If I Do That, Am I Putting Myself In COVID-19s Crosshairs?

Like many of you, I am trying to navigate Phase 2 of COVID. As things open, how do we, as a family, decide what to do and what to avoid? My son wants to go to the gym to lift weights. Good idea or bad idea? My wife hates zoom and wants to return to in-person bible studies and walks with her friends -- high risk or low risk? A friend invited us to go water skiing on his boat -- is that safe?  

Based on all the analysis I've been gathering of risk factors, I developed this crosshairs framework to help my family and friends. Admittedly, I am pandering to my conservative friends and family members who are quite familiar with lining up crosshairs on a target. What is it that let's COVID-19 set its sights on us? There are four risk factors for getting COVID-19, based on our behaviors.

• At 12:00 is the environment. If you put yourself outdoors with others, there is less of a chance of giving or getting COVID-19 than if you put yourself indoors with others. If you are wearing a mask, there is less of a chance of giving or getting the virus. 
• At 3:00 is activity. If the activity involves what the medical community calls "violent exhalation" you are more likely to give or get the virus. Violent exhalation occurs when signing, shouting, sneezing, cheering, loud talking, and heavy breathing from aerobic workouts -- all have been traced to higher rates of spreading the virus. 
• At 6:00 is distance. My wife is headed to a bible study today with a small group of women. It used to be inside, sitting right next to one another, and that is higher risk. They are moving the get together outside, increasing the space between people by about ten feet, and thereby effectively lowering the risk.  
• At 9:00 is duration. If you pass someone while walking on an outdoor trail for and the duration of being within 10 feet is a mere five seconds, the risk is much lower than lingering in an indoor restaurant talking to the person next to you for two hours. 

Because these different factors interact, if someone is yelling in your face, even outside, a minute of exposure without a mask can be enough to get a viral load sufficient to infect you. In the case of a sneeze, it may only take a few seconds, so please consider a mask as an essential way of reducing risk for yourself and others.   

Using this crosshair framework, we can evaluate risk. Infections have been traced to crowded bars, restaurants, choir practice, sporting events, aerobic exercise classes, call centers, etc. We can see how the combination of environment, activity, distance and duration conspire to make these more risky. 

I've been using this framework with my family to consider our decisions. I recently played 9 holes of golf with a friend. Environment is outside. We wore masks when we talked to staff to get our carts. We increased distance by each having our own cart. We were talking, but we used our bluetooth headsets so we could communicate at a safe distance. Normally we'd drive over to the clubhouse together, but this time we took separate cars. With the headsets, the social experience was pretty close to as good as it gets in golf. AirPods are a great way to be together, but at a safe distance for a lot of activities. 

In terms of our livelihoods, working from home is a luxury that three quarters of college graduates have, but only about one-third of non-college graduates can work from home. For those that have to work in person and indoors, the risk can be lowered with wearing a mask, sneeze barriers, good ventilation, washing hands regularly, avoiding touching one's face,  minimizing the duration of engagement with others, and distancing as much as possible. This is not always easy, which is why the rate of infection is so much higher among those that don't have the ability to work from home.  

A final consideration of risk is contracting COVID versus dying of COVID. The data suggests that getting infected with COVID is a risk everyone shares regardless of age, race, gender, etc. The risk of getting COVID is mainly related to the behavioral actions summarized in the crosshair framework and the level of infections in our surrounding area. The more people we come in contact with, in environments more conducive to the spread, the higher our risk of getting infected. That said, the risk of dying of COVID-19 is significantly stacked against those 65 and older. As my analysis back in February showed, those who are older and have pre-existing conditions need to be cautious and protected by family, friends and the community at large. 

Even if you think you don't need protection from a mask, wearing one is an act of kindness for those more at risk in our community. Wearing a mask is a visible symbol of the type of person you are and your love for your neighbor and for the least of us (immunity wise) in our community. 

The good news is that there are lots of ways we can make minor changes to our behaviors to enjoy our lives in a way that reduces risk for everyone.