As Marion County appeals to the Oregon State government to re-open, there are several things to keep in mind:
- We do not have the virus contained. If you remove NY/NJ, the number of cases in actually increasing in the US. In fact, outside of NYC, itâ€™s increasing in all the Top 10 metro areas of the country. (The 10 top hotspots are all rural, though, so this isnâ€™t just a big city issue.)
- Oregon has inadequate testing. Despite what the Oregon Health Authority claims, experts say that Oregon needs to be doing a lot more testing for test/trace/isolate to work. Even with inadequate testing, Marion Countyâ€”which has applied to re-open despite not meeting the governorâ€™s own flawed standardsâ€”is seeing new cases daily.
- Test/Trace/Isolate has not been successfully implemented in any state in the United States. (It has in other countries, but theyâ€™ve also locked down their borders. With the porous borders between states here and lack of federal leadership, Iâ€™m very skeptical that TTI will succeed. I think weâ€™ll have a second wave later this year and have to lockdown again.)
- The general public is not masking up sufficiently to stop the spread. We need about 80% of the people masking up in public to bring the retransmission rate (R0) down to 1 or less. I was at Rothâ€™s yesterday afternoon. Iâ€™d estimate only about 25% of people were masked.
Specific to personal services business like massage therapists, salons, etc., I generally agree with the concerns spelled out in this Oregonian article. Some thoughts:
- The activity takes place in a shared respiratory space with limited ability to vent the room. I do not believe that masking in this environment will be sufficient if a therapist encounter a COVID-19 positive client. The key bit about masks is that yours helps protects others, not yourself. That is to say, if youâ€™re COVID-19 positive and masked up, you reduce the respiratory transmission of the virus into the surrounding air making it less likely that someone else getsÂ the crud from you. It does very little to stop you from getting the virusâ€”thatâ€™s what the other personâ€™s mask is for.Â
- Even if both provider and client are masked, however, theyâ€™re spending a lot of time in a shared respiratory space andÂ masks arenâ€™t perfect. N95 masks are pretty good (about 95% effective, which is convenient for remembering), but how many people are using hospital grade N95s? Many hospital workers canâ€™t even get them. More likely weâ€™re talking about surgical masks (maybe 70% effective but thereâ€™s plenty of air leakage around the sides) or homemade cloth masks (maybe 40% effective). Iâ€™m not confident that masking will hold up for an hour in close proximity.Â
- Air purification is a great idea generally, but I am unaware of any source (medical or industry) that claims consumer level air purifiers (HEPA or PECO) will stop the coronavirus. Iâ€™ve read several sources (like this one) that say flatly that an air purifier wonâ€™t stop the virus. Plus thereâ€™s the issue of getting the air to the purifier. (Analogy: The casinos in Vegas have massive air filtration systems because they still allow smoking. Generally, this works well, but every once in a while youâ€™ll walk through an area and catch a smoke cloud in the faceâ€”youâ€™ve hit the exhale before the machines have had a chance to pull it away.)
- COVID-19 has a long pre-symptomatic/asymptomatic window. That is to say, typically for the first five days or so of infection (but up to 14 days) a person will have no idea that thereâ€™s anything wrong. But theyâ€™re still contagious. This is why the retransmission rate is so high.Â Temperature checksÂ to detect fever will miss anyone in this window, to say nothing of people who might take a fever reducing medication like ibuprofen. Thereâ€™s nothing wrong with a daily temperature check, but by the time it shows something you may have had COVID for two weeks. Then there are those who are asymptomatic, who are contagious but have no symptoms and never get any.
- A better early detection tool might be aÂ pulse oximeter. Because COVID attacks the blood/lungs, many people unknowingly see a significant drop in blood oxygen without realizing it. A pulse oximeter could help, but I don’t think it is an adequate safeguard.Â
- Iâ€™m not sure how concerned to be about the equipment and surfaces. Transmission from surface to person is actually fairly rare, and if those surfaces are being wiped down with disinfectant wipes, I’m not sure that’s the most likely transmission source in a person-to-person setting. Might be an issue in gyms, though, simply because it’s hard keep things sanitized. Â
- Iâ€™m also not that worried about hands on massage or stretch therapy. I donâ€™t think itâ€™s going to spread the virus any more than being in the same space already will.Â
- These businesses should definitely determine their potential liability if they were to infect a client. Is the business liability insurance in place sufficient? I doubt it, but these businesses really should know for certain before they reopen.
I fully appreciate that for many people, their person-to-person businesses are their livelihood. This has to be enormously difficult, especially when government help has been muddled at best.
For me, I rather desperately want to go back to the physical activity schedule that was (soccer, gym, pilates, massage, occasional tennis). But I bear the responsibility of many people relying on me (kids, Erin, extended family, friends, several hundred clients). I may not be able to escape infection, but I need to make every reasonable effort to try.
What I think that means so far as my return to the above listed activities is that itâ€™s likely outside my direct influence. I need to see the virus under control is Oregon and Marion County specifically with adequate testing before Iâ€™m going to feel comfortable venturing forth. I don’t think I’m alone in this whether Marion successfully re-opens or not.