When will it be really, truly be safe again?

April 30, 2020 4:32 PM

So this may be a question that no one can answer, but is there a reliable metric or statistic that I can refer to that will tell me when it is TRULY safe to resume normal life?

Here in the US, the response to coronavirus on the federal level has been an utter shambles and we've been abandoned to a patchwork of state and municipal governments to protect us. However, states all over the country are reopening services with the encouragement of the White House. This is true even in blue states like the one where I live. I am as eager as anyone to get out of quarantine and would like to resume normal life as soon as possible--but I don't trust even Democratic politicians to make evidence-based decisions about public health and safety when there are other pressures encouraging them to "open up America." I obsessively review data about new cases and death rates, but I'm wondering--is there a truly reliable indicator that I can turn to that will let me know when it's really safe again, if I can't trust the government?

posted by zeusianfog to Health & Fitness (18 answers total)

This depends on what you mean by TRULY safe - if you mean 100% safe, then this will only when there has been widespread application of a proven vaccine, administered to a decent proportion of the population around you and a cure or treatment has been developed. Clearly that is unrealistic for over a year, so I think you need to redefine your parameters, as we will be living with this for a long time. There will need to be precautions in place, and more widespread testing, but it won't be 'safe' as in "I can ignore all aspects of Covid-19" per se for a very, very long time. I think you need to work out where 'safe enough' is good enough for you, and then work out how to establish if that parameter has been met, because normal life resumption is a very, very long way off if you expect to be able to go back to as we were before the pandemic.
posted by Brockles at 4:38 PM on April 30, 2020 [28 favorites]

Agree with the above. Right now it seems like many states are reopening without meeting even the federal guidelines (Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period, etc etc). I think those guidelines make sense as a minimum, and *way* more testing and contact tracing should be happening, although experts disagree on exactly how much.
posted by pinochiette at 4:43 PM on April 30, 2020

You’ll only really be safe once you’ve had it and recovered, or been vaccinated.

(Assuming acquired immunity is persistent. So, probably.)
posted by Huffy Puffy at 5:02 PM on April 30, 2020 [4 favorites]

That question is almost impossible to answer, because what does it mean to be "safe?" You won't catch the disease? You won't die of it? Nobody will die of it? As Brockles said, the conservative estimate is vaccine and treatment.

I have set myself a benchmark of wanting to know about reinfection. I suspect I may have had a very mild case, but I have no way of finding out. If we learn that a person can only get it once (or get more info on reinfection and how fast it mutates). At that point, widespread testing will probably be the key to my comfort level.

But my main reason to isolate is to keep from spreading it to others. I have a pretty high risk tolerance for myself with things like this--I know that young and healthy people don't always do well, but I am not viscerally afraid of catching it. I *am* afraid of giving it to others and being part of the problem. So my personal baseline will be knowing for sure that I won't make anyone else sick, which probably means when I've had it and recovered.
posted by gideonfrog at 5:06 PM on April 30, 2020 [11 favorites]

New York Times: How Long Will a Vaccine Really Take?
posted by bluecore at 5:34 PM on April 30, 2020

Theoretically, if we get the number of new cases in a region down to near zero -- close enough that contact tracing can really work ( and of course we also need a robust contact tracing task-force)-- a system could be put into place to alert the public in that region to places that are "hot". At that time one could imagine going about life in a fairly normal way avoiding hot spots. Short of a working vaccine, this is the only scenario I can envision that will allow "normalcy".
posted by OHenryPacey at 5:37 PM on April 30, 2020 [3 favorites]

Things I'm looking at - when the curve of new cases flattens. When treatment is more effective. When a larger percentage of people are reliably shown to have had it and herd immunity starts to look like it's happening. When there's way better testing so people can quarantine and maybe test & trace. Also, if the virus recedes for summer, I might feel okay going out a little bit, with a mask and distance. Going to the grocery would be great. Also, my asthma is much better in summer, so I won't feel as at risk.
posted by theora55 at 5:48 PM on April 30, 2020

You’ll only really be safe once you’ve had it and recovered, or been vaccinated.

We don’t actually know if recovery results in subsequent permanent immunity yet, and it tentatively looks like it doesn’t. A vaccine is really going to be the only permanent way out of this
posted by mhoye at 6:18 PM on April 30, 2020 [2 favorites]

Actually, it tentatively looks like it does.
posted by praemunire at 6:31 PM on April 30, 2020 [3 favorites]

Mod note: Couple comments deleted. The question isn't what number of years might elapse. The question is "is there a truly reliable indicator... that will let me know when it's really safe again, if I can't trust the government?" that is, how can OP judge when we've arrived at the safe point.
posted by LobsterMitten (staff) at 6:31 PM on April 30, 2020 [4 favorites]

I'm looking for easy availability of quick testing for both the virus and the antibody. Information on how long non-symptomatic carriers are infectious. Do they have about the same 14 day-ish timeframe for beating it off and having antibodies or do they carry it much longer because it doesn't make them ill? If antibodies provide immunity and if so for how long? There's some question about that as far as testing positive after recovery but the tests might be picking up fragments of inactivated virus. Once we get the detection and treatment worked out to the point that the mortality rate is as low as a plain-old-flu and have a vaccine or add it into the flu-shot it wil be safe or at least as safe as life was before regarding picking up some random illness that the doctors can probably fix.
posted by zengargoyle at 6:33 PM on April 30, 2020 [1 favorite]

