The Reality is, We're in a Gray Zone
Our new reality is gray, and that is a very hard and uncomfortable place to live in. Where government officials prioritize economic panic or political popularity over public health, what are well-intentioned citizens to do? Where government guidelines are available and well-meaning but vague, how do we make choices that are safe for ourselves and our families? Even where curves are flat or down-sloping and government guidelines are specific, how should we behave day to day?
The truth is, there is no safe answer about how to behave in this gray zone because public health does not operate in absolutes. Instead, we respond to data—and not just what we know today, but what are the trends we have observed this week, this month, this year, and in other places across the globe. Data can be our collective guide as we head into this uncertain future. Let's try something (like open restaurants for outdoor dining or cautiously open stores with arrows taped to the floor) with reasonable measure and then watch what happens in terms of new cases on a community level. Only then will we know whether we can relax restrictions further or need to pull back.
Your First Gut Check
But on an individual level—what is right for YOU, RIGHT NOW—you have to first look inwards. Do a gut check. What is your own personal level of risk tolerance? In other words, how much risk are you willing to tolerate? We think about these issues all of the time in terms of our personal finances- how can we weigh potential risks with potential returns on investment? If you became ill after that haircut/manicure/shopping trip, would it have been worth it? There are those who will not be able to tolerate any amount of risk of becoming infected—their health is too delicate or anxiety too high to make that tentative outing worth the risk. Others will be early navigators into our reopened world, willing to take some degree of the risk of infection just to leave the confines of isolation. Knowing that we may have a window of opportunity this summer, between the epidemiologic waves, to see our friends and family may increase all of our levels of risk tolerance.
Your Second Gut Check
The second gut-check on your personal choices and behaviors is to ask yourself, how can I make this situation safer for my health? Practice harm reduction. We must acknowledge that the only way to be 100% safe from COVID-19 infection is to stay home and isolate. But where this is not feasible, practical, or even reflective of local guidelines, venture out in the safest way possible. Wear a cloth facial covering, wash your hands, keep your social distance, and disinfect high-touch surfaces. Get tested for COVID as it becomes increasingly available. In this way, you not only potentially benefit your own health but also the health of your community. Knowledge is power! The more data we have, the more we can respond to it in a way that is reasonable.
Beyond the who and the how, the where is important. There are microepidemics across this country and knowing your local context is important as you assess your level of risk. Rural Vermont is not L.A., Birmingham, suburban Westchester, or Portland. Right now, where you live matters in terms of your experience with this epidemic.
This is Not Forever
So as we cautiously navigate our new reality together, know that it is not forever. Vaccines are on the horizon. New treatments are gathering evidence every day. Testing and contact tracing are expanding. Here's hoping that all of this scientific progress will shed a little light into the gray.
And to get through this pandemic at your healthiest, don't miss these Things You Should Never Do During the Coronavirus Pandemic.
Jaimie Meyer, MD, a Yale Medicine infectious disease doctor and assistant professor of medicine at Yale School of Medicine.