemas, theatres and casinos?
No: Indoors. Proximity to other people. Prolonged duration of potential exposure. Ticking lots of those High Risk boxes and none of the Absolutely Necessary ones. Red flags everywhere.

Is meeting friends ok?
Difficult one. There’s more to life than physical health. Mental health is hugely important too, and we all require some degree of social contact to keep us sane. Zoom calls can only go so far to satisfy this need. So let’s put this in perspective: while not meeting friends poses zero risk of infection, meeting friends carefully, in controlled conditions: socially distanced, with masks on and OUTSIDE poses very limited risk of infection.

Here’s something else to factor into your quick risk assessment. It’s Dr Everett Koop’s quote:

When you have sex with someone, you are having sex with everyone they have had sex with for the last ten years, and everyone they and their partners have had sex with for the last ten years.

Now, I’m not suggesting that you have sex with your friends – that’s your call (and theirs, obviously). But with a little tweaking, that quote reads like this:

When you meet a friend, you are meeting everyone that they have met with for the last fourteen days, and everyone that they and their family have met in the last fourteen days.

How sensibly have your friends (and their families) been behaving?

Should I meet elderly/vulnerable friends or family?
Hard no. As difficult as this may be, it’s going to be a whole lot more difficult when they contract the virus and get sick or die. No good can come of them spending time with anyone at the moment. Horrible situation, I agree. Nothing we can do about it. Sorry.

Any quick advice for me?
Wear a mask (limits risk of transmitting virus).
Wash your hands often (removes any virus from your hands before it can get inside you).
Stay at home as much as you possibly can (the virus can’t come to you – you must go to it).
Don’t go into indoor spaces with other people where you can possibly avoid it (this is a high risk activity).
Remember that time is important (the longer you stay in any risky situation, the more chance you have of being infected).

There you have it. I’ve avoided the thorny “Should my kids be going to school?” one, because there are just too many variables and too much emotional stuff there. That’s even more of an individual choice than anything else here.

As mentioned above, I’m not saying that these answers are right for everyone, but I believe that the thinking and the approach behind them is solid and is a good way for anyone to gauge whether you should be taking part in any given activity.

Stay home. Stay safe. Have a great day.

Here’s an interesting article in the New York Times (behind a “free” “paywall”, but summarised here for your ease of reading):

These are the personal opinions of a group of 511 epidemiologists and infectious disease specialists who were asked by The New York Times when they expect to resume 20 activities of daily life, assuming that the pandemic and the public health response to it unfold as they expect.

These are American epidemiologists, so their timelines will (and should!) be different to what our local experts might think – maybe we need to add two or three months to each of the timelines presented here. Additionally, it should be noted that their 3-12 month period includes a winter – that’s our “now”.

Important disclaimer:

Their answers are not guidelines for the public, and incorporate respondents’ individual life circumstances, risk tolerance and expectations about when there will be widespread testing, contact tracing, treatment and vaccination for Covid-19.

So yes, there are a lot of variables, assumptions and personal opinions in there, but even given that, there are still some interesting trends to look at.

The NYT has helpfully highlighted the most popular option in each case and assigned them to a “now”, “soon” or “much later” section.

Those first three are pretty clear cut, but the haircut has divided them, hasn’t it? And – as I think we are experiencing already in our everyday lives – it’s very much a case of wanting/needing to do something and then performing a mini mental risk/benefit assessment as to whether it’s worth doing.
Mail – something we want and need, limited risk – let’s go.
Doctor – something we need, possible risk, but yes, beneficial – ok.
Weekend break – definitely a want more than a need, potentially risky, but you can make a call on where you’re going and what precautions or safeguards are in place there and then choose based on that knowledge – could be safe.
Haircut – would be nice, but certainly won’t die without it, prolonged close personal contact – hmm, maybe not just yet.

Although:

For Robert A. Smith of the American Cancer Society, a haircut might be worth the risk: “It really is a trade-off between risky behavior and seeing yourself in the mirror with a mullet.”

Fair point.

And then there are the ones which are a bit further out:

‘Hiking with friends’ and ‘sending kids to school’ are interesting, given that some people are already doing the former in Cape Town and we’re all being told to do the latter. And yet (with that time difference mentioned above), the majority of the experts questioned here would be looking at ±6 months before they would consider either of them.

A lot of epidemiologists have a lot more faith in the safety of tubular aluminium petri dishes than I do. It’ll take a lot to get me flying again before there’s a vaccine and I’ve had it.

Another figure that sticks out here for me is the 4% who will never go back to exercising in a gym. Earlier in lockdown, someone (locally) said on twitter that they had realised just how easily they could manage without gym. At that point, I was really missing my time at gym, but the longer that time goes by, the less I feel I need it. Will I go back when I am allowed to? Performing that little risk assessment in my head, no, probably not. Obviously, I appreciate the benefits of it, but it is a properly high risk environment:

Surprise, surprise, the more energetic your breathing, the more virus you expel. So runners are the ones who are more likely to be spewing clouds of virus out.

Stick a lot of heavily-breathing, exercising individuals in an enclosed space and… well… you do the maths. It’s not pretty.

No thanks.

And then there are the things which used to be perfectly normal, but are now – and will remain for the next year, at least! – out of bounds for most of the respondents.

And yes, it seems that social contact is the major casualty of the pandemic. But then, were our learned friends doing it anyway? T. Christopher Bond from Bristol Myers Squibb states:

“Real epidemiologists don’t shake hands.”

Yeah. Us microbiologists aren’t big fans of the practice, either.

Masks work. Epidemiologists recognise this fact and most will be wearing them for the foreseeable future – probably until they have been vaccinated. Mere mortals should take notice of this. Look at that 7% in the first column (and add the 3 months) and understand how much a part of our daily lives masks are going to be for the rest of 2020 and probably most of 2021 as well.

And then the sporting event, concert or play. Sadly, these things are now a high risk luxury and I can’t see them coming back (safely) any time soon. Maybe not ever again in the way that we used to enjoy them before.

So what was your last concert or sporting event BTV, and will it be your last one ever?
I bet you weren’t thinking that way when you were there.

As mentioned above: this isn’t a scientific study, but it is a study of scientists and I think it provides a valuable insight into how the behaviour and the lives of the people in the know is going to change.

And if they are thinking that way, why should we feel that we know any better?

Tag: behaviour

Day 102 – Virus FAQs

Day 75 – Epidemiologist expectations