Virus Outbreak New York

Two young women relax in a circle marked on the grass for proper social distancing in Brooklyn’s Domino Park as others do the same to prevent the spread of coronavirus, Monday, May 18, 2020, in New York. The small park, which offers good views of the Manhattan skyline and the Williamsburg bridge, was the site of severe overcrowding during a spate of unseasonably warm weather just over a week ago. The circles have been added to promote good behavior on the park of park visitors. (AP Photo/Kathy Willens)

Diana Butzlaff isn’t asking for much. All the retiree from Woodbury, Minn., wants is to pick up her granddaughter and drive to a nearby park to go for a hike.

But she’s had to go to great lengths to try to figure out if that — in the middle of a pandemic — is a safe thing to do.

“I did measure my distance from my driver’s seat to the rear passenger seat,” she said. “With a tape measure,” she added with a laugh.

Turns out: It’s 5 feet, just short of the 6-foot space that public health experts recommend for social distancing.

So, before picking up her granddaughter, Butzlaff is looking for specific guidance about whether that would be prudent.

But answers are elusive. Minnesota is now moving from its “stay home” order — during which people were urged to stay very close to home, and only businesses, activities and movement deemed “essential” were allowed — to its “stay safe” order, which loosens many of those restrictions and permits wider movement and activities.

As the guidance changes, the responsibility — and decision-making — shifts even more squarely onto the shoulders of individuals.

In the midst of all that, Randi Born of Plymouth is agonizing over whether her adult children, who live out of town, should stay at her house over Memorial Day weekend. She said her kids are “a little heartbroken” they may not be able to spend the night.

She’s worried about herself and her husband — and about the possibility that they might inadvertently carry the disease to her 93-year-old mother.

“But I also don’t want to be overly cautious if I don’t have to be,” Born said. “I’m trying to find that right place between what’s [a] reasonable risk and what’s the right amount of caution.”

Questions abound. Since the beginning of the pandemic, MPR News has been asking listeners to share their questions about this moment we’re in. We’ve been inundated.

Can I go to the cabin with extended family? What about having friends over for dinner? Can my kids have play dates?

The challenge in answering all of these questions is that we still have very little data on which we can base our answers on, said Mary Bassett, a physician and professor of public health at Harvard University, and a former New York City health commissioner.

As a result, she said, advice is typically based on a combination of our limited knowledge of the coronavirus and how it’s transmitted — and common sense.

Which means: There’s rarely a right or wrong answer.

Still, she acknowledged, it’s better to give people some guidance in making those decisions, because as states across the country continue to open up, people will do their best to juggle competing risks in trying to determine what’s safe to do, and what’s not.

So we’ve asked two medical and public health experts at the University of Minnesota to help answer some of these coronavirus conundrums: Susan Kline, an infectious disease physician and professor who’s also the medical director for infection prevention at the U’s Medical Center; and M. Kumi Smith, an epidemiologist at the School of Public Health.

Before tackling specific scenarios, they agreed on general guidelines to follow:

Wear a mask.

First, they both say, wear a mask, especially in crowded, indoor spaces. That’s to protect others in case you’re infected but aren’t showing symptoms yet.

Remember the basics.

Also, continue to follow all those steps that public health officials have preached for the past several weeks: Keep 6 feet of social distance, wash your hands, don’t touch your face.

Socialize outside.

Next, whenever possible, meet outside.

“I think outdoors is much safer than indoors because you just have a lot more air ventilation because there’s a much greater volume of air. And that helps dilute out the infectious particles,” said Kline.

The highest-risk situation — the one to avoid — Kline added, is a large group of people in close proximity to one another in a small enclosed space.

And now: On to some of the specific social scenarios you’ve asked about.

Should I ride in a car with someone not from my own household?

Both Kline and Smith say this is risky, especially on longer drives.

Here’s why: You’re in a small, enclosed space in which the air is recirculated, with lots of surfaces to touch.

Both advise avoiding this type of scenario if you can.

