vox--2020-05-21--8 ways to go out and stay safe during the coronavirus pandemic

Share All sharing options for : 8 ways to go out and stay safe during the coronavirus pandemic Americans are getting tired of staying inside .
Support for social distancing requirements is falling in the polls , and survey and cellphone data shows people are starting to trickle out of their homes .
Most states , ready or not , are moving to reopen parts of their economies .
For the past two months , experts ’ guidance has been absolute : As much as possible , stay home and avoid interacting with anyone you don ’ t live with @ @ @ @ @ @ @ a vaccine likely still months or years away , some experts caution a new approach is needed to get people to stay safe during the coronavirus pandemic — one based on harm reduction .
It might be better for people to stay home all the time , but given that many can ’ t or won ’ t , giving them advice on how to reduce the harm to them and others is better than insisting on the ideal .
Julia Marcus , an infectious disease epidemiologist at Harvard , compared the choice @ @ @ @ @ @ @ sex during the worst days of the HIV/AIDS epidemic : Completely avoiding sex would keep someone safe from HIV , but given that most people won ’ t do that , it ’ s better to give them the tools to practice sex as safely as possible .
“ There ’ s been a polarization between two purported options of staying home indefinitely … versus going back to business as usual , ” Marcus told me .
“ The idea of harm reduction gives us a way of thinking about risk as a @ @ @ @ @ @ @ between those two options.
” The safest thing anyone can do in the middle of the Covid-19 outbreak is still the same as it was a few months ago : Stay home as much as possible to avoid catching or spreading the virus until we get a vaccine or effective treatment or until the pandemic otherwise ends .
That especially applies to people who are sick , who should do all they can to avoid exposing others to the coronavirus .
But lapses will happen .
Some people were never able to stay @ @ @ @ @ @ @ states begin to reopen , many more will need to leave their homes for their jobs .
Others will do so simply because they ’ re tired of being stuck at home , even if it ’ s not advisable for their own health or for the public ’ s .
So I turned to several experts with a question : What can people do to minimize the harm to themselves and others if and when they choose to go out ?
Some of the advice reflected the message we ’ ve already @ @ @ @ @ @ @ .
Don ’ t touch your face .
Wear a mask .
Avoid shared surfaces and crowded settings , and keep physical distance — at least 6 feet — from people you don ’ t live with .
If you ’ re 65 or older or have chronic health conditions , you should take all of this advice more seriously .
Other tips were more novel .
For example , if you want to do something outside your home , it ’ s better to take advantage of the fresh air and do @ @ @ @ @ @ @ .
If you want to meet with certain friends or family , consider a pact with them in which you ’ ll both agree to minimize or eliminate contact with anyone else , to reduce overall exposure for everyone involved .
The most important thing : Avoid indoor spaces that bring you within 6 feet of people from outside your household for long periods .
“ It is about density .
It is about duration of contact , ” Cyrus Shahpar , a director at Resolve to Save Lives , told me .
@ @ @ @ @ @ @ harm reduction concepts to social distancing .
They acknowledged it ’ s not a perfect analogy to HIV or drug use , because a person who ’ s having risky sex or using drugs is perceived as largely harming themselves , while people who catch and spread the coronavirus put others at immediate risk too .
Still , experts took a pragmatic view toward harm reduction overall .
“ It reflects the fact this virus is going to be with us until there ’ s a vaccine , ” Amesh Adalja , a @ @ @ @ @ @ @ for Health Security , told me .
“ People are going to come up with their own ways to live with it .
That ’ s going to be different for each person , based on their own risk tolerance.
” He added , “ It ’ s important that people be well-informed about what the risks are and how to minimize the risks.
” So here ’ s how to go out and stay as safe as possible during this coronavirus pandemic .
Experts consistently gave one piece of advice for people @ @ @ @ @ @ @ do something outdoors instead of indoors , you should do it outdoors .
The coronavirus appears to spread through airborne droplets and droplets that land on surfaces , which people subsequently pick up with their hands .
The outdoors mitigates these vectors of spread in several ways .
First , the open air is going to make it much harder for airborne droplets to reach other people .
Shahpar said there ’ s a commonsense element to this : “ Any odor I have from cooking in a kitchen is going to linger @ @ @ @ @ @ @ .
It ’ s just the nature of it.
” Second , it ’ s easier to keep distance from others while outside compared to inside .
Third , there is some evidence that sunny , warm , and humid weather hurts the coronavirus a bit .
Based on the early research so far , the heat and UV light appear to kill the virus , while humidity might block airborne droplets from blowing from person to person .
The weather isn ’ t enough to stop the coronavirus — as major Covid-19 @ @ @ @ @ @ @ Louisiana , and Singapore demonstrate — but it at least seems to help .
The research into coronavirus and the outdoors , while still very early , backs this up , Kelsey Piper explained for Vox : So if you ’ re having friends over , consider hanging out outside ( and keep it to a small group ) .
If you want to eat at a restaurant , look for outdoor seating .
If you ’ re going for a run , go to the park , beach , or streets instead @ @ @ @ @ @ @ policymakers could take advantage of the outdoors as well — holding trials outside , or closing off some streets to cars so pedestrians can make better use of them .
“ It ’ s a good year for outdoor dining and outdoor shopping and outdoor all kinds of activities , ” Mark McClellan , who previously headed the Centers for Medicare and Medicaid Services and the Food and Drug Administration under President George W. Bush , told me .
The one exception , of course , is your home .
As long as @ @ @ @ @ @ @ people you live with in there , it ’ s safe — likely even the safest place during this pandemic if no one inside is sick .
This isn ’ t to say that the outdoors is totally safe .
Being around people you don ’ t live with will always create some risk during a pandemic .
This is about weighing the pros and cons : Does the relatively small risk other people present outdoors outweigh the benefit of getting some time outside of your house ?
Different people may come to @ @ @ @ @ @ @ equal , the outdoors is the safest place for activities outside of your home .
For some , that ’ s a reprieve that makes all the other requirements for social distancing a bit more bearable .
Plus , spending time outdoors can be good for you on its own .
You ’ ve probably heard it a million times already , but it ’ s worth repeating : Wash your hands frequently , and don ’ t touch your face .
If you ’ re going to frequently venture far outside your @ @ @ @ @ @ @ .
“ Those are harm reduction aspects have been built in already to the messaging that we ’ ve seen , ” Saskia Popescu , an infectious disease epidemiologist , told me .
Studies have shown the virus can survive on different surfaces for hours or days at a time .
If you touch those surfaces , then touch your face , you could get the virus in your eyes , nose , or mouth — and soon , you might be infected .
By now , there are plenty of guides out @ @ @ @ @ @ @ face and how to wash your hands .
For face-touching , the big thing is awareness .
Until you break the habit , you ’ re going to have to dedicate headspace to your face and avoiding touching it .
( I touched my face three times just typing this paragraph , so , yes , it ’ s going to take effort . )
For hand-washing , do it frequently — before , during , and after you go out .
Soap and water work great ; wash for 20 seconds , @ @ @ @ @ @ @ of your hands , your fingertips , your thumbs , and your wrists .
