COVID Absolutism

David Leonhardt (NYT):

Covid testing as exercise
In a public health emergency, absolutism is a very tempting response: People should cease all behavior that creates additional risk.
That instinct led to calls for gay men to stop having sex during the AIDS crisis. It has also spurred campaigns for teen abstinence, to reduce sexually transmitted diseases and pregnancies. And to fight obesity, people have been drawn to fads like the elimination of trans fats or carbohydrates.
These days, there is a new absolutist health fad: the discouragement — or even prohibition — of any behavior that seems to increase the risk of coronavirus infection, even minutely.
People continue to scream at joggers, walkers and cyclists who are not wearing masks. The University of California, Berkeley, this week banned outdoor exercise, masked or not, saying, “The risk is real.” The University of Massachusetts Amherst has banned outdoor walks. It encouraged students to get exercise by “accessing food and participating in twice-weekly Covid testing.”
A related trend is “hygiene theater,” as Derek Thompson of The Atlantic described it: The New York City subway system closes every night, for example, so that workers can perform a deep cleaning.
There are two big questions to ask about these actions: How much are they doing to reduce the spread of the virus? And do they have any downside?
No documented cases
The answer to the first question, according to many experts, is: They seem to do little good. Prohibiting outdoor activity is unlikely to reduce the spread of the virus, nor is urging people always to wear a mask outdoors.
Worldwide, scientists have not documented any instances of outdoor transmission unless people were in close conversation, Dr. Muge Cevik, an infectious-disease specialist at the University of St. Andrews in Scotland, told me. “The small number of cases where outdoor transmission might have occurred,” she wrote on Twitter, “were associated with close interactions, particularly extended duration, or settings where people mixed indoors alongside an outdoor setting.” The new variants of the virus are more contagious, but there is no evidence to suggest they will change this pattern.
As my colleague Tara Parker-Pope puts it, “Avoid breathing the air that other people exhale.”
A student walking across campus — let alone a masked student — presents little risk to another student who remains at least six feet away. The same goes for joggers in your neighborhood.
The story is similar for deep cleaning. “Scientists increasingly say that there is little to no evidence that contaminated surfaces can spread the virus,” my colleagues Mike Ives and Apoorva Mandavilli have written. The one surface that is important to wash, frequently and vigorously, is the human hand.
Which brings us to the second question — whether there is any downside to absolutism. Covid-19 is a horrible disease. And the notion that a jogger somewhere might infect somebody she passes, even from more than six feet away, is scientifically plausible.

So why not take every possible precaution at all times?

Unintended consequences

The short answer is: because we are human.
Taking every possible precaution is unrealistic, just as telling all gay men and teenagers to abstain from sex was unrealistic. Human beings are social creatures who crave connection and pleasure and who cannot minimize danger at all times.

Despite the risks, we eat carbs, drink wine, go sledding and even ride in automobiles. We enjoy taking outdoor walks and drinking a cup of coffee on a public bench. Many people who exercise find it difficult to do so in a mask. “It feels a bit like suffocating,” Shannon Palus wrote in Slate.

I’ve noticed that some of the clearest voices against Covid absolutism are researchers who have spent much of their careers studying HIV, including Cevik, Julia Marcus, Sarit Golub and Aaron Richterman. They know the history. The demonization of sex during the AIDS crisis contributed to more unsafe sex. If all sex is bad, why focus on safe sex?
There is a similar dynamic with Covid. “People do not have unlimited energy, so we should ask them to be vigilant where it matters most,” Cevik has written.
Telling Americans to wear masks when they’re unnecessary undermines efforts to persuade more people to wear masks where they are vital. Remember: Americans are not doing a particularly good job of wearing masks when they make a big difference, indoors and when people are close together outdoors.
Banning college students from outdoor walks won’t make them stay inside their dorm rooms for weeks on end. But it probably will increase the chances that they surreptitiously gather indoors.
And spending money on deep cleaning leaves less money for safety measures that will protect people, like faster vaccination.

“Rules that are really more about showing that you’re doing something versus doing something that’s actually effective” are counterproductive, Marcus told my colleague Ian Prasad Philbrick. “Trust is the currency of public health.”

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