vox--2020-07-02--How superspreading is fueling the pandemic — and how we can stop it

How superspreading is fueling the pandemic — and how we can stop it Share All sharing options for : How superspreading is fueling the pandemic — and how we can stop it We now know that , on average , people with the coronavirus infect about two other people and most actually pass the virus to just one other person , or to no one else at all .
But some go on to infect many , many more , often before they even get symptoms .
Many of these transmission chains begin with “ superspreading ” events , where @ @ @ @ @ @ @ indoor space ) passes the virus to dozens of others .
Early contact tracing studies suggest these events have been a large driver of transmission around the world .
By some estimates , 10 percent of people have been causing 80 percent of new infections .
This is one of the reasons experts are worried about large indoor events — more so than outdoor ones — causing large spikes in case numbers .
Some of the largest superspreading events have happened aboard ships , including Navy carriers and cruise ships .
But they @ @ @ @ @ @ @ smaller settings , including at a church in Arkansas .
In early March , a 57-year-old pastor and his wife , who both felt fine , attended a series of church events over three days , and the pastor returned for an additional Bible study group a few days later .
Soon after , they each started developing symptoms and eventually tested positive for the coronavirus .
But it had already spread .
At least 33 of the other 92 event attendees later tested positive for Covid-19 , and three of them died @ @ @ @ @ @ @ two dozen other illnesses — and another death — in the community .
One preliminary Centers for Disease Control and Prevention report analyzed all of the 3,184 confirmed Covid-19 cases in Japan through the beginning of April .
The researchers found that 61 percent of cases could be definitively traced to clusters of spread outside the household , such as at restaurants , bars , event venues , and workplaces .
And this is likely an undercount due to limitations in contact tracing .
What causes these superspreading clusters , and why are @ @ @ @ @ @ @ pandemic ?
Is it something about the people themselves who start them ?
Or is it more about the settings where these events take place ?
Or a combination ?
Thankfully , we are learning more about superspreading events , and this insight can help dramatically slow the spread of the coronavirus and save lives — all while potentially allowing more people to return to less risky activities .
That is , if policymakers implement the guidance , and people follow it .
“ If you could reduce superspreading , you could have @ @ @ @ @ @ @ ” Elizabeth McGraw , director of the Center for Infectious Disease Dynamics at Pennsylvania State University , told Vox in an email .
Let ’ s walk through it .
Why is the coronavirus so good at superspreading ?
To understand what might kick off a superspreading event , let ’ s review some basics about how this virus , SARS-CoV-2 , spreads .
Researchers have found that it often spreads through microscopic droplets created when an infected person coughs or sneezes — or even speaks — and another person breathes them in @ @ @ @ @ @ @ part of the reasoning behind staying at least 6 feet away from people and wearing a mask in public .
But scientists are finding that the virus likely also spreads through even tinier , longer-lasting aerosols particles from breathing or speaking ( or flushing a toilet ) .
These are so small they can linger in the air after an infectious person has left — and may contain infectious virus particles for up to three hours .
And they may be a key element to superspreading events : An infected person could seed @ @ @ @ @ @ @ without even getting physically close to all the people they end up infecting .
Superspreading also appears to be more likely with SARS-CoV-2 because people typically have the highest level of the virus in their system ( making them infectious ) right before they develop symptoms .
( This is very different from other severe coronaviruses like SARS and MERS , where people were most infectious seven to 10 days after they started feeling sick , when they were more likely to be in isolation or in medical care . )
So thousands @ @ @ @ @ @ @ to go about their lives not knowing that they could be spreading the disease .
This has meant that , as some researchers noted in a preprint , “ most transmissions are front-loaded ” toward the beginning of the illness .
As another team of researchers who analyzed cases and contacts in Taiwan noted in JAMA , people actually had a much lower risk of spreading the virus after five days of symptoms .
This might be in part because sick people are less likely to go out , whether because they don @ @ @ @ @ @ @ or because they simply don ’ t feel up to it .
But it also has to do with a person ’ s “ viral load ” — an amount that actually tends to go down as symptoms wear on .
A May study of samples collected from patients , published in Clinical Infectious Disease , suggests that people who had symptoms for more than eight days might not actually be very infectious .
“ I think the virus ’ s biggest weapon has been that it can be spread by asymptomatic or @ @ @ @ @ @ @ it so much more likely for people to be spreading the virus — sometimes to very large groups of people — unwittingly .
“ I think the virus ’ s biggest weapon has been that it can be spread by asymptomatic or presymptomatic people , ” McGraw says .
“ This , in combination with insufficient testing of people in the community , has meant that it can move from one host to the next while we are unaware.
” This coronavirus ’ s uneven spread is calculated by its “ dispersion factor @ @ @ @ @ @ @ ” ) : what proportion of cases cause the bulk of transmissions .
An even dispersion rate would mean most people cause the same number of secondary infections .
We still don ’ t have an entirely firm k factor for Covid-19 , and a lot of the research is still in the prepublication phase and has not been peer-reviewed .
But preliminary estimates , such as one co-authored by Adam Kucharski , an infectious disease dynamics expert at the London School of Hygiene and Tropical Medicine , suggest that about 10 percent @ @ @ @ @ @ @ of the virus ’ s spread .
Another early , non-peer-reviewed study from Israel put the local k factor at between 1 and 10 percent of infected people causing 80 percent of new infections .
And a preliminary analysis of superspreading events in Hong Kong put their estimates at around 20 percent of infections causing 80 percent of local transmission .
All of this shows how important superspreading events have been in the virus ’ s spread .
But it doesn ’ t fully explain why they are happening — or how to @ @ @ @ @ @ @ likely to be superspreaders ?
Scientists are learning that a person ’ s likelihood of kicking off a superspreading event probably depends a little bit on biology and a lot on behavior .
Some individuals seem to develop higher amounts of the virus in their system , upping their odds of transmitting it to others .
And given that the amount of virus in the body tends to shift over the duration of infection — rising until around the onset of symptoms , then declining — the chance that someone is a likely @ @ @ @ @ @ @ whether some people are predisposed to be superspreaders will take more time and research , McGraw says .
But what we have been learning is how individuals ’ behavior could increase the chance they spread the virus to many others — or not .
“ We do know that wearing masks , keeping up physical distancing , avoiding crowds , and isolating upon becoming sick or testing positive can prevent superspreading , ” she says .
The CDC report out of Japan found 22 people who likely started clusters of cases .
( @ @ @ @ @ @ @ years old . )
And for 16 people , the research team could figure out when transmission occurred , which is important because it showed that 41 percent of them didn ’ t have any symptoms when they spread the virus .
In fact , of the superspreaders , only one had a cough when they infected others .
This points to an important nuance in thinking about how some individuals might be sickening a disproportionate number of others .
“ We should not think about superspreaders as villains , ” McGraw says @ @ @ @ @ @ @ unknowingly be a superspreader ” — especially given what we know about how much it spreads when people are feeling just fine .
But that means we can probably also avoid becoming a superspreader .
How ?
By doing things we already know can limit the spread of the virus : “ Wear a mask .
Wash your hands .
Keep your distance , and respect the physical space of others , ” McGraw says .
As the pandemic has worn on and become increasingly politicized , however , many people in the @ @ @ @ @ @ @ leading to mask rebellions , large gatherings — and much greater chances of new superspreading events .
“ I see an increasing number of people not wearing masks in public as restrictions ease , ” McGraw says .
“ I find it disappointing .
I worry that our focus on personal freedoms in the US , rather than being more community-minded , is going to prolong the outbreak and lead to more deaths than necessary.
” Why superspreading is more common at concerts than in libraries Although we know that individuals ’ behavior @ @ @ @ @ @ @ might be even more important for these events is where they happen .
Researchers have been tracking many superspreading events around the globe , and there seem to be recurring locations no matter what the country .
In addition to those we have heard most about , like prisons , food processing plants , and elder care facilities , there have also been numerous large superspreading events at bars , churches , offices , gyms , and shopping centers .
These are also places , though , that are now reopening around the @ @ @ @ @ @ @ swing of cases in many states .
As Kucharski wrote in an email to Vox , “ Identifying and reducing risky events and environments could make a substantial dent in transmission.
