Thinking about Risk and Reopening

May 15, 2020 3:09 p.m.

One thing to consider when thinking about risk and infectious disease is the difference between individual and societal risk. Certain activities may have a very low level of risk across society. But are they possible sources of infection? Yes. Could they happen to you? Yes. Unlikely. But yes.

One thing that has been clear for a few weeks is that many of the big outbreaks outside of major cities have been in meat packing plants. That is probably in part because meat packing plants are some of the relatively few kinds of factories or workplaces that have remained open at full capacity. But it’s also in the nature of the plants themselves. (That’s likely why Amazon warehouses, which have been hit as well, haven’t been hit as badly as the meat packing plants.) People are bunched up together. There’s little regard for worker safety and quality of life. They’re natural places for spread.

A lot of things went wrong for New York City. But in addition to the number of people per square mile in the city – which is higher than any other place in the country – there are just lots of places in the city that are a lot like meat packing plants in terms of the concentration of people. COVID had a good three weeks to take hold and spread before anyone had any real idea what was going on and before the city took any meaningful steps to contain the damage.

If the outbreak began in the middle of February – as now seems likely – the city didn’t meaningfully shut down until about five weeks later. Looked at in that way, with lots of meat packing-like confined spaces all over the city and many others which, while luxurious, were nearly as good for spread, it’s hardly surprising that the outbreak was explosive and ended up infecting more than 1.5 million people.

I say this because it is helpful context and an expanding range of information to understand why a cataclysmic outbreak happened in New York and so far hasn’t happened elsewhere. Concentration of people; subways; international travel; bad luck.

One of the big public flash points and controversies has been people hanging out in parks and on beaches. But there seems to be a growing amount of negative evidence (lack of spreading, lack of super spreading events) that these just don’t tend to be places that drive a lot of COVID cases. If this is true and can be backed up with more granular data that’s probably a good place where relative loosening can happen to relieve some of the general house-bound-ness and stress of the COVID semi-lockdown.

This all seems borne out by this Post write-up of what a selection of public health experts plan to do themselves. Indoors vs outdoors is one of the biggest things. Not surprising but helpful to know. At beaches, if you can effectively social distance, that is likely relatively safe.

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