If you don ’ t have access to soap and water , hand sanitizer with at least 60 percent alcohol content works too .
Yes , good hygiene can be tedious , and we ’ re all tired of hearing about it over and over .
But it works .
If you want to minimize risk to yourself and others , you should do it .
After some mixed messaging from federal officials early on in the Covid-19 outbreak @ @ @ @ @ @ @ should wear masks when they go out — a surgical or medical mask if they have one , a cloth one if they don ’ t .
The Centers for Disease Control and Prevention recommends masks “ in public settings where other social distancing measures are difficult to maintain ( e.g.
, grocery stores and pharmacies ) , especially in areas of significant community-based transmission.
” But other experts — and , in some cases , government mandates — go further , saying that you should wear a mask in just about any @ @ @ @ @ @ @ the Covid-19 outbreak continues .
The primary reason for a mask is to stop transmission from the wearer to others , particularly from people who are infected but asymptomatic and therefore might not even know they ’ re infected .
If you wear a mask , you ’ re less likely to spray virus-containing droplets on surfaces or other people when you breathe , talk , sing , laugh , sigh , snort , cough , sneeze , and whatever else you might do with your mouth and nose .
A mask also @ @ @ @ @ @ @ creating a physical barrier to droplets from others in front of your mouth and nose ( at least if you ’ re wearing it properly — make sure that it ’ s covering both ) .
The research on masks isn ’ t great , but there ’ s some suggestive evidence : As long as people actually wear the masks and use them properly , studies indicate that they have some effect in reducing disease transmission overall .
Some experts hypothesize that masks have played a significant role in containing Covid-19 outbreaks @ @ @ @ @ @ @ is widespread , like South Korea and Japan .
It can still be difficult , depending on where you live , to find medical masks .
But there are cloth alternatives you can make at home .
The CDC has an extensive tutorial .
And here ’ s one from the US surgeon general : There are also things you can do to help others wear masks .
For example , if you ’ re hosting a large event or even throwing a party — not advisable , but it will happen — @ @ @ @ @ @ @ When wearing a mask , don ’ t fidget with it — that would be touching your face — and avoid taking it off until you ’ re back home .
Throw away disposable masks once they ’ re used , and wash reusable masks after you use them .
Masks are not an excuse to ease off on other hygiene practices .
In fact , you want to wash your hands before and after taking off a mask — before to avoid getting anything on your face and mask , and after @ @ @ @ @ @ @ on your mask .
And yes , it ’ s normal to have a slightly harder time breathing while wearing a mask for a long time .
But that discomfort should be weighed against the risk of getting sick or infecting others without a mask .
One of the common pieces of advice throughout this pandemic has been to keep 6 feet or more away from people you don ’ t live with , summarized by the catchy slogan “ 6 feet distance determines our existence.
” The closer you are to someone @ @ @ @ @ @ @ their coronavirus all over you , and vice versa .
One telling but preliminary study comes from a South Korean call center : The coronavirus spread to 43.5 percent of people working in the close-packed 11th-floor call center .
Proximity appeared to play a big role , as this graphic , in which desks marked in blue indicate infection , shows .
The risk here is close and prolonged contact .
A jogger running by you for a couple of seconds isn ’ t the end of the world .
But if you @ @ @ @ @ @ @ else for longer than that — especially for hours — it could be dangerous .
“ The two variables we worry about is that distance from another person who might be sick and the time spent with them , ” Crystal Watson , senior scholar at the Johns Hopkins Center for Health Security , told me .
This applies to the outdoors , too .
While the outdoors are generally safer than the indoors , it ’ s still a good idea to avoid packed parks or beaches .
People who don ’ @ @ @ @ @ @ @ be stacked together for long in any setting .
So if you ’ re going out to eat , consider skipping the packed restaurant .
If you ’ re going to a park or beach , look for an area without too many people around .
If you ’ re hosting an event , avoid inviting too many people .
If you ’ re meeting up with friends or family , try to stay at least 6 feet away and avoid handshakes , hugs , and kisses .
Part of avoiding crowded spaces @ @ @ @ @ @ @ those who have to be there .
For example , public transportation can be pretty packed , but some people need to use it to get to work or the grocery store .
If you have other means of transportation and use that instead , you leave more room on the bus or subway for those who don ’ t have a choice .
You don ’ t have to do all of this perfectly ; in some circumstances , that ’ s unrealistic .
But the better you can do it , @ @ @ @ @ @ @ coronavirus spreads when people pick up virus-containing droplets from different surfaces , one way to minimize that risk is by trying to avoid shared surfaces as much as possible .
So even if you go outdoors , maybe avoid surfaces touched by different people , like swings , slides , or benches — or , at the very least , wipe them down before using them .
If you have to use public transportation or go inside a building that isn ’ t your house , try to minimize how much of the @ @ @ @ @ @ @ ’ re meeting with people you don ’ t live with , try to avoid sharing things — food , drinks , toys , board game pieces , and so on .
That doesn ’ t mean you have to be paranoid about picking up food or getting various things delivered to you .
( As Jen Kates , director of global health and HIV policy at the Kaiser Family Foundation , told me , “ I often get asked the question : ‘ Can I get takeout ?
’ I think you @ @ @ @ @ @ @ a little caution is warranted , either in terms of avoiding these surfaces or taking steps to clean them before you touch them .
6 ) Space out trips outside the home as much as possible Whether you ’ re leaving your home because you have to for food or work , or you ’ re going out because you can ’ t stand the sight of your apartment anymore , one way to minimize risk is to space out all your trips .
With every venture outside , you are putting yourself @ @ @ @ @ @ @ world that ’ s still engulfed by a pandemic .
The risk calculus , then , is straightforward : Try to limit how often you do this .
“ It ’ s not a good idea to be going out to the store every day , ” Kates said .
“ You want to minimize the amount of times you might expose somebody [ to coronavirus ] or you might be exposed.
” One way to do this is to make the most out of necessary trips .
If you ’ re going @ @ @ @ @ @ @ as much as you can afford and carry in one go , and plan ahead so you don ’ t forget something .
( Still , be reasonable and conscientious of others ; taking a year ’ s supply of toilet paper is unnecessary and could force others to make more trips when the store runs out and they have to go home empty-handed . )
This applies to social gatherings , too .
If you saw friends recently , maybe go a few days or weeks before seeing them or another group @ @ @ @ @ @ @ ideal , since it would match the coronavirus ’ s possible incubation period .
Similar to avoiding crowded spaces and keeping physical distance , this isn ’ t something everyone is going to be able to do perfectly .
We all sometimes forget things at the store and have to go back earlier than we ’ d like .
But the more spaced out trips outside the home are , the better .
Especially if you ’ re single and living alone , these can be pretty lonely days .
One solution that @ @ @ @ @ @ @ creating a “ closed circle ” with a friend or family member , in which two people or a group agree to hang out in person but avoid contact with everyone else .
If you and your closed circle avoid everyone else , you ’ ll reduce the chances of infecting each other and the rest of the world even if you hang out regularly .
And if one of you does get sick , the spread should be limited to a small circle .
