Limiting risk during re-opening
We’ve been getting a lot of questions about how to think about the risk of various situations. This is a near-impossible task to answer simply in a newsletter. There is no such thing as zero-risk. If you’re feeling too uncertain, and you need guidance, please reach out and we will be happy to help you. Last newsletter, we laid out a four-part framework to help you be safe and weigh decisions in re-opening Oregon.
- Practice safe personal habits.
- Make wise choices about when and where to go out.
- Keep in mind that we’re all in this together.
- Reflect on your actions and their results.
Based on your questions, here are some examples of how to apply this framework to minimize risk as you live your life in the coming months.
What do I do when an outsider needs to come to my home?
First, you have to decide whether the visit/service/etc is necessary. If you decide that yes, it’s a wise choice, then keep in mind that the risk flows both ways. Either your household member or the other person(s) may be infected and not know it. Be mindful of the space you’re bringing someone into, and take precautions afterward.
- Discuss your safety policy before they arrive (are masks required?).
- Create a safe environment by washing your hands and disinfecting common surfaces beforehand.
- Check symptoms of those in your household and ask the other person(s) to do the same.
- Maintain 6 or more feet of space between people.
- If the situation requires someone inside your home, everyone should wear a mask.
- Once the person leaves, wash your hands and disinfect common surfaces.
- Reflect on what went well and what needs to be improved, and if that person will be returning, include them in the discussion.
What about get-togethers with others?
There’s no risk-free way to merge households. Your baseline risk is determined by your household size and each of the external human contacts those household members experienced over the preceding two weeks. If you meet up with another household, you have to account for the risk of each of the members of that household and their external contacts as well. If you and they weigh all of this with Frameworks 2&3 in mind, and you decide the risk is acceptably low, then be smart and practice care to exercise safe personal habits and share reflections together afterward.
The recent spike of cases in Deschutes County is an example of how this can go wrong, where 80% of new cases have been linked to extended family and social gatherings of multiple households. We encourage you to be conservative and be safe as you contemplate these choices.
Can’t I just test everyone before we do ____________________?
In Oregon, testing capacity is up to about 38,000 per week. We have nowhere near the testing capacity to use tests frivolously. Furthermore, the process of testing itself makes it a poor fit for decision making. A test is just a sample from a point in time. Results are delayed by a couple days or more while the lab analyzes the sample. And even the best test carries a possibility of being falsely negative. Not having enough virus present at the time of the test to produce a positive result doesn’t mean that there couldn’t be more virus by the time the results come back.
Shane’s sister-in-law is an orthopedic oncologist who was deployed to NYC on the USNS Comfort and recently returned home, where his high-risk parents were helping with childcare in her absence. While deployed, she was exposed to patients with confirmed positive SARS-CoV-2 tests. She didn’t develop symptoms and was not tested for COVID-19. Despite the considerable cost of not having their highly specialized doctor at work, the Navy quarantined her in a hotel for two weeks before returning home.
The moral of the story is that testing wouldn’t have short-circuited this process. Testing is useful in diagnosing cases, but it’s not a reliable enough screening tool to substitute for safe distance and hygiene.
As always, we want to leave you with something fun. After two months with the ones we love, what might we do differently for the next quarantine? This guy has the answer.
Take care,
Baskin Clinic