Atlanta Mayor Keisha Lance Bottoms notes in her Atlantic essay, Atlanta Isn’t Ready to Reopen—And Neither Is Georgia, "I may not have the legal authority to override the state. I do have the right to use my voice to encourage people to exercise common sense, listen to the science, follow guidelines from the Centers for Disease Control and Prevention, and stay home, if at all possible. We will transition to opening Atlanta when the health experts tell us that it is safe, and we will be a stronger city because of our prudence and deliberation," and maybe in the context of your question, the answer is "listen to the science," and what public health experts are saying, e.g.
* Here's How Scientists and Public-Health Experts Recommend the U.S. Gets Back to 'Normal' (TIME, Apr. 30, 2020 via Harvard T.H. Chan School of Public Health news updates)
* Testing Remains Scarce as Governors Weigh Reopening States (NYT, Apr. 25, 2020 / MSN reprint)
* Big unknowns about virus complicate getting back to normal (Associated Press, Apr. 21, 2020)
* Coronavirus distancing may need to continue until 2022, say experts (Guardian, Apr. 14, 2020)
* Can You Be Re-Infected After Recovering From Coronavirus? Here's What We Know About COVID-19 Immunity (TIME, Apr. 13, 2020) "There hasn’t been enough time to research COVID-19 in order to determine whether patients who recover from COVID-19 are immune to the disease—and if so, how long the immunity will last."
posted by katra at 6:35 PM on April 30, 2020 [4 favorites]

Mod note: One deleted. metasunday, just answer in a helpful way without the side commentary about moderation. If you want to talk to me, come to the contact form; if you want to hear community input, make a Metatalk post. But metacommentary doesn't belong in the thread.
posted by LobsterMitten (staff) at 6:57 PM on April 30, 2020 [2 favorites]

It's not the be-all and end-all of assessment, and it doesn't (or can't) answer the question of "when", but the new COVID-19 Risk assessment dashboard that the State of Washington set up is an example of the array of indicators that will all need to point to "low risk" before most people will really feel safe. It isn't going to be a single indicator, but a combination of many.
posted by Dip Flash at 7:18 PM on April 30, 2020 [9 favorites]

is there a reliable metric or statistic that I can refer to that will tell me when it is TRULY safe to resume normal life?

Bracketing off the 'what is normal and for who?' discussion, at the moment, the answer is 'no,' because we do not know enough about the virus itself to formulate any reliable metrics to begin with. We can make guesses, but they might be fatally wrong. It could be a while. About the only thing which seems to be working effectively right now is social distancing and use of PPE. But we do not know what will happen when people rush out of lockdown into a population with a low (so far) infection rate. By definition, seasonal behavior will take a year just to collect the first round of data. Vaccine development and trials could take a year minimum, at a highly accelerated pace. Ignoring politicians from both sides, and listening to the epidemiology and public health folks, 18 months (aka 2022) does not seem to be an unreasonable on-the-optimistic-side-if-things-go-well scenario. That is, after eighteen months or so, we may have both the knowledge of the epi side, and also the vaccines/treatments, to reduce this to a 'normal' level of risk. More pessimistic scenarios might take longer, but I get the impression that these are not being discussed too widely in public yet.
posted by carter at 7:47 PM on April 30, 2020 [2 favorites]

So Ontario put forth a road map ("not a calendar") that I think has some important principles. The metrics in it are:

Virus spread and containment
- 2-4 week decrease in # of new cases
- decrease in the rate of cases that can't be traced to a source
- decrease in new cases in hospitals

Health system capacity
- acute and critical care capacity, including access to ventilators
- availability of PPE

Public Health capacity
- 90% of contacts of someone with covid-19 reached within one day to contain spread

Incidence tracking capacity
- ongoing testing to detect outbreaks quickly
- new ways of testing and tracing (I think this is pretty fuzzy, but.)

What I like about this approach is basically its pessimism. It assumes you need to test and trace and keep finding cases and treating cases. It however looks for those to be events that can be contained, rather than an overwhelming wave of destruction.

For me, there isn't really safety until there's an effective vaccine and enough people are vaccinated and that's a pretty what-if scenario. I also think some of this depends on your risk factors and what "a normal life" looks like.

I suspect based on my reading on the Internet (ha) that we are looking at a scenario where there are travel restrictions and local, even hyper-local shutdowns on and off for a year or more, based on testing and tracking...so basically, you're "safe" if you're in a well-tested area that's cold, as long as you're not unlucky enough to be among the first cases in an outbreak. That may result in not feeling safe for much longer.
posted by warriorqueen at 8:14 PM on April 30, 2020 [6 favorites]

The polio vaccine was discovered in 1953 and polio was declared eradicated in the US by 1979, if that helps. I think the issue is, however, we don't know if Covid 19 will be like flu, and mutate so that any vaccine would not be 100% effective.

But if I were trying to think of something comparable I would look at the timeline for polio.
posted by lesbiassparrow at 11:19 PM on April 30, 2020

One of the things that makes this so intensely frustrating is that nobody knows. I live in a country where they started to ease restrictions this week, next to two other countries that started last week and two that will start next week or the week after. And they all prioritise slightly different things, some require masks in public, some only for some interactions etc. And the bottom line is, even with eased restrictions the only way to manage this for the time being is distancing and hand washing and various levels of ppe.

It is an interative process. They are literally trying things, monitor what happens, tweak/go further with easing restrictions and monitor some more. It is all absolutely reliant on people remaining sensible and on extensive testing so that any new hotspots can be identified quickly and individual and public responses can be modified timely.

My personal risk monitoring is that I check the national and local stats daily, work from home. But I did go for a massage this week because I was allowed and that was possibly the most exciting day in the last 7 weeks - it entailed being on two trams, meeting my new favourite masseuse, speaking to four actual human beings in person (incl. the masseuse) and going into a supermarket I haven’t been in for more than two months. And I have a feeling it may not get much more exciting than that for the time being.
posted by koahiatamadl at 4:10 AM on May 1, 2020 [1 favorite]