From outdoor dining to a trip down the shore: Your COVID-19 risk in NJ
With Governor Phil Murphy ending New Jersey’s stay-at-home order and allowing larger gatherings both indoors and outside, many are ready to enjoy activities that have been largely prohibited since New Jersey went into lock down on March 22.
However, with COVID-19 still present, there are risks associated with virtually every activity.
With the summer season here, taking a day trip down the shore or renting a shore house is not the same as it was before the pandemic.
We’ve asked some of our state’s top health experts to help us understand the risk of enjoying some of New Jersey’s favorite activities.
Generally, outdoor activities tend to be safer than indoor activities, says Dr. Matthew Lissauer, director of critical care for Rutgers-RWJMS Surgery. While Lissauer says there is much we still do not know about COVID-19, “what we do know is the virus is most likely spread through the air via droplets which can linger for an hour and a half in the air and perhaps to some degree by aerosols (very, very small droplets), which can linger for longer.
"While it is potentially possible to transmit the virus via surfaces and touch, the CDC suspects this a rarer way to transmit the virus than person to person via droplets.”
Amita Avadhani, a critical care advanced practical nurse with a specialty in gerontology, says until there is an effective vaccine available, extreme caution should be undertaken for any activity. Avadhani warns, “Whether at the beach or elsewhere, when we are in contact with other people, directly (by touching them) or indirectly (by touching the objects or surfaces touched by them), we are increasing our chances of contacting the virus.
With parents sending kids off to summer camp, some may believe their kids are not at great risk for coronavirus. Lissauer warns, “While younger healthy people are far more likely to have a mild case, I have seen plenty of younger people without comorbidities require ventilators in the ICU.”
Ultimately, our medical experts say everyone needs to determine their own personal risk tolerance.
With that in mind, here is a list of some of New Jersey’s favorite activities, and the risks associated with each.
We’ve ranked each activity as either LOW, MEDIUM or HIGH risk, with other factors that increase or decrease that risk level.
Going to the beach: LOW RISK
It seems the major route of infection tends to occur in indoor spaces with groups of people, especially when people spend a significant amount of time in that environment. Outdoors, the virus is likely diluted quickly by even a small breeze. Additionally, in direct sunlight, there is some evidence the virus cannot survive as infectious for long. That data however is not certain and was done in a lab environment.
What alters risk? Appropriate social distancing, staying at least six feet away from other people will reduce risk. Mask wearing has also been shown to reduce risk, but on a breezy beach, this maybe unnecessary. Avoiding those not in your group and keeping your group small can minimize risk. Frequent use of hand sanitizer can also reduce risk.
Swimming in the ocean: LOW RISK
While saltwater maybe an appropriate environment for the virus to survive, it would likely dilute too quickly to be infectious. The same outdoor advice as in going to the beach would apply.
What alters risk? Swimming away from others should decrease risk. If a mask gets wet while swimming it will be ineffective.
Walking on the boardwalk: LOW to MEDIUM RISK
On the boards, social distancing is the biggest factor to reduce transmission. Most towns have social distance ambassadors in place to help people keep their distance, and some have installed hand sanitizing stations.
What alters risk? If the boardwalk is crowded, and it is difficult to maintain social distancing, risk could be increased. Wearing a mask has also been proven to significantly decrease (though not 100% prevent) risk of transmission. If possible, try to go to the boardwalk when it is less crowded.
Renting a shore home: LOW to MEDIUM RISK
If you are renting a home with only people you have been isolated or staying at home with, the risk should be low. It’s also important to make sure the home has been sanitized prior to your arrival. Avoid going house-to-house or closely interacting with those in neighboring homes.
What alters risk? You should make sure the house has been sanitized appropriately prior to moving in. Also, if the house has been empty for a few days to a week, risk is lowered. If you rent a house with groups of people you have not previously been isolating/quarantining with or move into a short-term rental immediately after another group has moved out without proper sanitization, risk could be increased.
Going to an amusement park: Potentially HIGH RISK
Despite this being an outdoor activity, social distancing may not be possible if the amusement park is crowded. If rides are not altered to allow for 6 feet of social distance between riders, and the crowds are not wearing masks, the risk is high. Great Adventure, Disney, and Universal parks have already taken steps to address many of these concerns and limit the number of people allowed inside a park, but our medical experts warn there are many variables that could put you at greater risk
What alters risk? If the park has taken precautions to allow for social distancing, including while waiting on line for rides and on the rides themselves, and the crowds are required to wear masks, then risk is substantially lower. The park should aggressively sanitize rides and high-touch surfaces as well. Wash your hand frequently (at least after every ride) and carry hand sanitizer to use if a wash station is not available.
Using a public bathroom: MEDIUM to HIGH Risk
Public restrooms are generally designed to be sanitary, but as we have all seen, the standard of cleanliness can vary greatly from location to location. Most towns have implemented strict new protocols to assure each facility is sanitized, often between uses. One of the conditions for state and country parks to reopen, was adequate bathroom sanitization. Similar protocols are in place in many shore towns.
What alters risk? Many bathrooms are indoors with poor ventilation. This greatly alters risk. Wearing a mask would lower risk. The risk also depends on the number of people who use a bathroom, since it only takes one infectious person to create an exposure for another. Obviously, washing your hands after using a public restroom can lower risk.
Using a public shower: MEDIUM to HIGH Risk
As with the public bathroom, risk is higher than low risk, and you can’t wear a mask in the shower because masks fail when they are wet.
What alters risk? Proper ventilation, and waiting for at least six hours prior to the last person in the area, as well appropriate cleaning/sanitation of the shower between uses could reduce risk to medium or low, but few public showers operate in this manner.