” Not reducing these events has the opposite effect on the number of cases .
For example , as South Korea started to reopen in early May , one infected person who attended five nightclubs caused at least 50 new infections .
And a preliminary study of infection clusters in Hong Kong found that the largest one documented so far , which @ @ @ @ @ @ @ linked back to exposures from staff and musicians at a series of bars .
Seventy-three of the people in this cluster caught the virus at the bars ( including 39 who were customers ) , who then spread it to others in the community .
A team of researchers at the London School of Hygiene and Tropical Medicine has been collecting data on these superspreading events in a public database .
The largest ones — including two that resulted in more than 1,000 cases each — happened aboard ships .
Hundreds of cases @ @ @ @ @ @ @ close contact with others in worker dormitories , food processing plants , prisons , and elder care facilities .
But next on the list are an outbreak tied to a single person at an indoor-outdoor shopping market in Peru who likely infected 163 other people ; an indoor-outdoor religious service in India where one person likely sickened 130 others ; and an indoor-outdoor wedding in New Zealand where a single case sparked 98 more .
Only one of the 22 cluster location types the team analyzed in a preliminary study was an outdoor @ @ @ @ @ @ @ four clusters were linked to these sites , causing a total of 95 infections acquired directly from the sites ) .
These findings line up with other preliminary research that calculated closed environments to be almost 20 times more likely to spur additional coronavirus infections than open-air ones .
There has been concern that the massive protests across the US , which started in late May after the killing of George Floyd , would become superspreading events .
So far the data suggests that hasn ’ t been the case , with no @ @ @ @ @ @ @ had the largest demonstrations earlier in the month ( although public health officials will continue to track the numbers ) .
This lines up with the science .
“ Outdoor events like the protests are inherently less risky than indoor events , given greater airflow , ” McGraw says .
“ It is also easier to spread out and maintain physical distancing.
” And photographs of the protests have shown that a large number of people have been wearing masks .
Still , no massive gathering is guaranteed to stay Covid-19-free .
“ @ @ @ @ @ @ @ transmission given the large number of people present , ” she says .
It also appears that not all indoor venues and events are equally risky when it comes to starting a large cluster of new cases .
As we ’ ve learned from studying events , like the infamous March church choir practice in Skagit County , Washington , during which one person infected an estimated 52 of 61 people ( two of whom died ) , loud talking and singing “ can spread more virus than talking at a normal volume @ @ @ @ @ @ @ the recent analysis out of Japan found that “ many Covid-19 clusters were associated with heavy breathing in close proximity , such as singing at karaoke parties , cheering at clubs , having conversations in bars , and exercising in gymnasiums.
” Even looking more closely at cases from these locations can give us clues about what makes superspreading more likely .
A CDC report from South Korea detailed 112 Covid-19 infections that came from aerobic dance classes ( like Zumba ) in one city .
Interestingly , an instructor who infected dance @ @ @ @ @ @ @ classes , but none of those participants got ill. “ We hypothesize that the lower intensity of pilates and yoga did not cause the same transmission effects as those more intense fitness dance classes , ” the authors noted .
“ The moist , warm atmosphere in a sports facility coupled with turbulent air flow generated by intense physical exercise can cause more dense transmission of isolated droplets , ” thereby making the virus more likely to spread .
These hubs of contagion also are helping us learn what activities might be safer @ @ @ @ @ @ @ , from a distance , outdoors .
“ There ’ s increasing evidence that certain environments , like socially distanced picnics with a few other people , are far less risky than crowded , close-knit interactions , like large gatherings indoors , ” says Kucharski , who is also the author of a forthcoming book called The Rules of Contagion .
What should we be doing to limit superspreading ?
Superspreading can be both a curse and a potential blessing in a disease outbreak .
It means that having everyone on full lockdown @ @ @ @ @ @ @ disease in check when it is not already circulating widely in a community — if ( and that ’ s an important “ if ” ) we can determine the highest risks for superspreading and prevent them .
That ’ s the blessing .
The curse , Kucharski says , is “ if risky situations are missed or undetected , it means transmission could persist.
” Not only that , but there is also the danger that , as the authors of the one early report note , “ If a superspreader is @ @ @ @ @ @ @ other superspreaders.
” This seems entirely possible , especially given that people surrounding an original superspreader were probably already engaging in behavior ( like attending a crowded public location ) that would make them more likely to be a superspreader , too .
Superspreading events also can strain other systems in place , like contact tracing , to contain the virus , increasing the odds that further infections will continue to spiral in the community .
Just as a sudden spike in cases can surpass the capacity of health care systems , a @ @ @ @ @ @ @ to track and notify contacts of the infected to isolate and get tested .
But now that we have data from recent superspreading events , we could theoretically prevent future ones .
The good news is that the science suggests we can .
But it depends on government , businesses , and individuals to put these lessons into practice .
For example , in addition to physical distancing measures , limits on capacity , and requiring mask-wearing , governments and businesses could also take into account other details we are learning about superspreading @ @ @ @ @ @ @ more droplet-filled speech .
Some current efforts to prevent superspreading — like taking people ’ s temperature before they enter a building — can help , but are not failproof .
Even if a business , day care , or large-scale event checks everyone ’ s temperature before they enter , “ it won ’ t necessarily pick up everyone who is infectious , ” Kucharski says .
McGraw agrees , noting that it “ is really only going to catch a subset of people ” who have the virus .
For example @ @ @ @ @ @ @ fever , or “ their fever rises and falls over a single day ” or changes through the illness , she says .
One company that has tested more than 30,000 people for Covid-19 reported that just 12 percent of people with positive tests had a fever of 100 degrees or higher .
And only 37 percent even had a cough .
One thing that will help reduce these events is more contact tracing and testing .
These tools would also help us learn more about the nuances of superspreading and prevent more @ @ @ @ @ @ @ those 10 or 20 percent of people who would have sparked 80 percent of the new infections instead only passed the illness on to one or two other people , we could be in a much different place , and soon .
A first step is following the lead of infectious disease experts , who know well what potential superspreading situations to avoid .
McGraw says , “ Right now , I would not go to a gym , an indoor restaurant , or big , crowded events like rallies , concerts , @ @ @ @ @ @ @ feel comfortable doing ?
“ I might dine outside , if the tables were spaced apart , and I felt like the customers and restaurant staff were taking precautions.
” Earlier this summer , she went camping with her family , but she chose campgrounds following CDC guidelines .
“ For other places , like parks and beaches , my advice is to be prepared to leave if they get crowded and you can not safely distance , ” she says .
For his part , Kucharski cites the simple guidelines Japan has @ @ @ @ @ @ @ all possible , the “ 3 Cs ” — closed environments , crowded places , and close-contact settings .
And it ’ s a reminder that large , entirely optional indoor events seem exceptionally dangerous right now — not just for those who attend , but also for those they might come into contact with later .
Katherine Harmon Courage is a freelance science journalist and author of Cultured and Octopus !
Find her on Twitter at @ KHCourage .
Every day at Vox , we aim to answer your most important questions @ @ @ @ @ @ @ around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality @ @ @ @ @ @ @ Please consider making a contribution to Vox today .

How superspreading is fueling the pandemic — and how we can stop it
Share All sharing options for: How superspreading is fueling the pandemic — and how we can stop it
We now know that, on average, most people with the novel coronavirus pass the virus to just one other person, or to no one else at all.
But some go on to infect many, many more, often before they even experience symptoms. Many of these transmission chains begin with “superspreading” events, where one person (usually in a crowded indoor space) passes the virus to dozens of others. Early contact tracing studies suggest these events have been a large driver of transmission around the world. By some estimates, 10 percent of people have been causing 80 percent of new infections.
This is one of the reasons experts worry about large indoor gatherings — more so than outdoor ones — causing large spikes in case numbers.
With Friday’s news that at least 12 people who work in the White House or have recently attended events there, including President Donald Trump, have tested positive for the coronavirus, there are questions about whether the maskless indoor receptions on September 26 to celebrate Trump’s nomination of Judge Amy Coney Barrett to the Supreme Court kicked off a superspreading event.
The Amy Coney Barrett Rose Garden announcement was a superspreader event, despite being outdoors.
