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No Longer Just a Walk in the Park No Longer Just a Walk in the Park
(32 minutes later)
I’m 77 years old and I want/need to walk. The two buildings in my complex have a basketball court between them. I have previously taken the freight elevator down 36 stories at 5:30 a.m., meeting no one but armed anyway with mask, gloves, wipes and hand sanitizer. I walked for 35 minutes and went back upstairs, again meeting nobody. Should I force myself to continue? I am simply afraid to go outside.I’m 77 years old and I want/need to walk. The two buildings in my complex have a basketball court between them. I have previously taken the freight elevator down 36 stories at 5:30 a.m., meeting no one but armed anyway with mask, gloves, wipes and hand sanitizer. I walked for 35 minutes and went back upstairs, again meeting nobody. Should I force myself to continue? I am simply afraid to go outside.
BARRIE MOTOLABARRIE MOTOLA
New York CityNew York City
Ms. Motola’s world has mostly shrunk to one room. She lives by herself in a studio apartment high above Manhattan, with a piano, books and a narrowing set of routines. Her longtime habit of swimming laps is on pause. So are her dates with her children and grandchildren.Ms. Motola’s world has mostly shrunk to one room. She lives by herself in a studio apartment high above Manhattan, with a piano, books and a narrowing set of routines. Her longtime habit of swimming laps is on pause. So are her dates with her children and grandchildren.
“The walking was truly helping me keep it together,” she said on the telephone. But she stopped a week ago and hasn’t left her building since. “As this ramped up, I kept weighing anything and everything I was thinking about doing outside, and saying: ‘Is it worth getting sick for? Is it worth dying for?’”“The walking was truly helping me keep it together,” she said on the telephone. But she stopped a week ago and hasn’t left her building since. “As this ramped up, I kept weighing anything and everything I was thinking about doing outside, and saying: ‘Is it worth getting sick for? Is it worth dying for?’”
She’s not the only one asking. The outdoors is now contested ground. Parks and trails from Los Angeles to the Great Smokies are being closed. (Too many people were socially distancing in the same places, and therefore not at all.) Authorities are patrolling others, warning people to disperse. This week, India’s prime minister told 1.3 billion people not to set foot outside their homes. “Stay Home Save Lives” has become a rallying cry and a pressure point on social media.She’s not the only one asking. The outdoors is now contested ground. Parks and trails from Los Angeles to the Great Smokies are being closed. (Too many people were socially distancing in the same places, and therefore not at all.) Authorities are patrolling others, warning people to disperse. This week, India’s prime minister told 1.3 billion people not to set foot outside their homes. “Stay Home Save Lives” has become a rallying cry and a pressure point on social media.
“If you’re still not sure about an activity, skip it,” said Kate Brown, the governor of Oregon, one of 22 states and counting where residents have been told to keep to their residences.“If you’re still not sure about an activity, skip it,” said Kate Brown, the governor of Oregon, one of 22 states and counting where residents have been told to keep to their residences.
While some continue to congregate, many others are now worried about venturing outside at all. “Can we sit on an open lawn with a family member?” a reader from India wrote to ask.While some continue to congregate, many others are now worried about venturing outside at all. “Can we sit on an open lawn with a family member?” a reader from India wrote to ask.
The unpleasant truth, especially for city dwellers, is that every time you step outdoors, your risk of infection rises. Last week, scientists established that coronavirus droplets could linger in the air for a half-hour, raising new concerns about what is safe. Then there’s every surface you encounter on your way outside and back: doorknobs, keys, elevator buttons, gates, the carton of eggs you pick up at the deli that’s still open.The unpleasant truth, especially for city dwellers, is that every time you step outdoors, your risk of infection rises. Last week, scientists established that coronavirus droplets could linger in the air for a half-hour, raising new concerns about what is safe. Then there’s every surface you encounter on your way outside and back: doorknobs, keys, elevator buttons, gates, the carton of eggs you pick up at the deli that’s still open.
“The safest way to prevent the spread of this virus is for you to stay at home,” said Dr. Craig Spencer, a global emergency medicine specialist at Columbia. “This virus won’t infect you if it never meets you.”“The safest way to prevent the spread of this virus is for you to stay at home,” said Dr. Craig Spencer, a global emergency medicine specialist at Columbia. “This virus won’t infect you if it never meets you.”
But when we posed Ms. Motola’s dilemma to Dr. Spencer and other public health experts, along with scientists who study the virus’s behavior in air, each one recommended that she resume her dawn walks.But when we posed Ms. Motola’s dilemma to Dr. Spencer and other public health experts, along with scientists who study the virus’s behavior in air, each one recommended that she resume her dawn walks.
“We’re all struggling with a greater degree of ambient risk than we’re used to,” said Dr. Tim Lahey, an infectious disease specialist and ethicist at the University of Vermont. Each day is an exercise in trying to lower risk: avoid this, scrub that.“We’re all struggling with a greater degree of ambient risk than we’re used to,” said Dr. Tim Lahey, an infectious disease specialist and ethicist at the University of Vermont. Each day is an exercise in trying to lower risk: avoid this, scrub that.