Gambling in a casino: HIGH Risk
One of our medical experts labeled casino gambling VERY HIGH RISK if no additional safety protocols were in place. New Jersey has yet to announce when casinos will reopen, but they will likely follow a model similar to Las Vegas to ensure the health of gamblers and casino workers. Wearing a mask, social distancing, having barriers between the dealer and gamblers and not touching cards, chips and dice can reduce the risk.
What alters risk? Doctors note gaming floors are indoor places with crowds, which carry an already increased risk. With social distancing, 100 percent mask wearing, barriers between slot machines and slot machines spaced out, the risk should be lower. Equipment should be wiped down and sterilized frequently. Perhaps they can invent no-touch slot machines?
Attending on open-air concert: LOW to MEDIUM Risk
This is another activity where there are many variables. In the ideal situation the risk could be LOW. However, there are factors that could make this a HIGH-risk activity. It depends on the physical arrangement of the venue and the ability to be socially distant.
What alters risk: If the crowds are socially distancing, wearing masks, and seated well away from the stage, then outdoors it could conceivably be low risk. When asked about concerts, Lissauer was concerned about the performers singing. He noted that singing can produce large amounts of droplets and aerosols, which could transmit the virus. It’s unlikely, he said, that singers would have a mask on. In this scenario, fans closest to the stage could be at greater risk.
Eating indoors in a restaurant: MEDIUM to HIGH Risk
Even if social distancing is followed, indoor dining happens in an enclosed space with possibly poor ventilation. People also can’t eat or drink with a mask on. Dining can also be a prolonged activity, and the longer you are in a confined space with poor ventilation, the risk increases.
What alters risk? Data from one study demonstrated a large number of diners caught COVID-19 pneumonia from a single person in a restaurant. In this study, diners more than 6 feet from the infectious source caught the virus, likely due to the air conditioning blowing droplets or aerosols across the room. Ventilation/airflow in the establishment might lessen the risk from high to medium, given mask-wearing cannot be done while eating.
Going to a barbershop, beauty salon, or nail salon: LOW Risk
Gov. Phil Murphy will allow haircut and nail appointments beginning June 22. Our experts believe the protocols being put in place will make this a LOW-risk activity. Social distancing is still critically important to keep risk low. There is no doubt this will be a different experience than what people are used to. Some salons are asking patrons not to enter their building until they are called to limit the number of people inside.
What alters risk? Assuming the barber wears a mask, the client wears a mask, there are few other people in a closed room, and all are socially distanced, then risk can be low. Risk is lower than at restaurant because people can wear masks the entire time and there are likely fewer people in a salon than inside a crowded restaurant.
Going to a gym: MEDIUM to HIGH Risk
There has been a lot of controversy about opening gyms and health clubs in New Jersey, and Murphy says “we are just now there, yet.” As stated before, indoor activities pose a higher risk than outdoor activities. If no safety protocols are taken, working out inside a gym can be high-risk. However, many gyms have already committed to limiting occupancy, social distancing and thorough cleanings.
What alters risk? If patrons of the gym can wear masks throughout their workouts and remain socially distant, and the equipment can be disinfected between users, then risk should be minimized. There still is some risk as vigorous exercise leads to heavy breathing, which can increase spread if a person is infectious. Gyms are also enclosed rooms with air-conditioning, which may increase risk without proper air filtering.
Shopping at a mall: LOW Risk
Despite our medical experts labeling mall shopping as LOW-risk, New Jersey has yet to green-light malls to reopen. Most malls are big and airy, so if social distancing is maintained, masks are worn by all shoppers and employees, frequent hand washing is practiced and people avoid touching their face, there should be little risk of infection. Malls also tend to be large spaces with better ventilation than, for example, restaurants.
What alters risk? Avoid trying on clothes if there is the possibility other shoppers tried them on recently without being disinfected.
A backyard BBQ with 25 friends: LOW Risk
There are many variables, but if you BBQ with only those you know have had a low-exposure risk, maintain social distancing and practice good hand washing, this activity should pose little risk. Masks would further reduce risk. Governor Murphy says outside gatherings can now be up to 100 people. That limit rises to 500 on July 3. The larger the gathering, the greater the risk
What alters risk? While eating and masks are off, there could be a slight increased risk of transmission, though staying outdoors and with 6 feet between people, this should be a lower risk than in an indoor restaurant.
Letting a friend inside your house to use the bathroom: LOW Risk
Letting a friend inside the house to use the restroom should pose little risk as long as each guest cleans up after themselves and practices good hand washing.
What alters risk? Appropriate ventilation. Keep the venting fan on, disinfect/clean surfaces, have the friend wear a mask and go directly back outside.
Going to a Community pool: LOW Risk
Murphy has announced community pools can open as of June 22. This section also includes pools at summer camps our kids will be using after July 4. As noted above, outdoors, the virus threat is potentially diluted quickly by even a small breeze and it could be difficult to receive an infectious dose. However, this is another situation where crowd size is key. The more crowded the pool and deck area, the higher the risk. The pool itself, if appropriately chlorinated, should be low risk.
What alters risk? Appropriate social distancing will reduce risk. If a mask gets wet while swimming it will be ineffective. If a mask is not worn while swimming it is more important to remain socially distant.
Attending an indoor religious service: MEDIUM to HIGH Risk
Much of the risk of being inside a house of worship is due to crowd size, the size of the space, and ventilation. Crowds in indoor spaces with air conditioning tend to be highest risk. Social distancing and mask wearing are essential.
What alters risk? Singing can increase droplets or aerosols in the room, which makes mask wearing even more important. In services where bread, wafers, wine or juice are offered, the risk of contamination is high. Avoid any “community cup” sacraments.
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