As the economy slowly reopens across the Tri-State, some people are itching to get out and others are firmly staying put. Many, however, fall into the space between - having to weigh the risks with things they need and things they want.
WVXU asked three public health officials from Ohio, Indiana and Kentucky to discuss how they're making these decisions in their personal lives. The rules and guidelines governing each state vary, but many of our participants' answers are similar. They were all sent the same six questions and provided written responses, excerpted below, and answered a few follow-up questions in recorded phone interviews.
Agreeing to share are:
- Josh Schaffzin, M.D., Ph.D., director of Infection Control & Prevention at Cincinnati Children's and UC associate professor of pediatrics
- Christine Stinson, executive director of the Wayne County Health Department in Richmond, Ind.
- Steven Haist, M.D., associate dean for the Northern Kentucky UK medical campus
How are you making decisions about if or where you'll go somewhere as businesses reopen?
Our three public health officials are taking a "wait and see" approach when it comes to venturing out, and if they're not feeling well, they'll stay home.
"A virus with a 14-day incubation period means that we need at least 2-3 weeks to pass before we can be confident transmission is not widespread," Schaffzin says. "I plan to watch the early reopenings and follow the testing data closely, and start deciding whether I will venture out after at least two weeks."
Haist is keeping an eye on states that opened earlier, like Texas, but he's also cautious about looking exclusively at numbers because of changing benchmarks.
"A decline in the number of positive tests is being touted as a positive sign to open back up; however, I would not necessarily endorse this as a good sign. A decline in the percentage of tests that are positive is a number that cannot be interpreted in isolation. If the number of people being tested has gone up considerably, it is likely that a lot of those now being tested are asymptomatic people and are likely not infected. Early on most people who were tested were symptomatic and often at a hospital. Thus, they had a higher likelihood of being infected. So a decrease in the percentage of positive tests can occur even when there is an actual increase in the absolute number of positive cases."
Stinson is making her decisions based on the actions of the businesses and whether she thinks their protocols are in the interest of protecting her health. "I look to see if the business is following the guidelines set forth for their industry. If they are not doing what needs to happen to protect my health, chances are I will not go in and shop there."
What precautions will you be taking?
Our experts are unified in their response: They'll wear face coverings in public, wash their hands frequently and use hand sanitizer in between, avoid touching their faces, and maintain distancing.
Schaffzin may bring disinfecting wipes along and Stinson intends to limit her time in stores. "I go in and I get what I need and I am out. I limit how many times I need to stop at the stores through the week."
Will you go to a restaurant/bar, indoors and/or outdoors? If so, what's your criteria?
Haist plans to stick with carryout for a while. "Being almost 65 years of age I know I am at higher risk than those who are say, 20-50. We will probably wait several weeks before dining inside a restaurant. ... If there is an uptick in cases after the first couple of weeks, we will delay going to restaurants, etc."
Stinson also is putting off eating out and Schaffzin points out "masking at a restaurant is impractical, so I will limit companions and make sure we are all well before setting out," and only if the restaurant is utilizing spacing and hand hygiene.
Will you go to businesses such as stores or service providers (salons, gyms, etc.)? If so, what's your criteria?
Spacing, hygiene, masking, and patron limits will weigh into the decision to go to these types of businesses. However, all three declare the need for a haircut. Stinson says she'll wear a mask and ensure her stylist does as well. She also thinks she'll probably skip having her locks washed and blown dry.
"Similar to what I mentioned about restaurants," Haist adds, "I will be looking at the daily and weekly number of new cases and if there is an increase I will delay in re-engaging. But I really need a haircut!"
Will you socialize more?
"Yes. I miss my friends," says Schaffzin. "We will mask and interact in the context of maintaining safety and health. Maybe time spent outside rather than a meal."
Haist plans to keep things small. "We hope to soon, likely with one other couple at a time, say dinner at someone's house or at our place."
This is where our experts diverge. Stinson says she's going to wait. Her decision is based strongly on the health of close family members, including an adult son who lives at home and is immune compromised from an illness contracted while serving abroad in the military.
"I work and go home; I limit my interactions and reduce the chance of bringing the virus home to someone who may have a very difficult time dealing with it than I would. I owe that to him," she says.
"I also have elderly parents. I have limited my contact with them because I am out in the public more than I would like them exposed to."
She wears a mask and keeps her distance when she visits them, and they communicate often using FaceTime.
"At first my father was frustrated with me and my precautions," she says, "but now he appreciates it and understands it is out of an abundance of love and respect that I do this for my parents and my son."
What are you comfortable allowing your children to do this summer in terms of camps, playdates, etc?
Most of our participants have children beyond the age of camps and playdates, though Stinson says her grandson isn't playing sports this summer and has a limited play group.
If Haist's children - now 21 - were younger, he would be conflicted because of concerns about the mysterious Kawasaki-like syndrome affecting children, which has been reported in Kentucky.
He'd also worry about children being asymptomatic carriers infecting others. "This would be of particular concern if the children or their immediate family comes into regular contact with elderly grandparents or family or close friends who are immunocompromised who would likely do poorly if they became infected."
Haist and Schaffzin point out children's health concerns have to be weighed against their social, emotional, and physical development, too.
Assuming it's not canceled, Schaffzin's teen daughter is planning a trip abroad in the fall which, at the moment, she'll be allowed to take. "If she were younger, talking about day camps, I would look ahead to see how well controlled her environment would be at the camp. How serious and qualified is the staff to maintain necessary precautions?"
Schaffzin follows up about playgrounds, noting the risk there, for him, is more about close interactions than surfaces. "COVID dies extremely well through desiccation, or drying, and UV irradiation, or sunlight. A playground that sits outside when the sun is shining likely gets disinfected adequately but kids interacting close to one another ... there could be transmission."
Schaffzin, the pediatrics professor, offers a few more thoughts for parents debating what the should allow their children to do this summer:
- Have good communication with other parents about playdates, masking, distancing
- Avoid large get-togethers
- Talk with your kids about masking and distancing
"The same way we teach our kids to buckle up; the same way we teach our kids to not use certain substances or do other things; the same way we teach them how to treat one another and how to behave, this is another thing that we're teaching our kids how to do."
Will you enter pools once they reopen?
Finally comes something that might crush a few souls: public swimming pools.
Schaffzin points out COVID-19 is found in stool. As WVXU's Ann Thompson reported in early May, there's evidence even asymptomatic patients shed the virus into wastewater. The EPA is studying samples from MSD's seven major treatment plants in Greater Cincinnati to understand coronavirus trends.
"It likely falls into the category of diseases we are trying to avoid when we say don’t swim if you have diarrhea (like cryptosporidium, or enterovirus – aka hand foot and mouth disease)," Schaffzin says.
"Pools are chlorinated, but it takes time for the chlorine to kill an organism. Since we are not clear how much time is needed to kill COVID, I think we should study the fecal-oral transmission possibility more before opening pools widely."