Single risk reduction measures are not enough. Multiple measures are needed:
Masks AND distancing AND avoid crowds AND hygiene AND avoid prolonged contact.https://t.co/gqO23wjsHk — Dr. Angela Rasmussen (@angie_rasmussen) October 3, 2020
To date, some of the largest superspreading events have happened aboard ships, including Navy carriers and cruise ships. But they are also happening in smaller settings, including at a church in Arkansas.
In early March, a 57-year-old pastor and his wife, who both felt fine, attended a series of church events over three days, and the pastor returned for an additional Bible study group a few days later. Soon after, they each started developing symptoms and eventually tested positive for the coronavirus. But it had already spread. At least 33 of the other 92 event attendees later tested positive for Covid-19, and three of them died. These cases then spawned more than two dozen other illnesses — and another death — in the community.
One preliminary Centers for Disease Control and Prevention report analyzed all of the 3,184 confirmed Covid-19 cases in Japan through the beginning of April. The researchers found that 61 percent of cases could be definitively traced to clusters of spread outside the household, such as at restaurants, bars, event venues, and workplaces. And this is likely an undercount due to limitations in contact tracing.
Superspreading events can lead to potentially thousands of cases in the community, as an August 25 preprint that hasn’t yet been peer reviewed suggests. The authors sequenced the full viral genome in 772 Covid-19 cases in the Boston region, including 28 early cases that were linked to a late-February conference for the biotech company Biogen. By finding a specific genetic mutation in the conference infections, they could then trace the chain of transmission. This one variant was found in about one in three later cases in their Boston area study (and about 2.7 percent of all of the analyzed US cases), suggesting that the Biogen conference led to an estimated 20,000 Covid-19 cases in total.
What causes these superspreading clusters, and why are they such a key driver of this pandemic? Is it something about the people themselves who start them? Or is it more about the settings where these events take place? Or a combination?
Thankfully, we are learning more about superspreading events, and this insight can help dramatically slow the spread of the coronavirus and save lives — all while potentially allowing more people to return to less risky activities. That is, if policymakers implement the guidance, and people follow it. “If you could reduce superspreading, you could have a massive impact on the pandemic,” Elizabeth McGraw, director of the Center for Infectious Disease Dynamics at Pennsylvania State University, told Vox in an email. Let’s walk through it.
Why is the coronavirus so good at superspreading?
To understand what might kick off a superspreading event, let’s review some basics about how this virus, SARS-CoV-2, spreads. Researchers have found that it often spreads through microscopic droplets created when an infected person coughs or sneezes — or even speaks — and another person breathes them in. These disease-containing droplets are a large part of the reasoning behind staying at least 6 feet away from people and wearing a mask in public.
But scientists are finding that the virus likely also spreads through even tinier, longer-lasting aerosols particles from breathing or speaking (or flushing a toilet). These are so small they can linger in the air after an infectious person has left — and may contain infectious virus particles for up to three hours. And they may be a key element to superspreading events: An infected person could seed a poorly ventilated indoor space with virus without even getting physically close to all the people they end up infecting.
Superspreading also appears to be more likely with SARS-CoV-2 because people typically have the highest level of the virus in their system (making them infectious) right before they develop symptoms. (This is very different from other severe coronaviruses like SARS and MERS, where people were most infectious seven to 10 days after they started feeling sick, when they were more likely to be in isolation or in medical care.) So thousands of people with active Covid-19 infections continue to go about their lives not knowing that they could be spreading the disease.
This has meant that, as some researchers noted in a preprint, “most transmissions are front-loaded” toward the beginning of the illness. As another team of researchers who analyzed cases and contacts in Taiwan noted in JAMA, people actually had a much lower risk of spreading the virus after five days of symptoms. This might be in part because sick people are less likely to go out, whether because they don’t want to spread their illness or because they simply don’t feel up to it.
But it also has to do with a person’s “viral load” — an amount that actually tends to go down as symptoms wear on. A May study of samples collected from patients, published in Clinical Infectious Disease, suggests that people who had symptoms for more than eight days might not actually be very infectious.
“I think the virus’s biggest weapon has been that it can be spread by asymptomatic or presymptomatic people”
All of this makes it so much more likely for people to be spreading the virus — sometimes to very large groups of people — unwittingly.
“I think the virus’s biggest weapon has been that it can be spread by asymptomatic or presymptomatic people,” McGraw says. “This, in combination with insufficient testing of people in the community, has meant that it can move from one host to the next while we are unaware.”
This coronavirus’s uneven spread is calculated by its “dispersion factor” (sometimes abbreviated as “k”): what proportion of cases cause the bulk of transmissions. An even dispersion rate would mean most people cause the same number of secondary infections.
We still don’t have an entirely firm k factor for Covid-19, and a lot of the research is still in the prepublication phase and has not been peer-reviewed. But preliminary estimates, such as one co-authored by Adam Kucharski, an infectious disease dynamics expert at the London School of Hygiene and Tropical Medicine, suggest that about 10 percent of infected people cause about 80 percent of the virus’s spread.
Another early, non-peer-reviewed study from Israel put the local k factor at between 1 and 10 percent of infected people causing 80 percent of new infections. And a preliminary analysis of superspreading events in Hong Kong put their estimates at around 20 percent of infections causing 80 percent of local transmission.
All of this shows how important superspreading events have been in the virus’s spread. But it doesn’t fully explain why they are happening — or how to stop them.
Are certain people more likely to be superspreaders?
Scientists are learning that a person’s likelihood of kicking off a superspreading event probably depends a little bit on biology and a lot on behavior.
Some individuals seem to develop higher amounts of the virus in their system, upping their odds of transmitting it to others.
And given that the amount of virus in the body tends to shift over the duration of infection — rising until around the onset of symptoms, then declining — the chance that someone is a likely superspreader changes over time.
Another preprint posted on August 7 developed a model to better understand how these dynamics might be playing out for SARS-CoV-2. The research suggests that people carrying this virus are potentially infectious for about two and a half days — and rise to a “moderate probability of transmission per contact” for “less than half a day,” the researchers write.
This means that it would likely take someone having contact with a large number of people during the window when they had fairly large amounts of the virus (more than 10 million RNA copies) to spark a superspreading event infecting more than 50 people (whereas someone with 100,000 viral RNA copies was unlikely to infect others).
This helps us understand how superspreading can happen by chance, on a population level. Finding out whether some people are predisposed to be superspreaders will take more time and research, McGraw says.
But what we have been learning is how individuals’ behavior could increase the chance they spread the virus to many others — or not. “We do know that wearing masks, keeping up physical distancing, avoiding crowds, and isolating upon becoming sick or testing positive can prevent superspreading,” she says.
The CDC report out of Japan found 22 people who likely started clusters of cases. (Half of them were 20 to 39 years old.) And for 16 people, the research team could figure out when transmission occurred, which is important because it showed that 41 percent of them didn’t have any symptoms when they spread the virus. In fact, of the superspreaders, only one had a cough when they infected others.
And as the authors of the August 7 preprint found, about 62 percent of superspreading transmissions happened when the spreader was presymptomatic.
This points to an important nuance in thinking about how some individuals might be sickening a disproportionate number of others. “We should not think about superspreaders as villains,” McGraw says. “Any one of us could unknowingly be a superspreader” — especially given what we know about how much it spreads when people are feeling just fine.
But that means we can probably also avoid becoming a superspreader by doing things we already know can limit the spread of the virus: “Wear a mask. Wash your hands. Keep your distance, and respect the physical space of others,” McGraw says.
As the pandemic has worn on and become increasingly politicized, however, many people in the US are now resisting continued precautions, leading to mask rebellions, large gatherings — and much greater chances of new superspreading events.
“I see an increasing number of people not wearing masks in public as restrictions ease,” McGraw says. “I find it disappointing. I worry that our focus on personal freedoms in the US, rather than being more community-minded, is going to prolong the outbreak and lead to more deaths than necessary.”
Why superspreading is more common at concerts than in libraries
Although we know that individuals’ behavior plays a role in superspreading, what might be even more important for these events is where they happen.
Researchers have been tracking many superspreading events around the globe, and there seem to be recurring locations no matter what the country. In addition to those we have heard most about, like prisons, food processing plants, and elder care facilities, there have also been numerous large superspreading events at bars, churches, offices, gyms, and shopping centers.
