A person bikes wearing a protective mask

Staying Safe in the Summer of COVID-19

Amidst sunny days and climbing temperatures, COVID-19 remains a dominating presence in all of our lives. With the Fourth of July upon us and New York City fast approaching Phase 3 of reopening, now is a great time to learn more about what measures you can take to keep you and your family healthy this summer.

Angela Rasmussen, PhD, associate research scientist in the Center for Infection and Immunity, and Melissa Stockwell, MD, MPH, chief of the Division of Child and Adolescent Health and associate professor of pediatrics and population and family health, answered a few of the most pressing questions about staying safe this summer.

Is it safe to get out and enjoy summer? Can I attend an outdoor party or barbecue? What about swimming and visiting the beach?

“There is always risk, unless you're completely staying home all the time. But there are safer ways to enjoy some of these summer activities,” Rasmussen says. Up front, she recommends crossing crowded pool parties and packed beaches off your list.

“We still don't know a lot about transmission of this virus. But what we do know is that your risk of transmitting the virus or becoming infected is much higher when several different conditions are met,” she says. Those risk factors include:

  • You are indoors or in an enclosed space with others.
  • You are in close physical proximity to other people for a prolonged period of time, outside or in.
  • You are not wearing a mask.

Many of your favorite summer activities are, in and of themselves, not necessarily high risk. The question is how many of the above conditions are met.

“If you're going to a small beach and nobody is around, that's a pretty safe activity. But if you were to go to a pool party attended by dozens of people, that’s much higher risk. Even though it's outside, there are still many people in the same proximity for a long period of time,” she says. And while a pool party may be safer if the number of visitors is limited, taking the party inside presents an entirely different level of risk.

“When you’re planning summer activities, you need to consider ways that you can reduce risk across all of those measures,” Rasmussen advises. “Wear your mask. Limit risk by avoiding crowds, keeping your own events small, and trying to remain outside as much as possible. You can have a barbecue, but don't invite everybody in the neighborhood.”

Is it safe to travel right now? If so, what’s the safest way to get away?

If you absolutely can’t stay local, Rasmussen suggests hitting the road. “Travelling by private car is probably the safest. Especially if you're able to drive wherever you're going within a couple hours without many stops,” she says. “I've also heard a lot of people are planning to rent motorhomes and take a self-contained vacation in which they don't have to stay in any hotels.”

If you don’t have the option of a private car, “planes, buses, and trains do present some risks, depending on how full the vehicle is,” Rasmussen says. She advises that air travel may be safer, given the amount of active air filtration occurring compared to a bus or train, but none of these options are perfect.

“Anytime you're on a crowded flight or other crowded mode of transportation, your risk is going to increase, especially if people are not wearing masks,” she says. “With regard to air travel, it really does depend on the airline and the measures that each airline is taking.”

She recommends considering whether the airline is completely filling flights and whether passengers and the crew are required to wear masks. “You definitely want to fly with an airline that is taking these precautions. But be aware that regardless of the airline, flying on any kind of commercial aircraft is getting into a situation in which you can't control your exposure to other people,” she adds.

Is it safe to stay in a hotel?

Rasmussen reminds you to remember the risk factors. “In general, hotels aren't necessarily more dangerous, except that in common areas of the hotels, you might be exposed to more people,” she says. “As long as those hotels are cleaning the spaces properly, you’re avoiding common areas, and wearing your mask, the risk isn’t as high.”

You can even do some of that cleaning yourself, she says, by bringing along disinfectant wipes to wipe down high-contact surfaces and frequently washing your hands.

I’m staying in the city. Is it safe to ride public transit?

“The subway is one place where it really is important to wear masks, and that means everybody,” Rasmussen says. “This has been said a lot, but I think it's always worth repeating: Wearing a cloth mask is not protective for the person wearing it. The reason you wear that is for source control. You are reducing the number of respiratory droplets that other people in your environment will be exposed to. The only way that it works as a risk-reduction technique is if most of the people have, in fact, put on a mask.”

Whether you’re taking the subway, hopping on a city bus, or stopping in a public restroom, you need to wear a mask and be conscious of how many people are in that space, Rasmussen warns. 

“Avoid getting into a tightly packed elevator or subway car. I realize that not everybody's going to be able to do that, so if you do have to be in that situation, wear a mask. Encourage those you’re with to do the same.”

What about dining outside?

“Obviously, you can't really put on a mask and eat food at the same time if you want that mask to be effective,” Rasmussen says. “Right now, outdoor restaurants are a question of the spectrum of risk rather than the complete elimination of risk.”

Risk-free dining is impossible in close quarters, but you can reduce your risk by remembering the risk factors. “Make sure that you’re staying outside and that the tables in the restaurant are adequately distanced from each other,” she advises. “We've all had the experience in years past where you get up to use the bathroom and you're apologizing to everybody as you're jostling into them as you go. You should not go eat at a restaurant like that.”

