All 50 states have begun some form of reopening from the coronavirus-induced lockdowns, and the early signs are troubling. States like Alabama (restrictions were lifted April 30), Florida (May 4), and Arizona (May 8) have posted record-high levels of coronavirus cases as of June 11, and 24 states are observing rising case counts compared with two weeks ago. Hospitalizations are also at an all-time high in states such as Texas, which opened early. The additional impact on the pandemic of the large crowds that gathered during Memorial Day weekend and the recent antiracism protests is still unclear.
Massachusetts has so far performed well since reopening began on May 18. COVID-related hospitalizations have fallen by half, deaths are 75 percent lower, and the positivity rate for testing has steadily declined.
Despite this success, the state should not let down its guard.
New COVID-19 cases and deaths can easily rebound and grow exponentially. The coronavirus has not forgotten about us.
Since Memorial Day there have been alarming stories of people in Massachusetts having large parties and gathering on beaches, many without masks. With the warmer weather and lower rates of transmission currently prevailing, it is not surprising that people are tempted to stop social distancing. But this behavior is dangerous and jeopardizes the hard-fought gains by front-line health workers and the collective sacrifices each of us has made to suppress the COVID-19 curve.
As reopening continues, we face fewer regulations and advisories, and as individuals, we must act wisely.
▪ Assume you and those around you could be infected and act accordingly. There is strong evidence that asymptomatic spread accounts for 30-50 percent of new infections. Remember, your individual risk of infection is cumulative. This means that your chances are dependent on the intensity of exposure multiplied by the amount of time you are exposed. Staying outdoors in well-ventilated spaces and maintaining social distance reduces the intensity of exposure to the virus.
Indoor activities should be kept to the shortest time possible. If you must get a haircut, get in and out of the salon quickly. Do not linger in grocery stores; make a list ahead of time, get what you need, and get out. If you decide to go to a restaurant, make sure your seat is at least 6 feet away from the next diner. Do not have outdoor parties unless you can maintain social distance, wear masks, and have all households bring their own food and serving utensils.
We should not patronize businesses that aren’t strictly following guidelines for universal masking, social distancing, and regular testing of their workers. If customers insist, businesses will have an incentive to adhere to the state-mandated standards for protecting their workers and customers.
▪ We must all wear masks at all times when outside. Masks are one of the most important and effective defenses we have until there is a vaccine. In fact, we need to think of masks as our “interim vaccine” against COVID-19 until the real thing is ready, probably sometime next year.
Increasing evidence shows that if 80 percent of us wore masks consistently, total infections could be reduced by over 90 percent. Additional studies have found that masks, in addition to social distancing and hand washing, are highly effective at reducing coronavirus infection. And the recent example of a hair salon in Missouri where two stylists infected with COVID-19 cut the hair of 140 clients further reinforces the importance of masks: All wore masks and none of the clients became sick.
Masks work only if we wear them correctly; pulling the mask up and down, letting it droop below your nose, holding it in your hand, or dangling it around your neck render the masks ineffective and could increase your risk of infection.
▪ We can also make a difference by reinforcing responsible behavior. Speak out if masks and social distancing are not being respected at your workplace. Make good choices as a household. Before getting together with others, clearly establish the rules and boundaries. Do not wait until you are together and the one person without a mask becomes the norm for everyone else.
With the reopening of schools and universities in September and a further return to work after summer holidays, a second wave of COVID is expected. It could even start sooner if Massachusetts residents lower their guard as those in other states have done.
Despite the widespread ravages of COVID-19 since early March — 105,000 cases and over 7,600 deaths in Massachusetts — the pandemic is still controllable. Look at the examples of Hong Kong, Korea, and even poorer countries like Vietnam and Myanmar, which have stopped the virus in its tracks and reopened their economies gradually and safely.
We are not helpless in the face of this virus. We know much more now than we did in April about where COVID-19 is spreading and how. The shape of the second wave will be the direct product of our collective actions — we have the power to decide how we want this pandemic to end — either in triumph or in disaster.
Shan Soe-Lin is managing director of the Boston-based Pharos Global Health Advisors and a lecturer in global health at the Jackson Institute for Global Affairs at Yale University. Robert Hecht is the president of Pharos Global Health Advisors and a clinical professor of epidemiology at the Yale School of Public Health.