Editor’s note, Jan. 3, 2021: On Nov. 1, 2020, I ran a Q&A thread on Substack in order to answer readers’ questions in the lead-up to the U.S. election.
Thank you to everyone who asked questions in the thread today. I appreciated the chance to hear about your current COVID-19 concerns, and I got a few ideas for future issue topics. I hope that my answers were useful.
Here’s one question which I wanted to broadcast to everyone:
Ross asked: Hi Betsy—long time reader, first time asker. Have we seen significant spikes in COVID in connection with national holidays, or are spikes largely attributable to other factors? Should we be expecting a Thanksgiving spike? What about an election protest spike?
My response: Thanks Ross, that’s a good question! First of all, I need to clarify that it’s really hard to find a causal association between case spikes and specific events in the U.S., because our contact tracing apparatus simply isn’t up to it in most places. We can’t conclusively find out how many people were infected at a given event or location unless we can test all of them and get those test results to a central location and adjust for confounding factors, like other events that people attended/traveling they did. There have been a few scientific studies that look for these associations (Stanford University researchers recently published a paper about Trump rallies, for example) but largely it is difficult to make these conclusions as events are ongoing.
That being said, the COVID Tracking Project has noted case spikes in the South after Memorial Day, which occurred when many states were loosening lockdown orders. It’s important to note here that these kinds of case spikes are usually delayed; it takes a couple of weeks for people to notice symptoms and get tested (causing cases to spike), and then another week or two for hospitalizations to spike, and then another week or two after that for deaths to spike. (Caroline Chen has explained this lag for ProPublica.) But to answer your question of whether experts are expecting a Thanksgiving spike: yes, they definitely are. Here’s Fauci talking about it, from a couple of weeks ago.
And as for protests—this is also difficult to say for sure, as it is difficult to even estimate how many people attend a protest, let alone to test and contact trace them all. But, to my knowledge, no protest has been a superspreader event so far. Health experts cite the fact that protests are usually outside and have high mask compliance as a possible reason why they have not proven to be as risky as, say, Trump rallies.
And one more:
Martha asked: Hi Betsy, In this time of pandemic fatigue, I am interested in rankings of reasonable activities to keep some economic sectors going without becoming part of the problem (i.e. infected). What are your favorite (or a favorite) source that ranks activities? Do you know of any detailed studies that gets at nuances (with my pod vs. with people not in my pod)?
My response: Maryn McKenna has actually written a great story about COVID-19 risk charts, including the strengths and weaknesses of a couple of widely-cited resources. It has been a couple of months since this story, though, and since then, more interactive resources have popped up. One that I like is the microCOVID project, which estimates your risk based on your location, the number of people you’ll be seeing, mask types, and more. Another resource, which I’ve cited in the newsletter before, is Georgia Tech’s COVID-19 Event Risk Assessment Planning Tool. This tool is simpler, but it gets very precise about the risk levels in your state and county.
I haven’t seen specific studies that get at the nuances of risk levels inside/outside of a pod, largely because I think this is a hard thing for epidemiologists to track. (America! Bad at contact tracing!) But I will say that it is important for you to be clear and realistic about who is in your pod. For example, I live with three roommates in Brooklyn. I sometimes visit my sister, who lives in Manhattan. Two of my roommates are commuting to their respective offices on reduced schedules. So, if one of my sister’s roommates tests positive for COVID-19, that means that, depending on the timing, I, and all of my roommates, and all of my roommates’ coworkers should consider that we may have been exposed. The bigger your pod, the more regular testing can help assuage these types of concerns.
My comment sections are always open for questions about the week’s issue. Or, if you would like to use a less public platform, you can hit me up at email@example.com.