COVID-19: Evaluating the risk

[xplorer7]

Both of the following statements are on the CDC website on pages updated within the past week and a half:

1: COVID-19 Cases are Extremely High. Avoid Events and Gatherings. COVID-19 cases, hospitalizations, and deaths are extremely high across the United States. To decrease your chance of getting and spreading COVID-19, CDC recommends that you do not gather with people who do not live with you at this time. Attending events and gatherings increases your risk of getting and spreading COVID-19. Stay home to protect yourself and others from COVID-19. (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html)

2: Evidence suggests that many K-12 schools that have strictly implemented mitigation strategies have been able to safely open for in-person instruction and remain open. (https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strategy.html)

Well which is it? I don't understand why, given certain criteria and and mitigation strategies are satisfied, it is supposed be safe to send my younger child into a public classroom most of the day, every day, yet it is absolutely not safe to see my other child who just left home shortly before the pandemic, even rigorously using all the same mitigation strategies, and with community spread being equal. It just doesn't seem to add up.

To better frame my question, first consider my family still at home: Either my wife or I (not both) buys groceries once a week, at the time we believe is the least busy hour of the week. We carefully select and always use PPE based on the best information available. My son is in virtual school, and I work from home, except for rare occasions where it is necessary to go to work to perform my job, and then I follow strict social distancing and all the recommended Covid PPE and safety guidelines. We do get curbside pickup or go through the drive through a couple times a week. Otherwise, we never leave the house except for walks where we will not even be likely to encounter other pedestrians, or for essential doctor visits, or oddball one-off situations, like when we had to have a tire repair. Unfortunately this is against a backdrop of COVID-19 not being taken seriously in the surrounding community, with many acting as though there were no pandemic. Of course our strategies do really minimize encountering such people, but we can't reduce it to zero.

Now, I don't have a good feel as to whether we have reduced our risk 70%, 90%, 98%, or even to near zero compared to someone who does not take COVID-19 seriously. Do the experts have a good idea to what the risk would be to people with our lifestyle, or are we still at a point where there is still not enough research or information so that anyone really knows the answer to that question? If there is a good, evidence based estimate on how much the risk is reduced for a family like ours, what would that be?

And what is really the risk seeing family members you do not live with, given masks, social distancing, and other guidelines are adhered to? My personal prediction would be that it is less risky than buying groceries, but I would trust evidence that can be defended much more than my gut, and it really bothers me that an organization which is supposed to represent the gold standard for dispensing evidence based guidance makes both of those statements above without offering compelling justification as to why they should both be true.

[auntiejessi]

I think you also have to take into account where you are - are you somewhere in the US that has a lot of cases, like Florida or Cali? Are you in a state like Maine that never had a lot of cases? Does your area have a lot of variants?

We essentially have no real answers. Every district/county/state is doing things differently, and you have to make the best decision for you based on your area.

[Paxiled]

Overall, I don't think much of anywhere never had a big problem per capita.  Maine might be an exception.  But other sparsely populated states that missed the first wave got the second and third waves in a big way.  But even that is a bit misleading, because a lot of that was in nursing homes and meat processing plants and such places, which then broke out into their communities.  When colleges first reopened students went into town and partied and outbreaks started in some pretty small towns.  People trying to escape lockdowns moved from cities to countryside, spreading the virus there.  So the problem isn't what's happening at any given time, it's what's likely to happen if things open up.  As long as so many Americans consider being unsafe a political statement, it's just going to be a lot of starting and stopping, which might be worse than just stopping until the curve goes flat.  Right now things are better, but better than January, not better than last summer when all looked lost.  We're back there now and the variants are starting to cause the levels to go up again.  To everyone, if you want life to be more normal before the months or years it will take to get everyone vaccinated, comply with public health protocol.  That's the only difference between those countries such as China that are almost back to normal and the US, which is nowhere near that.  Peace, all.