But if you need to do it, wear a mask — and, if possible, keep the windows open.

I really want to see my aging parent!

How can I do that safely?

The first thing to do, Kline said, is to reflect on your movements.

“Be really cautious to make sure that you yourself haven’t been in a high-risk situation where you could have been exposed to anyone with coronavirus,” said Kline. And make sure you don’t have any symptoms.

Then, when it comes time to meet your aging parent in person, do all you can to make the visit as safe as possible: Meet outside, wear a mask, wash your hands and keep at least 6 feet apart.

And this one is really, really hard but: No hugging!

It’s important to remember how deadly this virus can be to our older loved ones, and what we could be exposing them to, said Smith. That said, social isolation is also a major risk factor for other negative health outcomes.

Smith said it’s a balance every family has to strike on their own.

“If you are able to visit with your parents and truly keep quite a distance from them and ideally do so outside,” she said, “I think that’s probably a relatively low risk.”

Should I stay with extended family at a cabin?

The answer here depends partly on how large the cabin is — and how feasible it is to maintain social distancing.

Use separate bathrooms if possible. Disinfect those surfaces frequently.

Smith said she would encourage staying outdoors as much as possible, and having a plan to social distance in the event of bad weather.

Can my kids have play dates?

Both Kline and Smith acknowledge the coronavirus is really tough to navigate with kids. They just have a really hard time staying 6 feet apart when they pay with each other.

So parents need to be realistic if they agree to play dates.

“Consider that a risk you will want to acknowledge, and look in the eye, and think about whether it’s worth it for your family to take that risk, and worth it for you or for your friends to be exposed to that risk,” Smith advised.

C

ould extended family sleep

overnight at my house?

This is a potentially risky situation because you’re inside the same house, you’re probably eating at the same table, and you’ll likely be spending long periods of time inside with these people.

And the more time you spend with an infected person, said Kline, the greater the risk that you may become infected.

Smith said it’s possible to do this safely, if guests can sleep in a separate part of the house.

The danger comes from shared facilities. So: Try to use the kitchen at different times. Practice stringent disinfection of contact surfaces in shared rooms. And spend as much time outdoors as possible.

Can I have friends or family over for dinner?

Keep gatherings as small as possible. Be diligent about staying 6 feet apart. If that’s a challenge, wear masks. Disinfect shared surfaces.

Both also recommend staying outside. Have a barbecue, or a picnic.

And again, be cautious with kids.

What about meeting friends for a picnic or around a fire pit or for a walk?

If you’re craving social interaction, which is really important to maintaining mental health, especially in these uncertain times, outdoors gatherings can be some of the safest ways to do it.

But, of course: Keep gatherings small.

Be cognizant about staying 6 feet apart.

Smith recommends having a conversation beforehand to lay out expectations, and what precautions you all want to take. Otherwise, it could be potentially uncomfortable when you get together.

“I started doing that because I had a so-called ‘socially distant’ picnic with friends, and everyone ended up sitting a lot more closely together than I was comfortable with,” she said. “And I was surprised, even though this is my job, I actually felt really awkward asking people to spread out more.”

It’s easier to do that ahead of time.

Also: Agree that if any of you start to feel symptoms afterwards to communicate that with the others.

What else should I keep in mind before meeting with people?

Smith said she’s found herself sharing one general observation with a lot of people: We tend to overestimate the risk of getting scary diseases like COVID-19 from strangers. But we underestimate the risk of getting it from people we know.

Smith said that means “we really take a huge amount of precaution when we’re around people that we don’t know. And then we really sort of let our guard down around our family and friends.”

The danger is that the coronavirus takes advantage of the kinds of social interactions we have with our loved ones, where we share close contact with one another for longer periods of time.

Smith says it’s important to think about how you would feel if you found out you may have infected a friend or family member, who later got really sick.

“Having that moment of reflection by ourselves is going to really help us stay grounded and centered as we navigate an increasingly confusing time,” she said.

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