As Sigal Samuel explained for Vox , this @ @ @ @ @ @ @ some experts are opposed to it .
There ’ s a risk that people just don ’ t stick to the pact , putting the whole circle at risk of infection — maybe even at a higher risk if it creates a false sense of security and people in the circle act recklessly toward each other .
But even if everyone follows the pact as best as possible , the concept expands your social network and , therefore , your risk of infection — from not only those in the circle , but @ @ @ @ @ @ @ interact with at the grocery store , pharmacy , work , or any other setting .
But that ’ s harm reduction .
The closed circle may not eliminate harm , but it does minimize it .
Consider the alternatives .
If people are going to interact with their friends and family , but they do it without a closed circle , that ’ s inherently worse than having a pact , even one that ’ s not perfectly followed .
“ Is there a way to make it that , 100 percent @ @ @ @ @ @ @ ?
No , ” Kates said .
“ But it ’ s a harm reduction approach.
” The risk that a closed circle doesn ’ t work as planned also has to be weighed with the significant risk of loneliness .
As Samuel noted , “ A meta-review of 70 studies found that loneliness increases your risk of premature mortality by 26 percent .
Some experts say it ’ s as bad for your longevity as smoking .
We know that it actually hurts our white blood cells.
” We can try to @ @ @ @ @ @ @ , or phone calls — but , for some people , that ’ s not going to be enough .
“ There are people suffering in isolation , ” Marcus said .
“ In order to sustain this for months or even years , we have to think about how we can connect with others in a way that keeps risk as low as possible , that allows people to feel like they ’ re living their lives.
” It ’ s also possible to mitigate the risk of breaches in a closed @ @ @ @ @ @ @ this list : Even when hanging out with your closed circle , go outside when possible , wear a mask , follow good hygiene , and keep physical distance from each other .
A closed circle doesn ’ t have to be a license for much riskier behavior ; it can just be an extra layer of protection if you want to regularly see other humans in person .
8 ) If you ’ re in an especially at-risk group , be extra careful Some people are more vulnerable to the coronavirus .
@ @ @ @ @ @ @ diabetes , liver disease , and obesity , appear to heighten the risk of complications and death due to Covid-19 .
Those who are older , especially 65 and up , are at higher risk too .
It ’ s not fair , but it means that those who are at greater risk should be extra careful .
One way experts described this concept : If you fall into one of these at-risk groups , follow the advice on this list but take it to an extra level .
If most people typically @ @ @ @ @ @ @ , someone in an at-risk group should do it 14 times .
If others should stay 6 feet from people , those in at-risk groups should try 10 feet .
If the typical person should minimize trips to the store to once a week , people in at-risk groups should try to minimize trips to once every two weeks .
And so on .
The safest thing for older people and those with chronic conditions is , like everyone else , to stay home as much as possible .
But just like everyone @ @ @ @ @ @ @ to be feasible for some people all day every day , or at least something everyone will be willing to do for weeks or months on end .
“ People will take risks , whether we like it or not , ” Marcus argued .
“ The best thing we can do is give them strategies to reduce harm in those situations .
If we don ’ t do that , we ’ re missing an opportunity.
” Every day at Vox , we aim to answer your most important questions and provide @ @ @ @ @ @ @ 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 and volume @ @ @ @ @ @ @ making a contribution to Vox today .

Share All sharing options for: 8 ways to go out and stay safe during the coronavirus pandemic
Americans have gotten tired of staying inside. As the coronavirus pandemic has continued for months and summer has kicked off, the number of people consistently practicing social distancing has steadily declined, according to Gallup’s surveys. Especially with the July Fourth weekend approaching, people are bound to go out more to celebrate.
At the beginning of the pandemic, experts’ guidance was more absolute: As much as possible, stay home and avoid interacting with anyone you don’t live with. More recently, with a vaccine likely still months or years away, many experts have advocated for a new approach to get people to stay safe during the coronavirus pandemic — one based on harm reduction.
It might be better for people to stay home all the time, but given that many can’t or won’t, giving them advice on how to reduce the harm to them and others is better than insisting on the ideal.
Related How to go out and not spread coronavirus this summer
Julia Marcus, an infectious disease epidemiologist at Harvard, compared the choice to preaching abstinence versus advising on safe sex during the worst days of the HIV/AIDS epidemic: Completely avoiding sex would keep someone safe from HIV, but given that most people won’t do that, it’s better to give them the tools to practice sex as safely as possible.
“There’s been a polarization between two purported options of staying home indefinitely … versus going back to business as usual,” Marcus told me. “The idea of harm reduction gives us a way of thinking about risk as a continuum and thinking about the middle ground between those two options.”
The safest thing anyone can do in the middle of the Covid-19 outbreak is still the same as it was a few months ago: Stay home as much as possible to avoid catching or spreading the virus until there’s a vaccine or effective treatment, or until the pandemic otherwise ends. That especially applies to people who are sick, who should do all they can to avoid exposing others to the coronavirus.
But lapses will happen. Some people were never able to stay home in the first place; as states begin to reopen, many more will need to leave their homes for their jobs. Others will do so simply because they’re tired of being stuck at home, even if it’s not advisable for their own health or for the public’s.
So I turned to several experts with a question: What can people do to minimize the harm to themselves and others if and when they choose to go out?
Some of the advice reflected the message we’ve already heard for months: Wash your hands. Don’t touch your face. Wear a mask. Avoid shared surfaces and crowded settings, and keep physical distance — at least 6 feet — from people you don’t live with. If you’re 65 or older or have chronic health conditions, you should take all of this advice more seriously.
Other tips were more novel. For example, if you want to do something outside your home, it’s better to take advantage of the fresh air and do it outdoors rather than indoors when possible. If you want to meet with certain friends or family, consider a pact with them in which you’ll both agree to minimize or eliminate contact with anyone else, to reduce overall exposure for everyone involved.
The most important thing: Avoid indoor spaces that bring you within 6 feet of people from outside your household for long periods. “It is about density. It is about duration of contact,” Cyrus Shahpar, a director at Resolve to Save Lives, told me.
Overall, experts were receptive to applying harm reduction concepts to social distancing. They acknowledged it’s not a perfect analogy to HIV or drug use, because a person who’s having risky sex or using drugs is perceived as largely harming themselves, while people who catch and spread the coronavirus put others at immediate risk too. Still, experts took a pragmatic view toward harm reduction overall.
“It reflects the fact this virus is going to be with us until there’s a vaccine,” Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told me. “People are going to come up with their own ways to live with it. That’s going to be different for each person, based on their own risk tolerance.” He added, “It’s important that people be well-informed about what the risks are and how to minimize the risks.”
So here’s how to go out and stay as safe as possible during this coronavirus pandemic. (Vox also has a guide on the risks of specific activities.)
1) Stick to the outdoors
Experts consistently gave one piece of advice for people leaving their homes: If you can do something outdoors instead of indoors, you should do it outdoors.
The coronavirus appears to primarily spread through airborne droplets, which the outdoors mitigates in several ways.
