We, as a society had made a collective decision or indecision to resume economic and social activity even before the anti-racism and anti-police brutality focusing event of Mr. Floyd’s murder by cops took place.
- Downward trajectory of Influenza Like Illness within past 14 days
- Downward trajectory of Covid Like Syndromic cases reported within past 14 days
- Downward trajectory of documented COVID Cases within past 14 days
- In context of constant or increasing testing, downward positivity rate of tests
- Hospitals have sufficienct non-crisis/non-surge capacity available to treat current patients
- Healthcare workers are well protected.
As of this morning, NO STATE has met all of these criteria. A few states are close. Yet all states have gone to at least a Phase 1 re-opening even as testing is still insufficienct to meet White House goals much less independent analysts’ predicates for safe re-opening. Testing and tracing is not widely deployed.
This is the case today. It was the case yesterday. It was the case on May 15th.
Yet we have made the societal wide decision that stay at home is over.
Breaking News: Casinos are filled with people choosing not to wear masks, and who generally poorly understand risk https://t.co/fj3DJTCUoB
— Kevin Collins (@kwcollins) June 7, 2020
So what should be communicated for public health in the context of a societal wide decision that first best advice will be blithely ignored?
I think the second best advice is to adopt harm reduction communication. That means acknowledging that people are going to be protesting and out and about and then offering strategies to minimize the very real risk of COVID spread. It won’t be perfect, but it will be much better. It is the same logic of safe injection sites for individuals addicted to injectable opioids and condom distribution to sex workers.
So what is the advice.
- If you feel like you have symptoms or know you have likely been exposed to someone who is infectious, go get tested and STAY HOME
- If you have significant risk factors, be aware of them and acknowledge your risk in your decision making.
- Stay outside
- Keep moving
- Keep a mask on and wear it correctly (over the mouth AND nose)
- Hand hygiene
- Keep physical distance as much as possible
Almost all of the protests are outside. Many but not all have significant movement through marches/walks. The Durham protest I was at on Thursday and the Chapel Hill march that my wife and daughter attended on Saturday were 97% or more masked. Looking at pictures from other protests, masks are fairly common to very common.
We as a society have made a collective decision to re-engage in economic and social activity despite still having insufficient testing, low contact tracing capacity and a fairly high baseline level of background infections. The collective socio-political decision is to engage in harm reduction while accepting significant risk of increased deaths from COVID. Protesting is part of that decision.