These are also places, though, that are now reopening around the country and likely contributing to the upward swing of cases in many states. As Kucharski wrote in an email to Vox, “Identifying and reducing risky events and environments could make a substantial dent in transmission.” Not reducing these events has the opposite effect on the number of cases.
For example, as South Korea started to reopen in early May, one infected person who attended five nightclubs caused at least 50 new infections.
And a preliminary study of infection clusters in Hong Kong found that the largest one documented so far, which resulted in 106 Covid-19 cases, was linked back to exposures from staff and musicians at a series of bars. Seventy-three of the people in this cluster caught the virus at the bars (including 39 who were customers), who then spread it to others in the community.
A team of researchers at the London School of Hygiene and Tropical Medicine has been collecting data on these superspreading events in a public database. The largest ones — including two that resulted in more than 1,000 cases each — happened aboard ships. Hundreds of cases also have originated from single individuals in close contact with others in worker dormitories, food processing plants, prisons, and elder care facilities.
But next on the list are an outbreak tied to a single person at an indoor-outdoor shopping market in Peru who likely infected 163 other people; an indoor-outdoor religious service in India where one person likely sickened 130 others; and an indoor-outdoor wedding in New Zealand where a single case sparked 98 more.
Only one of the 22 cluster location types the team analyzed in a preliminary study was an outdoor setting (building sites in Singapore; four clusters were linked to these sites, causing a total of 95 infections acquired directly from the sites).
These findings line up with other preliminary research that calculated closed environments to be almost 20 times more likely to spur additional coronavirus infections than open-air ones.
There was concern that the massive protests across the US, which started in late May after the killing of George Floyd, would become superspreading events. So far the data suggests that wasn’t the case, with no large surge in cases in cities that had the largest demonstrations.
This lines up with the science. “Outdoor events like the protests are inherently less risky than indoor events, given greater airflow,” McGraw says. “It is also easier to spread out and maintain physical distancing.” And photographs of the protests have shown that a large number of people have been wearing masks. Still, no massive gathering is guaranteed to stay Covid-19-free. “There will still be increased risk of transmission given the large number of people present,” she says.
It also appears that not all indoor venues and events are equally risky when it comes to starting a large cluster of new cases.
As we’ve learned from studying events, like the infamous March church choir practice in Skagit County, Washington, during which one person infected an estimated 52 of 61 people (two of whom died), loud talking and singing “can spread more virus than talking at a normal volume,” McGraw says.
Indeed, the recent analysis out of Japan found that “many Covid-19 clusters were associated with heavy breathing in close proximity, such as singing at karaoke parties, cheering at clubs, having conversations in bars, and exercising in gymnasiums.”
Even looking more closely at cases from these locations can give us clues about what makes superspreading more likely. A CDC report from South Korea detailed 112 Covid-19 infections that came from aerobic dance classes (like Zumba) in one city. Interestingly, an instructor who infected dance class participants also taught yoga and Pilates classes, but none of those participants got ill.
“We hypothesize that the lower intensity of pilates and yoga did not cause the same transmission effects as those more intense fitness dance classes,” the authors noted. “The moist, warm atmosphere in a sports facility coupled with turbulent air flow generated by intense physical exercise can cause more dense transmission of isolated droplets,” thereby making the virus more likely to spread.
These hubs of contagion also are helping us learn what activities might be safer, like seeing small groups of people, from a distance, outdoors.
“There’s increasing evidence that certain environments, like socially distanced picnics with a few other people, are far less risky than crowded, close-knit interactions, like large gatherings indoors,” says Kucharski, who is also the author of The Rules of Contagion.
What should we be doing to limit superspreading?
Superspreading can be both a curse and a potential blessing in a disease outbreak. It means that having everyone on full lockdown is not necessarily essential to keep the disease in check when it is not already circulating widely in a community — if (and that’s an important “if”) we can determine the highest risks for superspreading and prevent them. That’s the blessing. The curse, Kucharski says, is “if risky situations are missed or undetected, it means transmission could persist.”
Not only that, but there is also the danger that, as the authors of one early report note, “If a superspreader is infected, the disease may spread to other superspreaders.” This seems entirely possible, especially given that people surrounding an original superspreader were probably already engaging in behavior (like attending a crowded public location) that would make them more likely to be a superspreader, too.
Superspreading events also can strain other systems in place, like contact tracing, to contain the virus, increasing the odds that further infections will continue to spiral in the community. Just as a sudden spike in cases can surpass the capacity of health care systems, a big jump can also surpass local capacity to track and notify contacts of the infected to isolate and get tested.
But now that we have data from recent superspreading events, we could theoretically prevent future ones. For example, the preprint modeling superspreading dynamics suggests that just reducing exposure opportunities, such as events with 20 or more possible people, could get the virus’s spread under control.
The good news is that the science on this is growing. But it depends on government, businesses, and individuals to put these lessons into practice.
For example, in addition to physical distancing measures, limits on capacity, and requiring mask-wearing, governments and businesses could also take into account other details we are learning about superspreading events, like loud environments that encourage more droplet-filled speech.
One thing that will help reduce these events is more contact tracing, isolation, and testing. If those 10 or 20 percent of people who would have sparked 80 percent of the new infections instead only passed the illness on to one or two other people, we could be in a much different place, and soon.
A first step is following the lead of infectious disease experts, who know well what potential superspreading situations to avoid. McGraw says, “I might dine outside, if the tables were spaced apart, and I felt like the customers and restaurant staff were taking precautions.” Earlier this summer, she went camping with her family, but she chose campgrounds following CDC guidelines. “For other places, like parks and beaches, my advice is to be prepared to leave if they get crowded and you cannot safely distance,” she says.
For his part, Kucharski cites the simple guidelines Japan has put out: avoid, when at all possible, the “3 Cs” — closed environments, crowded places, and close-contact settings.
Katherine Harmon Courage is a freelance science journalist and author of Cultured and Octopus! Find her on Twitter at @KHCourage.
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vox--2020-07-02--The Trump administration is targeting homeless trans people in the middle of a pandemic

The Housing and Urban Development Agency announced a proposed rule Wednesday that would allow homeless shelters that receive federal funding to discriminate against transgender people .
Though the text of the proposed rule is not yet available and the rule has not been posted on the Federal Register , the agency issued a press release announcing it , explaining that while shelters are barred from excluding people based on their transgender status , they are also allowed to ignore a person ’ s gender identity and house them according to their assigned sex at birth or their legal sex .
@ @ @ @ @ @ @ can ’ t be turned away from a shelter for being trans , but she can be forced to house in a men ’ s shelter .
Dylan Waguespack , a spokesperson for True Colors United , an advocacy group that focuses on supporting LGBTQ homeless youth , said that HUD Secretary Ben Carson is “ talking out of both sides of his mouth.
” “ They are trying to put forward this narrative in which transgender people are protected from discrimination , but in fact , when you read the proposal itself @ @ @ @ @ @ @ ” he told Vox .
“ It creates unsafe conditions and unsafe barriers to housing and services for trans people in the midst of a global pandemic.
” The rule , if finalized , would not overrule state and local laws , but it would go into effect in the 38 states that do not already have housing protections for transgender people .
It ’ s the latest in a long line of anti-trans policies rolled out by the Trump administration .
Almost immediately after he took office in 2017 , the administration @ @ @ @ @ @ @ to fairly treat trans students .
Then in July of that year , Trump announced he would be ordering the military to ban trans people from serving .
The administration went after trans prisoners as well in May 2018 , deciding that in most cases , trans people should be housed according to their assigned sex at birth .
“ This is a continual angle for the administration to try to do anything to just harm my community , ” LaLa Zannell , trans justice campaign manager for the ACLU , told Vox @ @ @ @ @ @ @ , the Department of Housing and Urban Development could be focusing on making sure that [ trans ] people are staying in the houses that they already have , and that they ’ re in safe and stable housing .
They should not invest in resources that could crack down on homelessness for more trans people.
” The rule will allow shelters in most states to ignore a trans person ’ s gender identity when making housing policies As Waguespack noted , the text of HUD ’ s release is confusing .
Here @ @ @ @ @ @ @ people looking for shelter .