First, the open air is going to make it harder for airborne droplets to reach other people. Shahpar said there’s a common sense element to this: “Any odor I have from cooking in a kitchen is going to linger longer than if I had it outside. It’s just the nature of it.”
Second, it’s easier to keep distance from others while outside compared to inside.
Third, there is some evidence that sunny, warm, and humid weather hurts the coronavirus a bit. Based on the early research so far, heat and UV light appear to kill the virus, while humidity might block airborne droplets from blowing from person to person. The weather isn’t enough to stop the coronavirus — as major Covid-19 outbreaks in sunny and warm Ecuador, Louisiana, Singapore, and now Arizona, Florida, and Texas demonstrate — but it at least seems to help.
The research into coronavirus and the outdoors, while still very early, backs this up, Kelsey Piper explained for Vox:
One study from China (which has not yet been peer-reviewed) examined 318 outbreaks with three or more people across the country. Only one happened outdoors, and only two people got sick: Every outbreak with three or more cases happened indoors. A different study (also not peer-reviewed) in Japan found that “the odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment.”
So if you’re having friends over, consider hanging out outside (and keep it to a small group). If you want to eat at a restaurant, look for outdoor seating. If you’re going for a run, go to the park, beach, or streets instead of the gym. Some experts said policymakers could take advantage of the outdoors as well — holding trials outside, or closing off some streets to cars so pedestrians can make better use of them.
“It’s a good year for outdoor dining and outdoor shopping and outdoor all kinds of activities,” Mark McClellan, who previously headed the Centers for Medicare and Medicaid Services and the Food and Drug Administration under President George W. Bush, told me.
The one exception, of course, is your home. As long as it’s just you and the people you live with in there, it’s safe — likely even the safest place during this pandemic if no one inside is sick.
This isn’t to say that the outdoors is totally safe. Being around people you don’t live with will always create some risk during a pandemic. This is about weighing the pros and cons: Does the relatively small risk other people present outdoors outweigh the benefit of getting some time outside of your house? Different people may come to different answers.
But all else held equal, the outdoors is the safest place for activities outside of your home. For some, that’s a reprieve that makes all the other requirements for social distancing a bit more bearable.
Plus, spending time outdoors can be good for you on its own.
2) Follow good hygiene practices
You’ve probably heard it a million times already, but it’s worth repeating: Wash your hands frequently, and don’t touch your face. If you’re going to frequently venture far outside your home, that advice is especially pertinent.
“Those are harm reduction aspects have been built in already to the messaging that we’ve seen,” Saskia Popescu, an infectious disease epidemiologist, told me.
By now, there are plenty of guides out there about how to avoid touching your face and how to wash your hands. For face-touching, the big thing is awareness. Until you break the habit, you’re going to have to dedicate headspace to your face and avoiding touching it. (I touched my face three times just typing this paragraph, so, yes, it’s going to take effort.)
For hand-washing, do it frequently — before, during, and after you go out. Soap and water work great; wash for 20 seconds, and don’t forget the back of your hands, your fingertips, your thumbs, and your wrists. If you don’t have access to soap and water, hand sanitizer with at least 60 percent alcohol content works too.
Yes, good hygiene can be tedious, and we’re all tired of hearing about it over and over. But it works. If you want to minimize risk to yourself and others, you should do it.
3) Wear a mask
After some mixed messaging from federal officials early on in the Covid-19 outbreak, there is widespread consensus that people should wear masks when they go out — a surgical or medical mask if they have one, a cloth one if they don’t.
The Centers for Disease Control and Prevention recommends masks “in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.” But other experts — and, in some cases, government mandates — go further, saying you should wear a mask in just about any setting outside your home as long as the pandemic continues.
The primary reason for a mask is to stop transmission from the wearer to others, particularly from people who are infected but asymptomatic and therefore might not even know they’re infected. If you wear a mask, you’re less likely to spray virus-containing droplets on surfaces or other people when you breathe, talk, sing, laugh, sigh, snort, cough, sneeze, and whatever else you might do with your mouth and nose.
A mask also likely offers some protection to you by creating a physical barrier to droplets from others in front of your mouth and nose (at least if you’re wearing it properly — make sure that it’s covering both).
The initial research on masks wasn’t great, but it’s getting stronger. Several recent studies found masks alone reduce transmission. Some experts hypothesize — and early research suggests — that masks played a significant role in containing Covid-19 outbreaks in several Asian countries where their use is widespread, like South Korea and Japan.
It can still be difficult, depending on where you live, to find medical masks. But there are cloth alternatives you can make at home. The CDC has an extensive tutorial. And here’s one from the US surgeon general:
#DYK? @CDCgov's recommendation on wearing a cloth face covering may help protect the most vulnerable from #COVID19.
Here's how you can make one today, in just a few easy steps: pic.twitter.com/eFuE7Brw0J — U.S. Surgeon General (@Surgeon_General) April 4, 2020
There are also things you can do to help others wear masks. For example, if you’re hosting a large event or even throwing a party — not advisable, but it will happen — offer masks to the people attending.
When wearing a mask, don’t fidget with it — that would be touching your face — and avoid taking it off until you’re back home. Throw away disposable masks once they’re used, and wash reusable masks after you use them.
Masks are not an excuse to ease off on other hygiene practices. In fact, you want to wash your hands before and after taking off a mask — before, to avoid getting anything on your face and mask, and after, to get rid of anything that was on your mask.
And yes, it’s normal to have a slightly harder time breathing while wearing a mask for a long time. But that discomfort should be weighed against the risk of getting sick or infecting others without a mask.
4) Stay away from crowded settings
One of the common pieces of advice throughout this pandemic has been to keep 6 feet or more away from people you don’t live with, summarized by the catchy but grim slogan “6 feet distance determines our existence.” The closer you are to someone, the likelier they are to shed their coronavirus all over you, and vice versa.
One telling but preliminary study comes from a South Korean call center: The coronavirus spread to 43.5 percent of people working in the close-packed 11th-floor call center. Proximity appeared to play a big role, as this graphic, in which desks marked in blue indicate infection, shows.
The risk here is close and prolonged contact. A jogger running by you for a couple of seconds isn’t the end of the world. But if you’re within 6 feet of someone else for longer than that — especially for hours — it could be dangerous.
“The two variables we worry about is that distance from another person who might be sick and the time spent with them,” Crystal Watson, senior scholar at the Johns Hopkins Center for Health Security, told me.
This applies to the outdoors, too. While the outdoors are generally safer than the indoors, it’s still a good idea to avoid packed parks or beaches. People who don’t live together just shouldn’t be stacked together for long in any setting.
So if you’re going out to eat, consider skipping the packed restaurant. If you’re going to a park or beach, look for an area without too many people around. If you’re hosting an event, avoid inviting too many people. If you’re meeting up with friends or family, try to stay at least 6 feet away and avoid handshakes, hugs, and kisses.
Part of avoiding crowded spaces is also making these places safer for those who have to be there. For example, public transportation can be pretty packed, but some people need to use it to get to work or the grocery store. If you have other means of transportation and use that instead, you leave more room on the bus or subway for those who don’t have a choice.
