COVID Reminders for Cooler Weather

I have learned that people find it easiest to remember things when they come in groups of five or less. There are five primary methods for decreasing the risk of spreading COVID-19: (1) maintaining physical distancing, (2) frequently hand sanitizing, (3) wearing facemasks indoors or within 6 feet of others outdoors, (4) screening and testing for the disease, and (5) developing a supportive culture. There has been significant media coverage of the first four items. Number 5 deserves more attention.

A supportive culture is not typically punitive. A supportive culture encourages, motivates, and inspires others to follow the first four measures listed. No individual can reasonably be expected to adhere to all preventative actions all of the time. A supportive culture is one that follows the principal, “I have your back, and you have mine.” We help each other in achieving compliance with the measures. Communities that can maintain a supportive culture will have low numbers of COVID-19 cases and few outbreaks while working to establish widespread vaccination.

There are a few other concepts—five, as a matter of fact—that are important in minimizing spread of the virus, especially as the weather cools.

1. Risk of transmission increases as ventilation decreases. The virus is most easily transmitted indoors. The size of interior rooms can make it difficult to appropriately distance, and a critical mass of aerosolized particles can hang in the air without adequate ventilation and infect others. This is in contrast to being outdoors, where the particles readily disperse and are far less likely to make others sick. Even during the upcoming cold weather, maximize your time outdoors. Wear more clothing and use blankets. When visiting with friends, go on an outdoor walk together, even in the snow, rather than remaining indoors. Such efforts will help us avoid the increase in COVID-19 cases that are predicted to occur this winter.

2. Risk of transmission increases as time increases. We need to hold in-person work, school, and social events, as it is important for business productivity and emotional well-being. In order to do that safely, we must think differently this year than in the past. Recognize that in addition to distancing, hand cleansing, and the use of facemasks, time is a significant factor in spread of COVID-19. The greater the time you spend in proximity to people, the greater the likelihood of infection. Minimize the amount of time you are with other individuals outside of those in your household, especially when indoors. If you normally hold one-hour business meetings, cut them down to 20 minutes, and schedule some of them to occur outdoors, by telephone, or by video.

3. Precautions are synergistic. No one precaution is enough to prevent the spread of COVID-19. The measures work together and build upon each other. Wearing your mask is most effective if you are following the other precautions, too, including distancing.

4. Aim for consistency. We are beginning to notice clusters and outbreaks of illness due to people relaxing precautions as their perception of the risk decreases. When there are few cases in a community, some individuals become complacent and relax precautions. Then the number of cases increase, and people begin adhering to the mitigation measures again. Thus, a regional cycle is established, and at some point, large outbreaks result. To keep cases low and prevent outbreaks, we need to aim for consistency in following precautions, regardless of our perception of the risk.

5. Have Realistic Expectations. Cases will happen even when individuals and communities are diligent in adhering to mitigation measures. COVID-19 is very contagious. We need to understand and accept that in order to participate in some in-person activities, there is risk. We cannot expect that experiences at school, work, and social endeavors will lead to the same standards as those before and after the pandemic. Yet, we do not need to accept mediocrity. We can work together to innovate and strive for similar outcomes.

As a final note, if you know someone who has become ill with COVID-19, do not to judge or blame them. COVID-19 is truly something that can happen to most anyone, even those following all reasonably preventative measures. We will overcome the current discord that has engulfed our nation through a supportive culture to ensure the health of the community and discovery of joy in our existence.

Trey Dobson, MD, is the chief medical officer at Southwestern Vermont Medical Center.