“ The new rule allows shelter providers that lawfully operate as single-sex or sex-segregated facilities to voluntarily establish a policy that will govern admissions determinations for situations when an individual ’ s gender identity does not match their biological sex , ” the agency said in a statement .
This means that the rule allows shelters to completely ignore a trans person ’ s gender identity and can instead choose to house them according to their assigned sex at birth , which goes against the 2016 Equal Access @ @ @ @ @ @ @ The statement continues : “ Each shelter ’ s policy is required to be consistent with state and local law , must not discriminate based on sexual orientation or transgender status , and may incorporate practical considerations of shelter providers that often operate in difficult conditions.
” What the agency is seemingly trying to do with the rule is define discrimination against trans people as based on their transgender status rather than their gender identity — but for trans people , the two are intertwined .
In other words , a shelter provider @ @ @ @ @ @ @ from utilizing their services , but they can , for example , house trans women in men ’ s shelters .
There are two main problems with forcing trans homeless people into spaces that correspond with their birth-assigned gender rather than their gender identity .
The first is that such a policy exposes trans people , especially trans women , to potential violence and sexual assault inside those spaces .
And as a result , trans people are more likely to choose sleeping in the streets rather than risk going to a shelter @ @ @ @ @ @ @ and poverty , trans people are more likely than their cisgender peers to experience homelessness .
According to the National Center for Transgender Equality , 29 percent of trans people live in poverty , and one in five trans people in the US will be homeless at some point in their lifetimes .
The numbers are even starker for Black trans people : A 2015 report indicated that 34 percent of Black trans people live in extreme poverty , compared to 9 percent of Black cis people .
Rep. Jennifer Wexton ( D-VA @ @ @ @ @ @ @ HUD ’ s rule change ever since the department first said it was pursuing a change last May .
“ Requiring trans people to be housed according to their birth gender rather than their gender identity is a recipe for harassment and sexual or physical assault , ” she told Vox .
“ This population is already under enough attack .
We can ’ t have them avoid staying shelters.
” Wexton recalled asking Carson during a hearing of the House Financial Services Committee in May 2019 whether he had any intention of @ @ @ @ @ @ @ He said he had no plans to do so .
And the very next day , [ HUD ] announced their intention to gut the equal access rule .
So they are not being honest.
” The rule ’ s timing , about two weeks after the Supreme Court ruled that discrimination against transgender people constitutes discrimination on the basis of sex , caught the eye of both Wexton and LGBTQ advocates .
According to a letter obtained by Vox from Wexton and Rep. Maxine Waters ( D-CA ) to Carson and dated @ @ @ @ @ @ @ rule was in process before the Supreme Court ’ s decision in Bostock v. Clayton County .
“ The release of a potentially applicable Supreme Court decision during the period of our regulatory review is unique and raises concerns about the applicability and implementation of the proposed rule , ” reads Wexton and Waters ’ s letter , which asked Carson to reconsider publishing the proposed rule before conducting additional legal analysis .
The proposed rule now enters a 60-day public comment period before it can be finalized .
“ They ’ re @ @ @ @ @ @ @ may not be in control anymore , ” said Wexton .
“ It ’ s disappointing but not surprising that they ’ re rushing it through in this way , especially given the broad implications of Bostock.
” Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox @ @ @ @ @ @ @ than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

The Housing and Urban Development Agency announced a proposed rule Wednesday that would allow homeless shelters that receive federal funding to discriminate against transgender people.
Though the text of the proposed rule is not yet available and the rule has not been posted on the Federal Register, the agency issued a press release announcing it, explaining that while shelters are barred from excluding people based on their transgender status, they are also allowed to ignore a person’s gender identity and house them according to their assigned sex at birth or their legal sex. In other words, a trans woman can’t be turned away from a shelter for being trans, but she can be forced to house in a men’s shelter.
Dylan Waguespack, a spokesperson for True Colors United, an advocacy group that focuses on supporting LGBTQ homeless youth, said that HUD Secretary Ben Carson is “talking out of both sides of his mouth.”
“They are trying to put forward this narrative in which transgender people are protected from discrimination, but in fact, when you read the proposal itself, it does the exact opposite,” he told Vox. “It creates unsafe conditions and unsafe barriers to housing and services for trans people in the midst of a global pandemic.”
The rule, if finalized, would not overrule state and local laws, but it would go into effect in the 38 states that do not already have housing protections for transgender people.
It’s the latest in a long line of anti-trans policies rolled out by the Trump administration. Almost immediately after he took office in 2017, the administration rolled back an Obama-era memo for schools to fairly treat trans students. Then in July of that year, Trump announced he would be ordering the military to ban trans people from serving. The administration went after trans prisoners as well in May 2018, deciding that in most cases, trans people should be housed according to their assigned sex at birth.
“This is a continual angle for the administration to try to do anything to just harm my community,” LaLa Zannell, trans justice campaign manager for the ACLU, told Vox. “With a pandemic going on, the Department of Housing and Urban Development could be focusing on making sure that [trans] people are staying in the houses that they already have, and that they’re in safe and stable housing. They should not invest in resources that could crack down on homelessness for more trans people.”
The rule will allow shelters in most states to ignore a trans person’s gender identity when making housing policies
As Waguespack noted, the text of HUD’s release is confusing. Here’s how it could affect trans people looking for shelter.
“The new rule allows shelter providers that lawfully operate as single-sex or sex-segregated facilities to voluntarily establish a policy that will govern admissions determinations for situations when an individual’s gender identity does not match their biological sex,” the agency said in a statement.
This means that the rule allows shelters to completely ignore a trans person’s gender identity and can instead choose to house them according to their assigned sex at birth, which goes against the 2016 Equal Access Rule established by the Obama administration.
The statement continues: “Each shelter’s policy is required to be consistent with state and local law, must not discriminate based on sexual orientation or transgender status, and may incorporate practical considerations of shelter providers that often operate in difficult conditions.”
What the agency is seemingly trying to do with the rule is define discrimination against trans people as based on their transgender status rather than their gender identity — but for trans people, the two are intertwined. In other words, a shelter provider cannot simply disallow all trans people from utilizing their services, but they can, for example, house trans women in men’s shelters.
There are two main problems with forcing trans homeless people into spaces that correspond with their birth-assigned gender rather than their gender identity. The first is that such a policy exposes trans people, especially trans women, to potential violence and sexual assault inside those spaces. And as a result, trans people are more likely to choose sleeping in the streets rather than risk going to a shelter.
Because of a cycle of discrimination and poverty, trans people are more likely than their cisgender peers to experience homelessness. According to the National Center for Transgender Equality, 29 percent of trans people live in poverty, and one in five trans people in the US will be homeless at some point in their lifetimes. The numbers are even starker for Black trans people: A 2015 report indicated that 34 percent of Black trans people live in extreme poverty, compared to 9 percent of Black cis people.
Rep. Jennifer Wexton (D-VA) has been an outspoken critic of HUD’s rule change ever since the department first said it was pursuing a change last May. “Requiring trans people to be housed according to their birth gender rather than their gender identity is a recipe for harassment and sexual or physical assault,” she told Vox. “This population is already under enough attack. We can’t have them avoid staying shelters.”
Wexton recalled asking Carson during a hearing of the House Financial Services Committee in May 2019 whether he had any intention of changing the Equal Access Rule. “He said he had no plans to do so. And the very next day, [HUD] announced their intention to gut the equal access rule. So they are not being honest.”
The rule’s timing, about two weeks after the Supreme Court ruled that discrimination against transgender people constitutes discrimination on the basis of sex, caught the eye of both Wexton and LGBTQ advocates.
According to a letter obtained by Vox from Wexton and Rep. Maxine Waters (D-CA) to Carson and dated June 29, HUD’s proposed rule was in process before the Supreme Court’s decision in Bostock v. Clayton County.
“The release of a potentially applicable Supreme Court decision during the period of our regulatory review is unique and raises concerns about the applicability and implementation of the proposed rule,” reads Wexton and Waters’s letter, which asked Carson to reconsider publishing the proposed rule before conducting additional legal analysis.
The proposed rule now enters a 60-day public comment period before it can be finalized. “They’re rushing to get it through before they may not be in control anymore,” said Wexton. “It’s disappointing but not surprising that they’re rushing it through in this way, especially given the broad implications of Bostock.”