You don’t have to do all of this perfectly; in some circumstances, that’s unrealistic. But the better you can do it, the lower the risk.
5) Avoid shared surfaces
If the coronavirus spreads when people pick up virus-containing droplets from different surfaces, one way to minimize that risk is by trying to avoid shared surfaces as much as possible. Although the research suggests this is a rare form of transmission for Covid-19, there’s likely still some risk.
So even if you go outdoors, avoid surfaces touched by different people, like swings, slides, or benches — or, at the very least, wipe them down before using them. If you have to use public transportation or go inside a building that isn’t your house, try to minimize how much of the space you touch.
And if you’re meeting with people you don’t live with, try to avoid sharing things — food, drinks, toys, board game pieces, and so on.
That doesn’t mean you have to be paranoid about picking up food or getting various things delivered to you. (As Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me, “I often get asked the question: ‘Can I get takeout?’ I think you can.”)
But it does mean a little caution is warranted, either in terms of avoiding these surfaces or taking steps to clean them before you touch them.
6) Space out trips outside the home as much as possible
Whether you’re leaving your home because you have to for food or work, or you’re going out because you can’t stand the sight of your apartment anymore, one way to minimize risk is to space out all your trips.
With every venture outside, you are putting yourself at risk of contracting the coronavirus in a world that’s still engulfed by a pandemic. The risk calculus, then, is straightforward: Try to limit how often you do this.
“It’s not a good idea to be going out to the store every day,” Kates said. “You want to minimize the amount of times you might expose somebody [to coronavirus] or you might be exposed.”
One way to do this is to make the most out of necessary trips. If you’re going to the store, try to buy as much as you can afford and carry in one go, and plan ahead so you don’t forget something. (Still, be reasonable and conscientious of others; taking a year’s supply of toilet paper is unnecessary and could force others to make more trips when the store runs out and they have to go home empty-handed.)
This applies to social gatherings, too. If you saw friends recently, maybe go a few days or weeks before seeing them or another group of friends. Two weeks would be ideal, since it would match the coronavirus’s possible incubation period.
Similar to avoiding crowded spaces and keeping physical distance, this isn’t something everyone is going to be able to do perfectly. We all sometimes forget things at the store and have to go back earlier than we’d like. But the more spaced out trips outside the home are, the better.
7) Create a “closed circle” with specific friends or family
Especially if you’re single and living alone, these can be pretty lonely days. One solution that some experts have put out there is creating a “closed circle” with a friend or family member, in which two people or a group agree to hang out in person but avoid contact with everyone else.
If you and your closed circle avoid everyone else, you’ll reduce the chances of infecting each other and the rest of the world even if you hang out regularly. And if one of you does get sick, the spread should be limited to a small circle.
As Sigal Samuel explained for Vox, this idea isn’t risk-free, and some experts are opposed to it. There’s a risk that people just don’t stick to the pact, putting the whole circle at risk of infection — maybe even at a higher risk if it creates a false sense of security and people in the circle act recklessly toward each other. But even if everyone follows the pact as best as possible, the concept expands your social network and, therefore, your risk of infection — from not only those in the circle, but anyone people in the circle have to interact with at the grocery store, pharmacy, work, or any other setting.
But that’s harm reduction. The closed circle may not eliminate harm, but it does minimize it.
Consider the alternatives. If people are going to interact with their friends and family, but they do it without a closed circle, that’s inherently worse than having a pact, even one that’s not perfectly followed.
Related The rules of social distancing
“Is there a way to make it that, 100 percent, everyone is abiding by those standards? No,” Kates said. “But it’s a harm reduction approach.”
The risk that a closed circle doesn’t work as planned also has to be weighed with the significant risk of loneliness. As Samuel noted, “A meta-review of 70 studies found that loneliness increases your risk of premature mortality by 26 percent. Some experts say it’s as bad for your longevity as smoking. We know that it actually hurts our white blood cells.” We can try to alleviate that loneliness with Skype, Zoom, or phone calls — but, for some people, that’s not going to be enough.
“There are people suffering in isolation,” Marcus said. “In order to sustain this for months or even years, we have to think about how we can connect with others in a way that keeps risk as low as possible, that allows people to feel like they’re living their lives.”
It’s also possible to mitigate the risk of breaches in a closed circle by following the other tips on this list: Even when hanging out with your closed circle, go outside when possible, wear a mask, follow good hygiene, and keep physical distance from each other. A closed circle doesn’t have to be a license for much riskier behavior; it can just be an extra layer of protection if you want to regularly see other humans in person.
8) If you’re in an especially at-risk group, be extra careful
Some people are more vulnerable to the coronavirus. Certain chronic conditions, including asthma, diabetes, liver disease, and obesity, appear to heighten the risk of complications and death due to Covid-19. Those who are older, especially 65 and up, are at higher risk too.
It’s not fair, but it means that those who are at greater risk should be extra careful.
One way experts described this concept: If you fall into one of these at-risk groups, follow the advice on this list but take it to an extra level. If most people typically wash their hands seven times a day, someone in an at-risk group should do it 14 times. If others should stay 6 feet from people, those in at-risk groups should try 10 feet. If the typical person should minimize trips to the store to once a week, people in at-risk groups should try to minimize trips to once every two weeks. And so on.
The safest thing for older people and those with chronic conditions is, like everyone else, to stay home as much as possible. But just like everyone else, this isn’t going to be feasible for some people all day every day, or at least something everyone will be willing to do for weeks or months on end.
“People will take risks, whether we like it or not,” Marcus argued. “The best thing we can do is give them strategies to reduce harm in those situations. If we don’t do that, we’re missing an opportunity.”


vox--2020-05-21--My coronavirus survivor group is my most important medical support right now

When I first became sick with Covid-19 on March 13 , my symptoms matched the Centers for Disease Control and Prevention ’ s ( CDC ) description of the disease .
I was not surprised to test positive when I was admitted to Mt .
Sinai hospital in New York City on March 17 .
In the weeks that followed , however , my illness began to morph .
I developed a host of new symptoms , from severe sinus pain to rashes and hives , that weren ’ t yet being widely acknowledged .
My recovery dragged on for @ @ @ @ @ @ @ absence of public health information that could explain or validate my experience , I connected with other Covid-19 survivors and started the Body Politic Covid-19 support group for people living with the virus .
As the group grew to thousands of members from around the world , it became clear that others were desperate for information to understand their experience .
In the absence of comprehensive , up-to-date information from health authorities , the support group has allowed people living with or recovering from the disease to discuss lesser-known symptoms , crowdsource best @ @ @ @ @ @ @ , and arm against medical bias that affects marginalized populations .
There ’ s a rich history of such support groups in fighting disease , especially at early stages of public health crises when patients face stigmas and medicine is still playing catchup .
During the AIDS crisis , groups like the Gay Men ’ s Health Crisis ( GMHC ) , Gay Men of African Descent ( GMAD ) , and SisterLove , Inc. supported patients by providing structures of community care — peer counseling services and hotlines to answer questions about @ @ @ @ @ @ @ government were failing to address .
