Question: We have been letting our daughter (age 11) go to climbing team and dance because the facilities require masks and distancing and have much reduced capacity. I understand that indoor groups with no masks=very bad but I can’t get a sense of the level of risk of indoors with masks and distancing. With numbers going up, we are wondering if we need to cancel these or if a facility taking all the best precautions can still be safe enough. I know nothing is totally safe but I’m looking for some idea of what level of risk we are taking with these so I can balance against her sanity and physical health.
Answer: Your question and dilemma– balancing sanity and physical health with COVID safety– is so similar to the questions/dilemmas facing us all. The odds of contracting COVID depend on four sets of factors (described below and in our Q&A of 11/16). Taking these factors into consideration– with cases on the rise, with infectivity very high in the period before symptoms begin, and with the gym being a higher-risk environment generally meeting the 3Cs– I would consider your daughter’s climbing team and dance activities high risk. At this stage in the pandemic, we need to avoid as much as possible the 3Cs of closed spaces, crowded places, and close-contact settings. To better mitigate risk, keep masks and social distancing, and move the climbing and dance activities outside (buy loads of warm clothes)! When trying to consider risk for other types of activities, try and keep these four factors in mind and try to avoid the 3Cs.
- Community infection rates: How likely are you to be in the same location with an infected person?
- The pandemic is surging across the country. New cases and hospitalizations are at their highest ever; high test positivity rates are well above the 5% threshold. The likelihood of being among an infected individual increases as community infection rates increase. If you are outside your house in a place with other people, the chances that you interact with an infected person are the highest they’ve been since the pandemic began. Crowded places add to the risk.
- Person infected: How infectious are they?
- Evidence increasingly shows that people are most infectious “very early in the disease course (a few days before and within the first 5 days after symptom onset).” High infectivity before symptom onset makes the virus especially challenging to contain. Additionally, other factors like heavy breathing– as with exercise or singing– further propel the virus, increasing risk to others. Mask wearing and social distancing help keep the virus from spreading, but they do not offer full protection.
- Environment: How easily can the virus move through the environment?
- Outdoor environments are much safer than indoor environments. Indoor environments make the virus much easier to spread via airborne transmission, and poor ventilation adds to the risk. Dry air is also associated with increased viral spread (another challenge of winter). And loud environments are associated with increased risk (perhaps because they cause people to shout and expel/inhale more particulates). We do have examples of superspreader events occurring in gym settings, and gym settings generally fit higher risk criteria– 3Cs of closed spaces, crowded places, close-contact settings. (for more, see Q&A of 10/27 and Q&A of 7/10)
- Person susceptible: How much virus does the person inhale and what is their underlying state of health?
- Young people and people with no underlying health conditions are less likely to experience severe COVID, but evidence increasingly shows that young people are just as likely to become infected as older people and are also just as likely to spread the virus (see Q&A of 11/5). Other factors, like heavy breathing associated with exercise, may increase risk of virus inhalation. And then there are a number of other factors that we just don’t know enough about yet– like enhanced immunity from other coronaviruses or other vaccinations #BCG; or protection afforded by O blood type (see Q&A of 10/15 and Q&A of 9/6).