vox--2020-07-02--A likely culprit in Covid-19 surges: People hell-bent on ignoring social distancing orders

For months , it ’ s been clear that the world has separated into two camps : the rule followers , observant of social distancing and hopeful of quashing the pandemic ; and the risk takers , who have been storming the nation ’ s beaches , bars , and burger joints in spite of the coronavirus — and public health efforts to curtail its spread .
Some states , such as New York , have contained new cases , but others , including Texas and Arizona , brazenly reopened even as cases continued to rise , unleashing a torrent @ @ @ @ @ @ @ as an illusion of normalcy has slowly returned , rates of infection are reaching new records , with cases surging in dozens of states .
The US is “ going in the wrong direction , ” Dr. Anthony Fauci , the director of the National Institute of Allergy and Infectious Diseases and frequent face of the Trump administration ’ s virus response , warned senators recently .
In March , the new virus pushed dozens of countries to implement strict isolation methods to prevent a global health crisis .
In China , coronavirus @ @ @ @ @ @ @ authorities sealed apartment buildings and scanned millions for rising body temperatures .
But in the United States , these restrictions have been harder to devise and enforce , mostly because democratic norms and a strong sense of individual liberty prevail .
So , instead , the crisis has exposed humanity ’ s tendency to flout the rules .
Masks — although recommended by federal and world health officials as effective in slowing the virus ’ s spread — have become a polarizing symbol of this dangerous phenomenon .
In recent weeks , protesters @ @ @ @ @ @ @ businesses to decry face-covering requirements , calling them “ muzzles ” and “ communist.
” In one viral video , a maskless Florida man shoved a Walmart employee who tried to enforce the store ’ s face-covering policy .
In another , a woman at a California Trader Joe ’ s screamed at employees and customers after others in the store criticized her for shopping without a mask .
Some scofflaws have taken to brandishing sham cards from a phony “ Freedom to Breathe Agency ” that purportedly exempt them from mask-wearing .
@ @ @ @ @ @ @ say , are the multitudes of young people determined to socialize .
Some have tried to pin the problem on the Black Lives Matter protests that have continued for weeks , but preliminary research using geolocation data suggests these events had no impact on the virus ’ s spread .
Instead , public health experts are attributing the surge in new cases to the mask-free masses flocking to reopened restaurants and bars , pool parties and lazy rivers .
“ They ’ re conducting themselves like it ’ s pre-Covid , and that @ @ @ @ @ @ @ , ” Bruce Dart , director of the Tulsa Health Department , told the Washington Post .
Younger people , he said , are “ not social distancing , not wearing masks or paying attention to hand-washing.
” In one stunning case shortly after Memorial Day , a group of 16 friends all tested positive for the virus after visiting a newly reopened bar in Florida .
In the months since worldwide lockdowns were adopted , there ’ s been a recurring theme among coronavirus rebels : They do what they want .
@ @ @ @ @ @ @ , people swarmed beaches around the world , from Florida to Bondi Beach in Australia .
“ If I get corona , I get corona , ” one spring breaker told Reuters .
“ At the end of the day , I ’ m not gon na let it stop me from partying.
” ( He later apologized , calling his comment “ insensitive.
” ) Even after quarantines had been instituted , Washington , DC , Metro officials in March had to practically beg riders not to visit the city ’ s @ @ @ @ @ @ @ anyway , in droves .
Brits took to crowded pubs to chant “ f*** coronavirus !
” And one woman went viral when she tweeted about her defiant trip to a crowded Red Robin restaurant .
“ It was delicious , ” she tweeted , “ and I took my sweet time eating my meal .
Because this is America .
And I ’ ll do what I want.
” Even officials are taking smug positions on the public health warnings .
“ I don ’ t need his advice anymore , ” @ @ @ @ @ @ @ of Fauci on Fox News in late June .
The poor reaction of a growing number of people to social distancing and mask policies — even as the virus resurges — comes as no surprise to psychologists , sociologists , and public health experts .
No one alive today has experience with a pandemic of this severity , catching even the most experienced researchers off-guard , not to mention the average person sorting through their Facebook feed .
Conflicting government messaging and reopenings of restaurants , bars , hair salons , and gyms @ @ @ @ @ @ @ wildly divergent individual responses , and reliance on personal responsibility in public health matters .
It ’ s created fertile ground for the public to practice the long-held wisdom that we must “ carry on ” in a crisis : For at least a century , citizens have believed that in the midst of a disaster , their job is to go on with their daily lives as best they can — as if it were a safeguard against an unseen enemy .
“ We feel like we have to do something , @ @ @ @ @ @ @ at Princeton University and author of Be Very Afraid : The Cultural Response to Terror , Pandemics , Environmental Devastation , Nuclear Annihilation , and Other Threats .
But without a good frame of reference for the present crisis , we ’ ve looked to lessons learned from past calamities , including natural disasters , terrorism , war , and economic collapse , to guide us .
“ We ’ re a little bit like generals fighting the last war , ” he said .
But the old rules no longer apply .
@ @ @ @ @ @ @ Fairchild , a public health ethicist and the dean of Ohio State University ’ s College of Public Health .
“ In this moment in time , ‘ carry on ’ could be a formula for disaster.
” When the coronavirus first arrived in the United States , people cast about for comparisons .
“ So last year 37,000 Americans died from the common Flu , ” President Trump tweeted on March 9 .
“ It averages between 27,000 and 70,000 per year .
Nothing is shut down , life & the economy @ @ @ @ @ @ @ are 546 confirmed cases of CoronaVirus , with 22 deaths .
Think about that !
” Experts including Fauci debunked the comparison .
“ The flu has a mortality of 0.1 % , ” he told Congress on March 11 .
“ This has a mortality rate of 10 times that.
” But the analogy — intended to make an extraordinary threat look like ordinary — persists .
In reality , the coronavirus has no clear analogue .
“ The normal mechanisms we ’ re using to predict things don ’ t work @ @ @ @ @ @ @ professor of cognitive neuroscience at the University College London who studies human motivation .
“ Actually , nothing else that has happened before in our lifetimes is relevant or helpful here.
” Many contemporary disaster mantras emerged in past wars , and they often contained a kernel of a consumerist message .
At the outset of World War I , British politicians such as Winston Churchill encouraged “ business as usual , ” suggesting that both companies and citizens should continue to behave just as they did in peacetime .
But the status @ @ @ @ @ @ @ defense effort when the state realized it would need to control manufacturing , trade , and commerce to win the war .
Twenty years later , in World War II , the British government coined “ Keep Calm and Carry On ” to boost morale in anticipation of a Nazi invasion .
But it quickly pulped the test posters ; other campaigns about courage in a crisis provoked public outcry as many people found the messages tone-deaf .
After half a century , however , the phrase was exhumed — in part as @ @ @ @ @ @ @ Recession .
In times of crisis , Americans have borrowed English idioms , and coined a few of their own homespun mottos for personal and economic perseverance .
During the Great Depression , President Franklin D. Roosevelt made an enemy of an emotion , telling the public , “ We have nothing to fear but fear itself.
” In the aftermath of the 9/11 terrorist attacks , President Bush gave this famed aphorism a consumerist spin when he told airline employees , “ When [ the terrorists ] struck , they wanted to @ @ @ @ @ @ @ one of the great goals of this nation ’ s war is to restore public confidence in the airline industry .
It ’ s to tell the traveling public : Get on board .
Do your business around the country .
Fly and enjoy America ’ s great destination spots .
Get down to Disney World in Florida.
” “ Get down to Disney World ” was probably never meant to apply to the people who actually traveled to the Magic Kingdom in March amid public health warnings to avoid crowds .
( @ @ @ @ @ @ @ visitors , though some reopenings are imminent . )
But that didn ’ t stop some politicians from applying this logic to the coronavirus .
In a White House press briefing , President Trump said , “ America will again and be soon open for business , ” and later suggested relaxing guidelines by Easter .
That jingoistic outlook quickly dissipated as the virus seemed to metastasize , killing more than 120,000 Americans and requiring social distancing to continue for months .