The fact that the SARS-CoV-2 virus is completely novel means that governments , scientists , and medical officials were caught off guard and are still scrambling to understand this complex disease .
Today , my support group is one of many attempting to meet the needs of people living with coronavirus .
There ’ s Survivor Corps , Long Haul COVID fighters , and COVID-19 Support Group ( have it/had it ) , which are all active on Facebook .
As we wait for institutions to catch @ @ @ @ @ @ @ , parallel forms of information-sharing via communities , personal stories , and support groups like the one I started have become crucial .
The mainstream media is starting to report on the wide variety of symptoms patients are experiencing , in large part due to the efforts of survivors who have shared personal stories and information .
With medical care arguably more inaccessible than ever due to high demand and testing still unavailable or being discouraged in many places , my support group allows patients who were unable to be tested or are @ @ @ @ @ @ @ from others in the same situation .
Neurological symptoms , for example , while still not recognized by the CDC , are one of the most discussed issues in the group , along with GI issues and skin sensitivity .
Lauren Nichols , 32 , a member of the group from Boston who tested positive for Covid-19 on March 17 , told me she has dealt with “ moderate-to-severe lower GI issues for 60 days , ” which was not what she was told by doctors to expect .
In the “ GI @ @ @ @ @ @ @ members say they wish they could see a GI specialist about symptoms , which include debilitating nausea and diarrhea that can lead to extreme weight loss or dehydration .
Those who have been able to seek medical care for these kinds of symptoms have also shared recommendations from their doctors on over-the-counter treatments , foods to avoid , and the potential effects of consuming too much ibuprofen or vitamin C. The CDC symptom list was updated on April 27 to include six new symptoms , including chills , muscle pain , loss of @ @ @ @ @ @ @ excludes many of the issues widely experienced by people living with Covid-19 .
The CDC list is “ not all-inclusive , ” and many survivors in the group are reporting symptoms that aren ’ t on it .
There ’ s a rich history of such support groups in fighting disease , especially at early stages of public health crises when patients face stigmas Cognitive and neurological issues are another big topic of discussion in the support group ; brain fog and trouble concentrating seem to be major effects of the virus for @ @ @ @ @ @ @ was shared in my group , David Lilienfeld , an epidemiologist , argues that neurological deficits are a likely impact of Covid-19 , writing , “ Do you really think that only smell and taste are affected ?
” I , myself , have experienced debilitating headaches , occasional memory loss , and difficulty focusing on simple tasks .
Others in the support group have navigated partial paralysis of the face , or pins-and-needles sensations that they attribute to nerve damage .
In the “ neurological issues ” channel of our chat , @ @ @ @ @ @ @ coin their own phrases for difficult-to-explain symptoms like a tingling , vibrating sensation that seems to afflict many .
“ I call them nerve storms , ” Melody Rose , 34 , from Arizona , wrote of the unexplained vibrating feeling .
She asked other members experiencing this symptom to chime in : “ Do you relax and let them just sweep over you ?
Or do you push through and ignore them ?
” Rose is one of many people in the group creating a new vernacular as they seek advice and @ @ @ @ @ @ @ recommendations from around the world , together Because the support group includes people from nearly every region of the world , members are able to share helpful advice from local authorities .
That ’ s particularly valuable because guidelines seem to vary greatly by region , and are often based on local availability of tests or political pressure .
For instance , some current and former CDC staff believe the CDC has been successfully sidelined by the current administration , and Rachel Maddow has argued that the health agency ’ s recommendations may @ @ @ @ @ @ @ of the biggest questions facing survivors is when it ’ s safe to cease isolation .
When I was discharged from Mt .
Sinai hospital on March 18 , I received instructions to be retested before I could stop isolating .
But , when I spoke to my local department of health about getting a test , I was told no one was being retested and that I could cease isolation seven days after my first symptoms if the last three days were fever-free .
I was initially skeptical of this advice , @ @ @ @ @ @ @ virus can live on some surfaces for up to two to three days .
A recent study from Wuhan detected the virus in patients for a median of 20 days after symptom onset , although there is not yet a proven link between viral shedding and infectiousness .
After connecting with patients in other countries through the support group , it quickly became clear that there were further reasons to prolong my isolation beyond the DOH recommendation .
I learned that countries such as Singapore , Italy , and Australia often require patients @ @ @ @ @ @ @ ceasing isolation or to isolate for up to 28 days , indicating that a lack of available testing might be the reason for lighter precautions in the United States .
Second , many of those in the group experiencing long recovery times were dealing with recurring fevers weeks and even months after initial symptoms .
Since my instructions prioritized the importance of isolating while feverish but didn ’ t account for the possibility that a fever might return later in recovery , I thought it best to stay inside until I felt fully @ @ @ @ @ @ @ Body Politic support group have shared suggestions on contagiousness from doctors , recommendations which were sometimes conflicting , and often advocated being more cautious than local health authorities had advised .
A member of our group who lives in Virginia has been sick for over 50 days with a low-grade fever among other symptoms .
She has received conflicting advice from doctors and health officials in her area on when to stop self-isolating .
“ The virus is so new that I don ’ t think the medical community has clear guidelines about @ @ @ @ @ @ @ ” she said .
Lisette Piper , a group member in the United Kingdom , told me that the group ’ s discussions had influenced her decision to self-isolate longer than National Health Service recommendations .
She said it ’ s made her more aware of how much guidelines differ from country to country , and the fact that the UK ’ s guidelines are more liberal than many .
“ With this knowledge , I felt I had a moral responsibility not to break the isolation , ” Piper said .
Members @ @ @ @ @ @ @ where testing is more available have also provided useful context for analyzing test results .
Piper was told by her doctor that if she received a negative test , she was likely virus-free , but after learning more from the support group about the prevalence of false test results , she ’ s decided to wait until symptoms completely subside .
Perhaps , it is unsurprising then that in a recently published survey done by group members , a majority of respondents said they had used personal judgment or recommendations from doctors , @ @ @ @ @ @ @ when to re-integrate with family .
Over time , public health guidelines are likely to evolve and become more consistent , as more survivors are studied and further evidence becomes available , but in the meantime , the group allows people living with Covid-19 to collectively analyze global recommendations and discuss the best course of action .
While Covid-19 has disproportionately affected black and brown communities in the US , the public faces of Covid-19 survivors tend to be white .
Stories on the massive impact of coronavirus on communities of color often @ @ @ @ @ @ @ experiences , like the fact that people of color and women are more likely to have their symptoms dismissed by doctors , or that black people are being turned away at emergency rooms and urgent care centers .
Michelle Lemus , a Mexican-American group member in California , developed chills and fever on March 16 after having contact with someone who ’ d traveled to Italy and was tested on March 17 .
Her test came back negative , but Lemus is concerned that may have been due to the type of test @ @ @ @ @ @ @ her sputum , but she was not yet coughing at the time of her test .
When Lemus ’ s symptoms persisted , her doctor prescribed her antibiotics , citing the negative test result as proof that she didn ’ t have Covid-19 .
Lemus ’ s fever continued to cycle on and off , and her shortness of breath became severe , making it impossible to sleep without , she says , “ waking up gasping for air.
