COVID-19 hit our country hard. Once the impact was seen in New York, Los Angeles and the Bay Area, Napa County began to shelter in place to decrease the risk of COVID-19 overwhelming our hospitals and ICUs. It worked.
Up until Memorial Day weekend, Napa has done a great job of limiting the spread of COVID-19. In March, COVID-19 cases doubled every two to three days, but now are doubling about every 30 days. After testing over 13,000 people, the positive tests in Napa County are less than a half a percent. Napa County has one of the highest testing rates in California, with up to 400 tests per day.
So yes, we have done very well. Dr. Relucio and her staff have done a wonderful job protecting our community. They guided us through risk mitigation and now they will help up us to reopen our community safely.
But COVID-19 is not gone. Opening up brings with it the risk for a resurgence of COVID -19 infections. The recent surge in cases (37 new cases from June 3 to 10) is largely due to people forgetting to wear face masks and not maintaining a physically safe space.
Nobody wants to stay home. We are social by nature. We want to see our family and friends. We want to go work and shop like we did before. We want to go back to normal. We know our economy desperately needs us to reopen.
People are infectious with COVID-19 before they know they are sick. To catch COVID-19, you have to be around someone who has the virus or touch something they recently handled.
COVID-19 is transmitted by droplets, but can be in the air with coughing or sneezing. Face masks matter. When we all wear masks, the virus must cross two barriers to infect another person.
Ventilation matters. Good air movement decreases the risk of airborne transmission. Handwashing matters. The virus on our hands after touching something or shaking hands can lead to infection when we touch our face.
Harm reduction means limiting the risk of infection by limiting exposure to the virus. To maximize safety, we must: minimize the time exposed, maximize the distance between people, use a barrier (a face mask), look for well-ventilated open spaces, and wash our hands often to reduce the harms as our community is opened.
So how does this work in our real lives?
Sitting six feet apart in your backyard with friends and wearing masks is low risk. Going to the store where everyone wears a mask is low risk. Even passing someone in the aisle of a grocery store is low risk if you both wear masks and your contact time is very short. Walking outside and passing someone on the side walk or running past someone while jogging is low risk if you stay six feet apart.
We know that singing, shouting, laughing and close conversations between people without masks are very high-risk activities. Being indoors with other people also increases risk. Masks help, but depending on the ventilation and the length of time you are there, most masks will not offer enough protection. No one knows how exactly long is safe, but it would be reasonable to minimize the time indoors with others. Yes, you can get a haircut, but don’t hang around to catch up on the last three months.
Social bubbles: You and your immediate household are a social unit. You live together. If you all act safely when outside of the home, your small unit will likely stay safe. If you merge with another safe family, you are creating a social bubble.
This makes sense for families with small children or if a caretaker must come into your home to care for a family member. The safety of these bubbles depends upon a great deal of trust between the two families. If one person gets COVID-19, then two families are now at risk.
As schools open and people return to work, we have to look closely at our activities and the risk to our social bubbles. All of our safety will depend using harm reduction practices at home, school, work and in the community.
The most important way we can reduce the harm to our friends and family is to practice safe social contact when we are out. Always have your mask with you. Wear it every time you are around other people. Remain six feet apart. Wash your hands frequently and slowly count to 20 while you do it. If you are over 65 or have medical conditions, be as careful as you can for the foreseeable future since we are at the highest risk.
Please be very careful out there.
Dr. James Cotter
Napa Medical Reserve Corps
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