And Americans haven ’ t been the best socially distant citizens @ @ @ @ @ @ @ a new catalyst for the spread of the virus , and many officials are desperate to reinstate or expand social distancing policies before the Fourth of July .
At the Lake of the Ozarks , for example , a raucous pool party was later linked to multiple coronavirus infections .
Alabama students reportedly threw parties attended by infected students that one local lawmaker has alleged were “ Covid parties , ” aimed at intentionally getting others sick .
“ It ’ s almost like we don ’ t want the virus to win @ @ @ @ @ @ @ go out drinking , go to parties , go out to the beach , ” Wuthnow said .
But these are risky responses when the enemy is not a person or a bad year for the stock market , but a virus — one that can be transmitted asymptomatically .
“ It ’ s almost like we don ’ t want the virus to win , so we ’ re going to go out drinking , go to parties , go out to the beach ” Humans are generally terrible at assessing risk @ @ @ @ @ @ @ true in the case of the coronavirus .
“ It ’ s about our risk to others , and that might make it a little more difficult to understand , ” said Cynthia Rohrbeck , an associate professor in clinical and community psychology at George Washington University .
People are used to talking with their doctors about their personal health , but taking responsibility for the health of others comes up only infrequently , often in public discourse around smoking , drinking and driving , and getting vaccinated .
Our judgment could be @ @ @ @ @ @ @ to believe you are less likely than others to experience something negative .
In late February , researchers polled 4,348 people in France , Italy , the United Kingdom , and Switzerland and found half of them believed they were less likely to get the coronavirus than others , sans real evidence .
Another poll , conducted in mid-March on more than 800 people from the US , the United Kingdom , and Germany , suggested this optimism was bolstered by people ’ s belief that they had fewer human interactions than their @ @ @ @ @ @ @ the virus inherently lower .
When countries finally began to roll out isolation measures , they encountered additional obstacles .
“ One of the most important things for people is to have a sense that they are in control of their own life , that they have agency , ” Sharot said .
In a paper in The Lancet , researchers reviewed 24 past publications on the psychological effects of quarantine and found it can cause post-traumatic stress symptoms , confusion , and anger .
But the desire for agency can have an @ @ @ @ @ @ @ , the authoritarian government has wide latitude to control the behavior of its citizens .
But in the United States , few Americans have experienced government-imposed restrictions on when they can go out and whom they can see .
Many politicians criticized the rules as an infringement on people ’ s freedom , not to mention a disaster for the economy .
In March , Arizona state Rep. Anthony Kern ( R ) and Oklahoma Gov .
Kevin Stitt ( R ) both tweeted ( and deleted ) defiant photos from crowded restaurants @ @ @ @ @ @ @ just shut ourselves and stay home , ” Sen. Ron Johnson ( R-WI ) told the Milwaukee Journal Sentinel .
“ The economy has to move forward.
” And even the president has refused to be photographed wearing a mask , underscoring the way protective face coverings have become a partisan lightning rod .
Now , as states are seeing terrifying spikes in their coronavirus cases , some are reinstating the social distancing strategies they just rolled back .
“ Me , personally , I just refuse to live my life in fear @ @ @ @ @ @ @ Las Vegas resident who went viral for her Red Robin tweet , told Vox in March .
“ As Americans , we typically do what we want .
It ’ s kind of that attitude we ’ ve always had , ” she added .
“ I think if we ’ re going to start pressuring people that they have to stay home , or publicly shaming them like pariahs , I think we ’ re just starting to lose a little bit of our sense of country and our sense of rights.
@ @ @ @ @ @ @ , said she understands these concerns .
But there are other rights to consider .
“ As an individual , I have a right not to be infected by somebody who is not paying attention , ” she said .
People may bristle at being told what to do — especially when American coronavirus quarantine strategies look superficially similar to those used by authoritarian nations such as China or Singapore .
But Susan Michie , a health psychologist and the director of the Center for Behavior Change at the University College London , @ @ @ @ @ @ @ elect people to [ make ] decisions at a national level to look after ourselves .
That ’ s not authoritarianism ; that ’ s democracy.
” And officials are largely dependent on the public ’ s compliance in a crisis .
“ This is not something we are doing because we are the fun police , ” an Australian official said in a press conference as he implored people to stay home in March .
“ This is about saving lives.
” To convince people to cooperate , Michie said , politicians @ @ @ @ @ @ @ sense of urgency , while providing support for everyone who is forced indoors .
“ We ’ re interconnected , ” she said , and the coronavirus proves it .
Eleanor Cummins reports on the intersection of science and popular culture .
She ’ s a former assistant editor at Popular Science and writes a newsletter about death .
She previously wrote about the “ death-positive generation ” for The Highlight .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around @ @ @ @ @ @ @ the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please @ @ @ @ @ @ @ .

For months, it’s been clear that the world has separated into two camps: the rule followers, observant of social distancing and hopeful of quashing the pandemic; and the risk takers, who have been storming the nation’s beaches, bars, and burger joints in spite of the coronavirus — and public health efforts to curtail its spread.
Some states, such as New York, have contained new cases, but others, including Texas and Arizona, brazenly reopened even as cases continued to rise, unleashing a torrent of pent-up partiers. Now, even as an illusion of normalcy has slowly returned, rates of infection are reaching new records, with cases surging in dozens of states.
The US is “going in the wrong direction,” Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and frequent face of the Trump administration’s virus response, warned senators recently.
In March, the new virus pushed dozens of countries to implement strict isolation methods to prevent a global health crisis. In China, coronavirus measures were hard to evade, as authorities sealed apartment buildings and scanned millions for rising body temperatures. But in the United States, these restrictions have been harder to devise and enforce, mostly because democratic norms and a strong sense of individual liberty prevail. So, instead, the crisis has exposed humanity’s tendency to flout the rules.
Masks — although recommended by federal and world health officials as effective in slowing the virus’s spread — have become a polarizing symbol of this dangerous phenomenon. In recent weeks, protesters have descended on government buildings and private businesses to decry face-covering requirements, calling them “muzzles” and “communist.” In one viral video, a maskless Florida man shoved a Walmart employee who tried to enforce the store’s face-covering policy. In another, a woman at a California Trader Joe’s screamed at employees and customers after others in the store criticized her for shopping without a mask. Some scofflaws have taken to brandishing sham cards from a phony “Freedom to Breathe Agency” that purportedly exempt them from mask-wearing.
Adding fuel to this fire, officials say, are the multitudes of young people determined to socialize. Some have tried to pin the problem on the Black Lives Matter protests that have continued for weeks, but preliminary research using geolocation data suggests these events had no impact on the virus’s spread. Instead, public health experts are attributing the surge in new cases to the mask-free masses flocking to reopened restaurants and bars, pool parties and lazy rivers.
“They’re conducting themselves like it’s pre-Covid, and that’s not going to work anymore,” Bruce Dart, director of the Tulsa Health Department, told the Washington Post. Younger people, he said, are “not social distancing, not wearing masks or paying attention to hand-washing.” In one stunning case shortly after Memorial Day, a group of 16 friends all tested positive for the virus after visiting a newly reopened bar in Florida.
In the months since worldwide lockdowns were adopted, there’s been a recurring theme among coronavirus rebels: They do what they want. In the early weeks of the pandemic, people swarmed beaches around the world, from Florida to Bondi Beach in Australia. “If I get corona, I get corona,” one spring breaker told Reuters. “At the end of the day, I’m not gonna let it stop me from partying.” (He later apologized, calling his comment “insensitive.”)
Even after quarantines had been instituted, Washington, DC, Metro officials in March had to practically beg riders not to visit the city’s famous cherry blossoms, which they did anyway, in droves. Brits took to crowded pubs to chant “f*** coronavirus!” And one woman went viral when she tweeted about her defiant trip to a crowded Red Robin restaurant. “It was delicious,” she tweeted, “and I took my sweet time eating my meal. Because this is America. And I’ll do what I want.”
Even officials are taking smug positions on the public health warnings. “I don’t need his advice anymore,” Texas Lt. Gov. Dan Patrick said of Fauci on Fox News in late June.