” Lemus felt she had no choice but to go to urgent care , @ @ @ @ @ @ @ re-test her and ignored her concerns , telling her that her symptoms were likely anxiety or heartburn .
“ It didn ’ t surprise me , ” Lemus told me .
“ I ’ ve had doctors dismiss me my entire life.
” Lemus is overweight and says she ’ s faced bias from doctors in the past due to her race and size .
She had polycystic ovary syndrome ( PCOS ) , a hormonal imbalance , for years before she was accurately diagnosed , because doctors kept telling her her menstrual @ @ @ @ @ @ @ .
One of the biggest questions facing survivors is when it ’ s safe to cease isolation Discussions about medical bias come up regularly in the support group .
When *Karen , a 52-year-old white woman in New York City , posted in the mental health channel of our group that a doctor had dismissed her cardiac pain and shortness of breath as anxiety , a number of women and people of color replied that they felt they ’ d been treated similarly .
“ When I saw ‘ anxiety ’ on that @ @ @ @ @ @ @ Karen told me .
“ I don ’ t even have anxiety .
...
This wasn ’ t a medical diagnosis ; this was a judgment.
” The opportunity to connect with others to both affirm one another , but also to offer tangible advice , is even more important for patients who are less likely to have their concerns taken seriously by medical professionals .
Sarah Chambers , a member of our group who also tested negative but was told by a doctor to assume she had Covid-19 due to her symptoms @ @ @ @ @ @ @ result , recently shared a guide in the “ under 40 ” channel of our group on navigating ERs and ambulances from a patient ’ s perspective .
“ Often doctors don ’ t take young [ people ] , women and [ people ] of color seriously , ” Chambers ’ guide begins .
She goes on to suggest that patients ask doctors to “ explain ALL of the test results and diagnosis before you leave , ” saying that the doctor she and her partner saw failed to mention several important @ @ @ @ @ @ @ that her partner had severe pneumonia .
When Lemus returned from her urgent care visit , she felt physically and mentally exhausted .
She turned to the support group .
“ Knowing I wasn ’ t alone in my symptoms and experiences is what kept me going , ” Lemus told me .
“ I ’ m so grateful to have found this group .
They were way more helpful than any doctor I ’ ve spoken to.
” Many doctors are aware of discrepancies in care — the National Medical Association , @ @ @ @ @ @ @ , recently urged federal health agencies to study the role of medical bias in Covid-19 cases — and some medical professionals seem eager to address patients like Lemus whose symptoms or test results mean they ’ ve been ignored by other healthcare providers .
The Body Politic support group receives frequent inquiries from doctors and researchers who are eager to review our data or join the chat , and we ’ re working to set up Zoom webinars with healthcare workers who are interested in providing virtual support and care .
It is @ @ @ @ @ @ @ broader medical community and those engaging in community networks like the Body Politic Covid-19 support group will ultimately lead to more informed , accessible , and unbiased medical care for all .
Fiona Lowenstein is the founder of Body Politic , a queer feminist wellness collective , events series , and media company aimed at creating content and events on accessible wellness for marginalized populations .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that @ @ @ @ @ @ @ 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 consider making a contribution to Vox @ @

When I first became sick with Covid-19 on March 13, my symptoms matched the Centers for Disease Control and Prevention’s (CDC) description of the disease. I was not surprised to test positive when I was admitted to Mount Sinai Hospital in New York City on March 17.
In the weeks that followed, however, my illness began to morph. I developed a host of new symptoms, from severe sinus pain to rashes and hives, that weren’t yet being widely acknowledged. My recovery dragged on for more than seven weeks. In the absence of public health information that could explain or validate my experience, I connected with other Covid-19 survivors and started the Body Politic Covid-19 support group for people living with the virus.
As the group grew to thousands of members from around the world, it became clear that others were desperate for information to understand their experience. In the absence of comprehensive, up-to-date information from health authorities, the support group has allowed people living with or recovering from the disease to discuss lesser-known symptoms, crowdsource best practices from health authorities around the world, and arm against medical bias that affects marginalized populations.
There’s a rich history of such support groups in fighting disease, especially at early stages of public health crises when patients face stigmas and medicine is still playing catchup. During the AIDS crisis, groups like the Gay Men’s Health Crisis (GMHC), Gay Men of African Descent (GMAD), and SisterLove Inc. supported patients by providing structures of community care — peer counseling services and hotlines to answer questions about the disease that the medical establishment and government were failing to address.
The fact that the SARS-CoV-2 virus is completely novel means that governments, scientists, and medical officials were caught off guard and are still scrambling to understand this complex disease. Today, my support group is one of many attempting to meet the needs of people living with the coronavirus. There’s Survivor Corps, Long Haul COVID fighters, and COVID-19 Support Group (have it/had it), which are all active on Facebook.
As we wait for institutions to catch up with a new and fast-moving virus, parallel forms of information-sharing via communities, personal stories, and support groups like the one I started have become crucial.
Validating symptoms
The mainstream media is starting to report on the wide variety of symptoms patients are experiencing, in large part due to the efforts of survivors who have shared personal stories and information. With medical care arguably more inaccessible than ever due to high demand and testing still unavailable or being discouraged in many places, my support group allows patients who were unable to be tested or are struggling with lesser-known symptoms to receive validation from others in the same situation. Neurological symptoms, for example, while still not recognized by the CDC, are one of the most discussed issues in the group, along with GI issues and skin sensitivity.
Lauren Nichols, 32, a member of the group from Boston who tested positive for Covid-19 on March 17, told me she has dealt with “moderate-to-severe lower GI issues for 60 days,” which was not what doctors had told her to expect. In the “GI Issues” channel of our group, members say they wish they could see a GI specialist about symptoms, which include debilitating nausea and diarrhea that can lead to extreme weight loss or dehydration. Those who have been able to seek medical care for these kinds of symptoms have also shared recommendations from their doctors on over-the-counter treatments, foods to avoid, and the potential effects of consuming too much ibuprofen or vitamin C.
The CDC symptom list was updated on April 27 to include six new symptoms, including chills, muscle pain, loss of smell, and headache, but still excludes many of the issues widely experienced by people living with Covid-19. The CDC list is “not all-inclusive,” and many survivors in the group are reporting symptoms that aren’t on it.
There’s a rich history of such support groups in fighting disease, especially at early stages of public health crises when patients face stigmas
Cognitive and neurological issues are another big topic of discussion in the support group; brain fog and trouble concentrating seem to be major effects of the virus for many. In a Twitter thread that was shared in my group, David Lilienfeld, an epidemiologist, argues that neurological deficits are a likely impact of Covid-19, writing, “Do you really think that only smell and taste are affected?”
I have experienced debilitating headaches, occasional memory loss, and difficulty focusing on simple tasks. Others in the support group have navigated partial paralysis of the face, or pins-and-needles sensations that they attribute to nerve damage.
In the “neurological issues” channel of our chat, people share results of blood tests and coin their own phrases for difficult-to-explain symptoms like a tingling, vibrating sensation that seems to afflict many.
