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Activities and their risk levels for coronavirus - magnus - 07-04-2020

The Texas Medical Association recently released a graphic listing many common activities and their risk for getting coronavirus. 

[tweet]https://www.twitter.com/texmed/status/1279046501054980096[/tweet]

This assumes participants take all possible safety precautions. 

Anything look particularly out of place?  I feel that sitting in a doctor's waiting room should be riskier... unless they've taken precautions to reduce occupancy.   Why is visiting an elderly relative's house more risky than eating at someone else's house?  I'd think those should be reversed.  Unless an elderly relative's house is a nursing home. 

I wonder where playing catch (baseball,  football or frisbee,  ) would rank.  An outdoor activity with plenty of spacing but a shared object.

RE: Activities and their risk levels for coronavirus - Goose - 07-04-2020

(07-04-2020, 05:32 PM)magnus Wrote:  The Texas Medical Association recently released a graphic listing many common activities and their risk for getting coronavirus. 

[tweet]https://www.twitter.com/texmed/status/1279046501054980096[/tweet]

This assumes participants take all possible safety precautions. 

Anything look particularly out of place?  I feel that sitting in a doctor's waiting room should be riskier... unless they've taken precautions to reduce occupancy.   Why is visiting an elderly relative's house more risky than eating at someone else's house?  I'd think those should be reversed.  Unless an elderly relative's house is a nursing home. 

I wonder where playing catch (baseball,  football or frisbee,  ) would rank.  An outdoor activity with plenty of spacing but a shared object.

I also wonder where they got the data for this. How much is "derived" (extrapolated) and how much is data driven? Perhaps it doesn't matter, because the public can't know either, but still...

RE: Activities and their risk levels for coronavirus - BostonCard - 07-04-2020

(07-04-2020, 05:32 PM)magnus Wrote:  The Texas Medical Association recently released a graphic listing many common activities and their risk for getting coronavirus. 

[tweet]https://www.twitter.com/texmed/status/1279046501054980096[/tweet]

This assumes participants take all possible safety precautions. 

Anything look particularly out of place?  I feel that sitting in a doctor's waiting room should be riskier... unless they've taken precautions to reduce occupancy.   Why is visiting an elderly relative's house more risky than eating at someone else's house?  I'd think those should be reversed.  Unless an elderly relative's house is a nursing home. 

I wonder where playing catch (baseball,  football or frisbee,  ) would rank.  An outdoor activity with plenty of spacing but a shared object.

Risk can reflect probability of catching COVID-19 or the probability of passing COVID-19 as well as the probability of leading to a serious or fatal case.  Thus, I think visiting an elderly relative is risky because of the chance you infect them and they get very sick or die.

That being said, the infographic says “know your risk”, so that doesn’t support my theory.

Goose, the graphic says that this was “ranked by physicians from the TMA COVID-19 task force”. In other words, this is expert opinion, and thus, though hopefully informed by data, the ranking was not based solely on data.

BC

RE: Activities and their risk levels for coronavirus - akiddoc - 07-05-2020

(07-04-2020, 05:32 PM)magnus Wrote:  The Texas Medical Association recently released a graphic listing many common activities and their risk for getting coronavirus. 

[tweet]https://www.twitter.com/texmed/status/1279046501054980096[/tweet]

This assumes participants take all possible safety precautions. 

Anything look particularly out of place?  I feel that sitting in a doctor's waiting room should be riskier... unless they've taken precautions to reduce occupancy.   Why is visiting an elderly relative's house more risky than eating at someone else's house?  I'd think those should be reversed.  Unless an elderly relative's house is a nursing home. 

I wonder where playing catch (baseball,  football or frisbee,  ) would rank.  An outdoor activity with plenty of spacing but a shared object.

Sitting in a doctor's office is a risk that is difficult to quantify. Many offices are trying to minimize the risk. In the places that I work we do not allow our patients to sit in the waiting room. We have them stay in their vehicles until we are ready to see them. They are escorted directly to their exam rooms. Then they are escorted out of the building at the end of the visit. No one with symptoms of C19 is allowed in the building. They are seen outside.

RE: Activities and their risk levels for coronavirus - JustAnotherFan - 07-05-2020

The moderate risk of sending children to school is obviously the risk to the child. Because the risk to the teachers and staff is high.

RE: Activities and their risk levels for coronavirus - magnus - 07-05-2020

(07-05-2020, 09:12 AM)JustAnotherFan Wrote:  The moderate risk of sending children to school is obviously the risk to the child. Because the risk to the teachers and staff is high.