I want to join a protest. Does this increase my susceptibility to COVID-19?

“That environment is a risk in and of itself,” Rasmussen concedes, but she notes that it’s another case of considering a spectrum of risk rather than risk elimination, as well as weighing that risk alongside the importance of the movement.

“In the case of Black Lives Matter protests, you're talking about people taking a risk deliberately, for the purpose of protesting another critically urgent public health problem, and that is systemic racism,” she says. “So while protests are not risk free, I have been happy to observe that many of the protesters are wearing masks. They are trying to observe physical distance, they’re outdoors, and they're moving around.”

What has alarmed Rasmussen in terms of virus transmission is the police response to protestors.

“I think many of the police responses are actually increasing risk for the protesters. For example, we don't know the impact of tear gas or pepper spray on susceptibility to coronavirus, but we do know that it makes people cough, it makes their eyes water, and it probably increases respiratory droplet production. Police also haven't been wearing masks in many cases,” she says. “We’ve seen instances of people being herded into very tightly packed crowds or being arrested and put into tightly packed enclosed police vehicles or jail cells. Police need to protect the people who are protesting peacefully. Just because you're protesting doesn't mean that your risk of being exposed to coronavirus should increase.”

But are protests themselves to blame for climbing case reports across the country? Not necessarily, according to Rasmussen. “We can’t point to an increase in cases and blame that entirely on protests, because the reality is that the situation is a lot more complicated than that,” she says. “We can't really attribute those increases in cases to any one thing, except perhaps a general failure to implement adequate public health policies for controlling community transmission.”

What if I’m a little older and/or have pre-existing conditions? What extra level of caution should I take as re-opening continues?

If you’re older or aware of any pre-existing conditions, Rasmussen recommends doing everything in your power to minimize your exposure to the virus.

“Older people should be trying to minimize the amount of time they are going out, socializing, or getting together with large crowds of people,” she says. But age isn’t the only consideration.

“People are very focused on age, but there are other conditions to consider. If you have hypertension, if you have diabetes, if you have HIV or if you're undergoing cancer treatment, or if you have some type of immunosuppression—you should be very, very cautious about going out,” she advises.

Limit your excursions to essential errands, and if you do make summertime plans, limit your exposure to people who aren’t a part of your household as much as possible. Rasmussen reminds that seeking routine medical care, especially for things like vaccinations or cancer screenings, are still essential to your wellbeing.

I’m headed back to work. How can I stay safe as the crowds of customers or visitors return?

“People who are not able to work remotely should make sure that their employers are providing them with adequate measures to protect their safety,” Rasmussen says.

“If you're working in a grocery store, for example, or some other customer-facing job, it's important that employers install barriers so that people aren't being exposed to a direct spray of everybody else's respiratory droplets. It's important that employers require people to wear masks in their stores,” she says.

It’s also important to note that safety is not just the responsibility of workers. “It's also the responsibility of the public to protect those people when they have to go out,” Rasmussen says. “This is one area where we as a society have fallen short, and I hope that this will be part of the discussion in the years to come about what went wrong. It is unfortunate, but if some people can't take these precautions for themselves, they have to at least proactively do that to help other people.”

What about my kids? Is it safe for them to play outside with other kids right now?

It's all right to have your children play with friends outside, but if you’re visiting playgrounds or other public spaces, wear a mask and try to visit at a time when those spaces are less crowded.

“As New York City reopens, I can't stress enough the importance of wearing masks and keeping socially distant. When you walk around the city, you see that there are people who are doing that and there are people who aren’t, and I think what it comes down to is whether you want to keep your family safe,” Stockwell says. “Not only that, we should want to help other families stay safe. We don’t know if people are asymptomatic or pre-symptomatic and potentially spreading the virus.”

But that doesn’t mean shutting your family in and watching summer pass you by. “I do want to encourage people to get out to the parks. It's good to go outside and get some air,” she says. “Obviously, we want people to enjoy their summer as much as possible and to engage with one another. But we need to do that in a socially distant and safe way.”

What about seeking medical care that we’ve been putting off because of COVID-19?

“Summer is the time when people tend to come in and catch up on a lot of their needed care,” Stockwell says. “Right now, we’re not only reopening as a city, we’re also welcoming patients back to the medical center for medical care which may have been cancelled or postponed due to COVID. We want to reassure families that we have extensive plans in place to make sure that our offices are COVID-safe.”

Those measures include extensive screening ahead of appointments and at the appointments themselves, as well as expanded cleaning practices. Physicians also go through screening before arriving on campus each day.

Stockwell stresses that families should no longer delay care, especially vaccinations. “If your child has missed vaccines because they were due for a visit in the spring or in the summer, reach out to your provider,” she recommends. “Many providers are offering telehealth visits and vaccine-only appointments, so make sure that you’re staying up to date.”