“I call them nerve storms,” Melody Rose, 34, from Arizona, wrote of the unexplained vibrating feeling. She asked other members experiencing this symptom to chime in: “Do you relax and let them just sweep over you? Or do you push through and ignore them?” Rose is one of many people in the group creating a new vernacular as they seek advice and help others navigate lesser-known symptoms.
Analyzing recommendations from around the world, together
Because the support group includes people from nearly every region of the world, members are able to share helpful advice from local authorities. That’s particularly valuable because guidelines seem to vary greatly by region and are often based on local availability of tests or political pressure. For instance, some current and former CDC staff believe the agency has been successfully sidelined by the current administration, and Rachel Maddow has argued that the health agency’s recommendations may be influenced by President Trump.
One of the biggest questions facing survivors is when it’s safe to cease isolation. When I was discharged from Mount Sinai hospital on March 18, I received instructions to be retested before I could stop isolating.
But when I spoke to my local department of health about getting a test, I was told no one was being retested and that I could cease isolation seven days after my first symptoms if the last three days were fever-free. I was initially skeptical of this advice, since I’d read that the virus can live on some surfaces for up to two to three days. A recent study from Wuhan detected the virus in patients for a median of 20 days after symptom onset, although there is not yet a proven link between viral shedding and infectiousness.
After I connected with patients in other countries through the support group, it quickly became clear that there were further reasons to prolong my isolation beyond the DOH recommendation. I learned that countries such as Singapore, Italy, and Australia often require patients to receive multiple negative Covid-19 tests before ceasing isolation or to isolate for up to 28 days, indicating that a lack of available testing might be the reason for lighter precautions in the United States.
Related How to fight fear and anxiety when quarantine ends
Second, many of those in the group experiencing long recovery times were dealing with recurring fevers weeks and even months after initial symptoms. Since my instructions prioritized the importance of isolating while feverish but didn’t account for the possibility that a fever might return later in recovery, I thought it best to stay inside until I felt fully recovered. Finally, some in the Body Politic support group have shared suggestions on contagiousness from doctors, recommendations that were sometimes conflicting and often advocated being more cautious than local health authorities had advised.
A member of our group who lives in Virginia has been sick for over 50 days with a low-grade fever among other symptoms. She has received conflicting advice from doctors and health officials in her area on when to stop self-isolating. “The virus is so new that I don’t think the medical community has clear guidelines about what to do for prolonged cases,” she said.
Lisette Piper, a group member in the United Kingdom, told me that the group’s discussions had influenced her decision to self-isolate longer than National Health Service recommendations. She said it’s made her more aware of how much guidelines differ from country to country, and the fact that the UK’s guidelines are more liberal than many. “With this knowledge, I felt I had a moral responsibility not to break the isolation,” Piper said.
Members of the group who live in areas where testing is more available have also provided useful context for analyzing test results. Piper was told by her doctor that if she received a negative test, she was likely virus-free, but after learning more from the support group about the prevalence of false test results, she’s decided to wait until symptoms completely subside.
Perhaps it is unsurprising, then, that in a recently published survey done by group members, a majority of respondents said they had used personal judgment or recommendations from doctors, over public health guidelines, to determine when to re-integrate with family.
Over time, public health guidelines are likely to evolve and become more consistent, as more survivors are studied and further evidence becomes available, but in the meantime, the group allows people living with Covid-19 to collectively analyze global recommendations and discuss the best course of action.
Arming against medical bias and discrimination
While Covid-19 has disproportionately affected black and brown communities in the US, the public faces of Covid-19 survivors tend to be white. Stories on the massive impact of coronavirus on communities of color often miss the nuances of people’s experiences, like the fact that people of color and women are more likely to have their symptoms dismissed by doctors, or that black people are being turned away at emergency rooms and urgent care centers.
Michelle Lemus, a Mexican American group member in California, developed chills and fever on March 16 after having contact with someone who’d traveled to Italy and was tested on March 17. Her test came back negative, but Lemus is concerned that may have been due to the type of test she took — she was tested via her sputum, but she was not yet coughing at the time of her test.
When Lemus’s symptoms persisted, her doctor prescribed her antibiotics, citing the negative test result as proof that she didn’t have Covid-19. Lemus’s fever continued to cycle on and off, and her shortness of breath became severe, making it impossible to sleep without, she says, “waking up gasping for air.” Lemus felt she had no choice but to go to urgent care, but the staff there was unwilling to retest her and ignored her concerns, telling her that her symptoms were likely anxiety or heartburn.
“It didn’t surprise me,” Lemus told me. “I’ve had doctors dismiss me my entire life.” Lemus is overweight and says she’s faced bias from doctors in the past due to her race and size. She had polycystic ovary syndrome (PCOS), a hormonal imbalance, for years before she was accurately diagnosed, because doctors kept telling her her menstrual cycle would improve if she lost weight.
One of the biggest questions facing survivors is when it’s safe to cease isolation
Discussions about medical bias come up regularly in the support group. When Karen, a 52-year-old white woman in New York City, posted in the mental health channel of our group that a doctor had dismissed her cardiac pain and shortness of breath as anxiety, a number of women and people of color replied that they felt they’d been treated similarly. “When I saw ‘anxiety’ on that paper, I was livid,” Karen told me. “I don’t even have anxiety. ... This wasn’t a medical diagnosis; this was a judgment.”
The opportunity to connect with others to both affirm one another and offer tangible advice is even more important for patients who are less likely to have their concerns taken seriously by medical professionals.
Sarah Chambers, a member of our group who also tested negative but was told by a doctor to assume she had Covid-19 due to her symptoms and her partner’s positive test result, recently shared a guide in the “under 40” channel of our group on navigating ERs and ambulances from a patient’s perspective. “Often doctors don’t take young [people], women and [people] of color seriously,” Chambers’s guide begins. She goes on to suggest that patients ask doctors to “explain ALL of the test results and diagnosis before you leave,” saying that the doctor she and her partner saw failed to mention several important aspects of her bloodwork or the fact that her partner had severe pneumonia.
When Lemus returned from her urgent care visit, she felt physically and mentally exhausted. She turned to the support group. “Knowing I wasn’t alone in my symptoms and experiences is what kept me going,” Lemus told me. “I’m so grateful to have found this group. They were way more helpful than any doctor I’ve spoken to.”
Many doctors are aware of discrepancies in care — the National Medical Association, the largest professional organization representing black doctors, recently urged federal health agencies to study the role of medical bias in Covid-19 cases — and some medical professionals seem eager to address patients like Lemus whose symptoms or test results mean they’ve been ignored by other health care providers.
The Body Politic support group receives frequent inquiries from doctors and researchers who are eager to review our data or join the chat, and we’re working to set up Zoom webinars with health care workers who are interested in providing virtual support and care. It is my hope that such partnerships between the broader medical community and those engaging in community networks like the Body Politic Covid-19 support group will ultimately lead to more informed, accessible, and unbiased medical care for all.
Fiona Lowenstein is the founder of Body Politic, a queer feminist wellness collective, events series, and media company aimed at creating content and events on accessible wellness for marginalized populations.