[Paxiled]

Part of the problem is the age of your kids, which you don't state.  Very young children don't get covid in large numbers, though nobody knows why.  Older kids do, and while most are asymptomatic or have very mild cases, they are the ones along with young adults who are spreading the virus to everyone else.  Us older folks are mostly, at least in urban areas where most people live, and except in very Trump-loving states, staying as safe as we can because we are more susceptible not just to getting covid but getting it bad.  Then there's the issue of underlying conditions.  If you have them, you're never safe around others.  Then of course some of us have much better immune systems than others.  I go to the grocery store.  I've been to dentists.  I pick up take-out at restaurants, though I don't eat at them.  I always wear a mask -- now.  In the beginning, we were told not to, and I still did these things.  But I seldom get very sick with anything, so I'm probably not at as much risk as someone who does get sick often.  When I do get sick, it's usually mild.  Now, I do have a ton of things wrong with me due to a medication that messed me up completely, so I have a lot of injuries and pain and other things but that's not the same thing as being susceptible to illness easily.  As for school, it can be done.  The problem is in the US we don't do it.  Ever seen a video of a South Korean school?  Every child behind plexiglass.  No eating lunch together.  No playing together.  I don't believe their school ever completely closed.  They spent the money to provide this and enough space for social distancing and masks were already commonly worn there so no mask resistance.  The problem is the US or Brazil or England and other countries where for political reasons society isn't willing to cooperate or to provide the funding to redo the schools.  But the problem is still that the kids can pass the virus to you even if it doesn't bother them a whole lot, and then there are the kids who have had a bad case and that is even more tragic than when a very old person gets it.  At home, you can gather, but only outside and socially distanced.  If you have a big enough yard you can do that.  There are videos from Canada of families gathering but never getting close to one another.  Stuff can be done but apparently not by Americans.  You want to fix that, you have to fix our culture and our politics, and good luck with that.  So it's not so simple.  Just hold on a while longer and we'll get our shots, but only if enough Americans agree to get vaccinated and wear masks and still what is needed to rob the virus of hosts.  Until then, everything will be of some risk, and yes, it can be managed, but it isn't being managed yet.  If it hadn't gotten political, we'd all be better off and a whole lot of dead people wouldn't be dead.  Peace.

[Paxiled]

And I should add, while the CDC has said schools could open theoretically for the very young, almost no place in the US currently meets the standard of low community spread that makes that possible, so if you read the entire guidance, almost no place in the US yet qualifies.

[AnnieBrooke]

You are saying the CDC says to stay home from events and gatherings (notably, holiday gatherings) to reduce risk, yet also says schools that have "strictly implemented mitigation strategies" have been able to safely open and remain open, and you find this contradictory? I've seen a rundown of some of the strict mitigation strategies our school district is going to use. All kids get their temps taken on entry to the building, every day. The kids and teachers are masked all day. The staff sprays the desks between classes. They seat the kids spaced out more than 6 feet. And they are going to send the kids home for lunch every day, rather than have them eat together in a lunchroom. This doesn't remotely look like Thanksgiving at Uncle Bob and Aunt Jenna's house. Holiday gatherings involve an affectionate group who wants to be close to each other. There are hugs, laughter, loud talking and shouting, eating sitting next to each other, and drinking and the let-down of restraint. Schools have control over their population, if they want to not create superspreader events, they implement the controls. There are no such controls at Grandma's house at Christmas. It doesn't seem so hard to understand, to me.

I don't think there are absolute answers to the kind of questions you're asking about the exposure and the odds, not only because there are questions about how people get exposed, but also, some people are more susceptible than others to the same exposure. (A family I know has five kids. Covid came, and the wife got it, and her newborn baby got it. Nobody else in the family got it. Figure that out when trying to put together a standard rule.) My husband and I are cautious about the virus, and don't do much that we used to do. (We order online and pick up our groceries at the store, for example -- the employees come out and load them in the back of our car.) My loving and gregarious extended family, I have no way to know what they've been doing lately, like who they've been greeting exuberantly and talking loudly with. (Maybe nobody and maybe their buddy next door, who happens to have just been exposed to Covid and doesn't know it.) So we're just really cautious and don't expose, and we wear our  best-quality masks when out, and we in fact stay home a lot. I'm hoping that by the time our middle-schooler is back in school in person, we have our shots.