The poor reaction of a growing number of people to social distancing and mask policies — even as the virus resurges — comes as no surprise to psychologists, sociologists, and public health experts. No one alive today has experience with a pandemic of this severity, catching even the most experienced researchers off-guard, not to mention the average person sorting through their Facebook feed. Conflicting government messaging and reopenings of restaurants, bars, hair salons, and gyms in many states have only exacerbated the wildly divergent individual responses, and reliance on personal responsibility in public health matters.
It’s created fertile ground for the public to practice the long-held wisdom that we must “carry on” in a crisis: For at least a century, citizens have believed that in the midst of a disaster, their job is to go on with their daily lives as best they can — as if it were a safeguard against an unseen enemy.
“We feel like we have to do something,” said Robert Wuthnow, a sociologist at Princeton University and author of Be Very Afraid: The Cultural Response to Terror, Pandemics, Environmental Devastation, Nuclear Annihilation, and Other Threats. But without a good frame of reference for the present crisis, we’ve looked to lessons learned from past calamities, including natural disasters, terrorism, war, and economic collapse, to guide us. “We’re a little bit like generals fighting the last war,” he said.
But the old rules no longer apply. The pandemic is unprecedented, said Amy Fairchild, a public health ethicist and the dean of Ohio State University’s College of Public Health. “In this moment in time, ‘carry on’ could be a formula for disaster.”
When the coronavirus first arrived in the United States, people cast about for comparisons. “So last year 37,000 Americans died from the common Flu,” President Trump tweeted on March 9. “It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”
Experts including Fauci debunked the comparison. “The flu has a mortality of 0.1%,” he told Congress on March 11. “This has a mortality rate of 10 times that.” But the analogy — intended to make an extraordinary threat look like ordinary — persists.
In reality, the coronavirus has no clear analogue. “The normal mechanisms we’re using to predict things don’t work,” said Tali Sharot, a professor of cognitive neuroscience at the University College London who studies human motivation. “Actually, nothing else that has happened before in our lifetimes is relevant or helpful here.”
Many contemporary disaster mantras emerged in past wars, and they often contained a kernel of a consumerist message. At the outset of World War I, British politicians such as Winston Churchill encouraged “business as usual,” suggesting that both companies and citizens should continue to behave just as they did in peacetime. But the status quo eventually gave way to a coordinated defense effort when the state realized it would need to control manufacturing, trade, and commerce to win the war.
Twenty years later, in World War II, the British government coined “Keep Calm and Carry On” to boost morale in anticipation of a Nazi invasion. But it quickly pulped the test posters; other campaigns about courage in a crisis provoked public outcry as many people found the messages tone-deaf. After half a century, however, the phrase was exhumed — in part as a message to those weathering the Great Recession.
In times of crisis, Americans have borrowed English idioms, and coined a few of their own homespun mottos for personal and economic perseverance. During the Great Depression, President Franklin D. Roosevelt made an enemy of an emotion, telling the public, “We have nothing to fear but fear itself.”
In the aftermath of the 9/11 terrorist attacks, President Bush gave this famed aphorism a consumerist spin when he told airline employees, “When [the terrorists] struck, they wanted to create an atmosphere of fear. And one of the great goals of this nation’s war is to restore public confidence in the airline industry. It’s to tell the traveling public: Get on board. Do your business around the country. Fly and enjoy America’s great destination spots. Get down to Disney World in Florida.”
“Get down to Disney World” was probably never meant to apply to the people who actually traveled to the Magic Kingdom in March amid public health warnings to avoid crowds. (Disney eventually closed its theme parks to visitors, though some reopenings are imminent.) But that didn’t stop some politicians from applying this logic to the coronavirus. In a White House press briefing, President Trump said, “America will again and be soon open for business,” and later suggested relaxing guidelines by Easter. That jingoistic outlook quickly dissipated as the virus seemed to metastasize, killing more than 120,000 Americans and requiring social distancing to continue for months.
And Americans haven’t been the best socially distant citizens: Memorial Day weekend festivities served as a new catalyst for the spread of the virus, and many officials are desperate to reinstate or expand social distancing policies before the Fourth of July. At the Lake of the Ozarks, for example, a raucous pool party was later linked to multiple coronavirus infections. Alabama students reportedly threw parties attended by infected students that one local lawmaker has alleged were “Covid parties,” aimed at intentionally getting others sick.
“It’s almost like we don’t want the virus to win, so we’re going to go out drinking, go to parties, go out to the beach,” Wuthnow said. But these are risky responses when the enemy is not a person or a bad year for the stock market, but a virus — one that can be transmitted asymptomatically.
“It’s almost like we don’t want the virus to win, so we’re going to go out drinking, go to parties, go out to the beach”
Humans are generally terrible at assessing risk. But it’s proven especially true in the case of the coronavirus. “It’s about our risk to others, and that might make it a little more difficult to understand,” said Cynthia Rohrbeck, an associate professor in clinical and community psychology at George Washington University. People are used to talking with their doctors about their personal health, but taking responsibility for the health of others comes up only infrequently, often in public discourse around smoking, drinking and driving, and getting vaccinated.
Our judgment could be clouded by optimism bias, the tendency to believe you are less likely than others to experience something negative. In late February, researchers polled 4,348 people in France, Italy, the United Kingdom, and Switzerland and found half of them believed they were less likely to get the coronavirus than others, sans real evidence. Another poll, conducted in mid-March on more than 800 people from the US, the United Kingdom, and Germany, suggested this optimism was bolstered by people’s belief that they had fewer human interactions than their peers, making their risk of contracting the virus inherently lower.
When countries finally began to roll out isolation measures, they encountered additional obstacles. “One of the most important things for people is to have a sense that they are in control of their own life, that they have agency,” Sharot said. In a paper in The Lancet, researchers reviewed 24 past publications on the psychological effects of quarantine and found it can cause post-traumatic stress symptoms, confusion, and anger.
But the desire for agency can have an ideological component, too. In China, the authoritarian government has wide latitude to control the behavior of its citizens. But in the United States, few Americans have experienced government-imposed restrictions on when they can go out and whom they can see.
Many politicians criticized the rules as an infringement on people’s freedom, not to mention a disaster for the economy. In March, Arizona state Rep. Anthony Kern (R) and Oklahoma Gov. Kevin Stitt (R) both tweeted (and deleted) defiant photos from crowded restaurants. “We can’t all just shut ourselves and stay home,” Sen. Ron Johnson (R-WI) told the Milwaukee Journal Sentinel. “The economy has to move forward.” And even the president has refused to be photographed wearing a mask, underscoring the way protective face coverings have become a partisan lightning rod. Now, as states are seeing terrifying spikes in their coronavirus cases, some are reinstating the social distancing strategies they just rolled back.
“Me, personally, I just refuse to live my life in fear,” Katie Williams, the 30-year-old Las Vegas resident who went viral for her Red Robin tweet, told Vox in March. “As Americans, we typically do what we want. It’s kind of that attitude we’ve always had,” she added. “I think if we’re going to start pressuring people that they have to stay home, or publicly shaming them like pariahs, I think we’re just starting to lose a little bit of our sense of country and our sense of rights.”
I just went to a crowded Red Robin and I'm 30.
It was delicious, and I took my sweet time eating my meal. Because this is America. And I'll do what I want. — Katie Williams (@realkatiejow) March 14, 2020
Fairchild, the public health ethicist, said she understands these concerns. But there are other rights to consider. “As an individual, I have a right not to be infected by somebody who is not paying attention,” she said.
People may bristle at being told what to do — especially when American coronavirus quarantine strategies look superficially similar to those used by authoritarian nations such as China or Singapore. But Susan Michie, a health psychologist and the director of the Center for Behavior Change at the University College London, saw it another way: “We elect people to [make] decisions at a national level to look after ourselves. That’s not authoritarianism; that’s democracy.”
And officials are largely dependent on the public’s compliance in a crisis. “This is not something we are doing because we are the fun police,” an Australian official said in a press conference as he implored people to stay home in March. “This is about saving lives.” To convince people to cooperate, Michie said, politicians need to continue to communicate a clear sense of urgency, while providing support for everyone who is forced indoors. “We’re interconnected,” she said, and the coronavirus proves it.
Eleanor Cummins reports on the intersection of science and popular culture. She’s a former assistant editor at Popular Science and writes a newsletter about death. She previously wrote about the “death-positive generation” for The Highlight.