Public health practice is as much about reducing risk, as eliminating it — which is often impossible. The AIDS crisis was not stemmed by persuading people to quit sex, Dr. Lahey said. Instead, people adopted tolerable rules like choosing partners carefully and wearing condoms. The term “safer sex” worked because it seemed doable, he added.Public health practice is as much about reducing risk, as eliminating it — which is often impossible. The AIDS crisis was not stemmed by persuading people to quit sex, Dr. Lahey said. Instead, people adopted tolerable rules like choosing partners carefully and wearing condoms. The term “safer sex” worked because it seemed doable, he added.
The safer-sex equivalent of an outdoor walk, most medical authorities say, is one that involves six feet of distance from others. (Linsey Marr, an engineering professor at Virginia Tech who studies how particles move through air, says she gives it 10 feet just to be cautious.) Governments are beginning to put in place rules to encourage people to spread out. This week, Gov. Andrew M. Cuomo announced a pilot program in New York to close some streets to traffic in order to give pedestrians more space. As of Tuesday, the French must follow new restrictions on outdoor exercise: It can be done alone, for up to an hour a day, within a one-kilometer radius of home. Walkers and runners must carry permission slips that can be checked by authorities.The safer-sex equivalent of an outdoor walk, most medical authorities say, is one that involves six feet of distance from others. (Linsey Marr, an engineering professor at Virginia Tech who studies how particles move through air, says she gives it 10 feet just to be cautious.) Governments are beginning to put in place rules to encourage people to spread out. This week, Gov. Andrew M. Cuomo announced a pilot program in New York to close some streets to traffic in order to give pedestrians more space. As of Tuesday, the French must follow new restrictions on outdoor exercise: It can be done alone, for up to an hour a day, within a one-kilometer radius of home. Walkers and runners must carry permission slips that can be checked by authorities.
If the distancing rules are too strict, prohibiting excursions entirely, people could give up, said Dr. Carlos Del Rio, a public health and AIDS specialist at Emory University. “I want to be sure that people don’t get frustrated and say, ‘We won’t be able to defeat this,’ because we can,” he said.If the distancing rules are too strict, prohibiting excursions entirely, people could give up, said Dr. Carlos Del Rio, a public health and AIDS specialist at Emory University. “I want to be sure that people don’t get frustrated and say, ‘We won’t be able to defeat this,’ because we can,” he said.
“Our mental health is going to be so important,” added Dr. Spencer, who was treated for Ebola in 2014 and endured 19 days of near-total isolation. “This is only going to get worse.”“Our mental health is going to be so important,” added Dr. Spencer, who was treated for Ebola in 2014 and endured 19 days of near-total isolation. “This is only going to get worse.”
“Telling people to stay inside works right now, but in two or three weeks, it’s going to be a tough message to hold up,” he said.“Telling people to stay inside works right now, but in two or three weeks, it’s going to be a tough message to hold up,” he said.
Updated June 12, 2020Updated June 12, 2020
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Walks and runs are signs of life to which even doctors and scientists on the front lines are clinging. Amandine Gamble, a postdoctoral fellow at the University of California, Los Angeles, is a co-author of that study that raised alarm last week about how the virus lingers in the air. She walks near her home in Santa Monica every day. She finds complete adherence to the six-foot rule challenging, she said, and if someone crosses her path, she does not panic.Walks and runs are signs of life to which even doctors and scientists on the front lines are clinging. Amandine Gamble, a postdoctoral fellow at the University of California, Los Angeles, is a co-author of that study that raised alarm last week about how the virus lingers in the air. She walks near her home in Santa Monica every day. She finds complete adherence to the six-foot rule challenging, she said, and if someone crosses her path, she does not panic.
Dr. Spencer spends his days treating Covid-19 patients at Columbia. When he comes home, he laces up his sneakers and goes jogging, sometimes late at night.Dr. Spencer spends his days treating Covid-19 patients at Columbia. When he comes home, he laces up his sneakers and goes jogging, sometimes late at night.
“It’s one of the only ways I can decompress and disconnect completely from coronavirus,” he said.“It’s one of the only ways I can decompress and disconnect completely from coronavirus,” he said.
We called Ms. Motola to share what the experts had advised. She wasn’t convinced.We called Ms. Motola to share what the experts had advised. She wasn’t convinced.
“I do have to sit and calculate the risk,” she said. “As soon as I contemplate putting on my sneakers, my anxiety goes right up.”“I do have to sit and calculate the risk,” she said. “As soon as I contemplate putting on my sneakers, my anxiety goes right up.”
“One of these mornings I will be brave enough,” she said. “I have to be brave.”“One of these mornings I will be brave enough,” she said. “I have to be brave.”
Lauren Messman contributed research.Lauren Messman contributed research.
Dilemmas is a new column about dealing with the human quandaries presented by the coronavirus pandemic. Please send yours to dilemmas@nytimes.com.Dilemmas is a new column about dealing with the human quandaries presented by the coronavirus pandemic. Please send yours to dilemmas@nytimes.com.