Clusters of cases have also been reported following family, work, or social gatherings where close, personal contact can occur [40,41]. As an example, epidemiologic analysis of a cluster of cases in the state of Illinois showed probable transmission through two family gatherings at which communal food was consumed, embraces were shared, and extended face-to-face conversations were exchanged with symptomatic individuals who were later confirmed to have COVID-19 [40].
The risk of transmission with more indirect contact (eg, passing someone with infection on the street, handling items that were previously handled by someone with infection) is not well established and is likely low.
Pointer from a commenter.*
This is not the final word, but suppose that it is confirmed by solid experimental evidence. In that case, maybe the science will say that for most of us, all the social distancing we need is to adopt the custom of bowing when we greet relatives, friends, and associates, rather than shaking hands or hugging or cheek-kissing. The science may say that it also is safer not to live in a nursing home, ride a subway, or spend a lot of time in an enclosed room with a person who might be sick, especially if they are coughing or singing. But the “6 foot rule” and frequent hand-washing and staying at home except for essential outings might turn out to be Bubbameise, a Yiddish expression that roughly translates as your grandmother’s superstition. Masks also could be Bubbameise, but without causing much disruption.
*I have been complemented on the high signal/noise ratio in the comments section on this blog. .
Perhaps, but in the presence of a novel and unknown threat it makes sense to secure oneself as much as possible initially and gradually relax in a rational manner as the exact limits of the threat become clear.
But “as much as possible” implies some consideration of burden. For example, a married couple might consider it too unreasonably burdensome to temporarily live separately “just to be on the safe side” in case transmission among family members turns out to be the main way the virus spreads. Others might consider it too burdensome to shut down every business that the government deems non-essential.
It’s interesting that we are implementing ever more restrictive measures to minimize indirect casual contact, but maybe the limiting factor at this point is close personal contact among people that live together for which we have implemented few, if any, measures.
I do observe that after knee surgery in 2015, I started washing my hands more, and using much more soap. (Due to fear of infection reaching the implant, which is an issue.)
And there is no two ways about it, I got sick less after 2015. But mostly fewer head colds.
So lots of hand washing almost certainly does not harm, and may do good, unrelated to covid-19.
By The Way – University of Washington announced today they are ramping up on what they seem to say is a stronger antibody test. And they *seem* to be pursuing the sorts of experiments you (and many of the rest of us) have been crying out for.
(Here’s one link, but not the one I wanted:
https://www.seattletimes.com/seattle-news/health/have-you-recovered-from-covid-19-the-uw-medicine-virology-lab-wants-to-test-your-blood/
Links to experimental data (finally!) though so far with bad selection bias (people who happened to answer a web query before they were full, etc.):
https://www.seattletimes.com/seattle-news/health/king-county-gets-new-glimpse-into-unreported-cases-of-covid-19-through-first-ever-swab-and-send-home-testing-kits/
https://www.seattletimes.com/seattle-news/health/have-you-recovered-from-covid-19-the-uw-medicine-virology-lab-wants-to-test-your-blood/
Since I’m putting observations into the comment section….
There’s another kind fraud afoot here – “government” types who seem to think that shutdown orders meant a particular thing and had a particular effect, while the observed on the ground behavoir is different.
In particular, WA state legislatures are now discussing when house cleaning services and landscapers may resume commercial work. Both are acitve right now, I see them basically every day I leave my house. (And the risk in both cases is surely hyper low – if you can hire people to clean your factory, why not your house?)
At least some gun stores and ranges in WA state are open, perhaps because the authorities fear losing a lawsuit trying to shut them down, especially since they allowed marijuana stores to say open….
I presume similar divergence between the reality of “lockdown” and the theory of lockdown will exist almost everywhere, even in China….
Arnold, I think you aren’t sufficiently weighting the phrase “extended face-to-face conversations were exchanged.” All vocalizations produce aerosols which can remain in the air for minutes and if the individual speaking is infected those aerosols will contain the virus. While it is true that speaking isn’t as bad as singing, an extended conversation will produce a giant cloud of the virus in a windless indoor setting giving all those around a lot of chances to inhale the virus where it happily invades the lungs.
Let me add some noise, i want the lockdowns to end.
So you can’t ride the subway or bus the work, which is the only way some people get to work.
Presumably taking an uber wouldn’t be so great either.
Being in a restaurant or bar probably qualifies as risky in this instance. At a minimum, most would need to be way below capacity to spread people out.
Maybe the “six foot rule” is less of an issue when you are outdoors and there aren’t that many people around. Passing people on a hiking path (if they have masks and aren’t that close) and picking up delivered boxes (I let them sit a few hours and give them a spray of disinfectant) seems less dangerous then I thought a few weeks ago.
I still would be weirded out by sending my kids to a playground with other kids touching everything.
So still can’t send kids to daycare, go to an office, have an in person meeting, take public transportation/ubers, eat at a restaurant, get a haircut, or go to a wedding. That’s a pretty long list.
You are weirded out about sending your kids to a playground where other kids have touched the equipment because you have no scientific data upon to make your risk assessment.
Based on the justification for the 6 ft rule, spitting droplets into each other’s mouth and nose, there is no reason to think that passing someone within 6 ft if one or other are looking away from the other wouldn’t also avoid getting spittle in the face. For that matter, treat your mouth as a firearm and hold your fire when someone is crossing your barrel.
The ‘we’ in phrases like “all the social distancing we need” is probably better split out into multiple groups; at least, e.g. people living or working in NYC (or areas of similar density) versus everyone else.
Passing someone within 6 feet is probably low risk, but passing hundreds or thousands of people has to be a greater risk at some frequency. Similarly, long before this pandemic, having lived in NYC for many years, I learned that the skin on my face was much more likely to break out if I touched my face after riding the subway before washing my hands. Surface transmission seems to be relatively low probability, but I would expect a kind of ‘law of large numbers’ in some places where there are lots of people in relatively short periods of time.
There are some other margins of adjustment that seem warranted for ‘private experimentation’: being outside, especially with substantial winds or breezes, opening all of the windows on buses and trains (even subways), or using fans (pointed outwards) on the same, or opening windows and using outward-pointed fans inside buildings as well.
“I have been complemented” – should be complimented.
+ 1
Best Blog Ever
I have always been somewhat casual about personal hygiene, so I suppose that influences my opinion on this issue.
I am dumbfounded by someone who would be worried about sending their child to a public playground. The majority of cases seem to derive from close gathering of adults, and there is little proof (I believe) that the virus is transferred from any surfaces, much less from swing sets.
Some city in California went to a skateboard park and covered it with sand so no one could use it. Boy, those sixteen year olds who whiz by one another 8 feet apart are no doubt the super-spreaders we need to watch out for.
It takes all kinds, as Arnold has reminded us.
I’ve been told many times that the virus can live on surfaces for some time. Certainly it can live on a surface for a five seconds before my kid touches the same thing at a crowded playground. This doesn’t even get into the issue of them breathing on each other. Kids can’t practice social distancing.
My experience with children is that they are germ factories. I get sick way way more often now that I have children.
My own view on this may be biased. I have Type 1 Diabetes, asthma, deformed lungs, and auto immune disorder. There is a 100% chance I die if I get the virus. “Most cases” isn’t really the metric I’m using to determine if my kids will grow up with a father.
“I have been complemented on the high signal/noise ratio in the comments section on this blog.”
Long time reader here – I really appreciate the blog articles and the comments section is also well worth reading.