Are you including post infection outcomes as part of your risk assessment?  From just an infection vs no infection perspective,  aren't all demographics still believed to be about the same?  And one might argue that school kids might be more likely due to their inclination to touch everything including their faces?

RE: Activities and their risk levels for coronavirus - M T - 07-05-2020

Considering Texas didn't require masks until a couple of days ago, I presume this survey took place before that and reflects opinions of that environment.

To make sense of these, note these factors: Personally, I'd judge schools to be very high risk for < 10yo (9-12 months/yr at 6 hours a day, too often at less than 6', possibly without mask some of the time, careless behavior, inability to comprehend symptoms, likelihood of child to infect others,  versus transitive bubbles and low infectability)

Frankly, I don't understand why "going to a beach" is more risky that "eating at a restaurant (outdoors)".   If you mean going to Spring Break and partying with a few tens of thousands of strangers, then it should be up there with going to sports stadiums.   Beaches are usually in the sun, and often have a prevailing wind and are hot (reduced stability of the virus).  I haven't been to the beach in Texas in decades, but having another group within 10' would feel very cramped, where I would be surprised if restaurants really keep tables 6' apart.  They might have some slight breeze, but not much.  I would generally associate restaurants as being used at night and not particularly hot.

It is interesting to see what California allows versus where it is on this list.  The very highest risk is "Going to bars".  Maybe bars in California are different than in Texas, but California state allowed this a while back (but closed them for 18 counties).   Disneyland (high risk) was going to open July 17 but has backed off that.  Moderate-high risk eating indoors is allowed by California except those 18 counties.  Even once-conservative Santa Clara County apparently is allowing (in ~2 weeks) high risk working out at a gym, moderate-high barber shop and hair salon, moderate-high weddings & funerals.

RE: Activities and their risk levels for coronavirus - Goose - 07-05-2020

(07-04-2020, 11:17 PM)BostonCard Wrote:  Goose, the graphic says that this was “ranked by physicians from the TMA COVID-19 task force”.  In other words, this is expert opinion, and thus, though hopefully informed by data, the ranking was not based solely on data.


BC

I am not sure I would have as much confidence in what the TMA COVID-19 task force believes to be true. While I am sure this is their "best guess" I think there is lts of public confusion already on what is a fact and what is an opinion. This ranking is an opinion. It is an informed opinion (to an unknown degree, because I have no idea at all how "good" the TMA COVID-19 task force is), but it isn't a fact and it isn't directly supported by data. Next thing we know, we will hear somebody saying you are "denying science" if you question that sitting in a doctors waiting room is safer than going to the beach. That is why I was interested in the methodology of this ranking. I doubt there is any data available that measures the incidence of contracting COVID-19 in a doctors office. So how do they know?

RE: Activities and their risk levels for coronavirus - chrisk - 07-05-2020

(07-05-2020, 11:07 AM)M T Wrote:  Considering Texas didn't require masks until a couple of days ago, I presume this survey took place before that and reflects opinions of that environment.

To make sense of these, note these factors:
  • activities have to be done without masks (eating, swimming (incl. at the beach))
  • whether the activity is indoors or out (eating at a restaurant)  (indoors also extends duration to include exposure from those there earlier)
  • how many people one is exposed to (going to a mall)   Bubbles help, but less so when they are transitive.
  • duration of exposure
  • how much interaction is within 6' (barber, hair salon)
  • whether careless behavior is likely or unlikely (bars)
  • whether the activity is controlled or uncontrolled (beaches)
  • possible exposure to infected individuals (doctor's offices)
  • likelihood of individual to be infectable (children's exposure)
  • risk to individual if they do get infected, and secondarily, risk of individual to infect others.
  • shared equipment (amusement parks)
Personally, I'd judge schools to be very high risk for < 10yo (9-12 months/yr at 6 hours a day, too often at less than 6', possibly without mask some of the time, careless behavior, inability to comprehend symptoms, likelihood of child to infect others,  versus transitive bubbles and low infectability)

Frankly, I don't understand why "going to a beach" is more risky that "eating at a restaurant (outdoors)".   If you mean going to Spring Break and partying with a few tens of thousands of strangers, then it should be up there with going to sports stadiums.   Beaches are usually in the sun, and often have a prevailing wind and are hot (reduced stability of the virus).  I haven't been to the beach in Texas in decades, but having another group within 10' would feel very cramped, where I would be surprised if restaurants really keep tables 6' apart.  They might have some slight breeze, but not much.  I would generally associate restaurants as being used at night and not particularly hot.

It is interesting to see what California allows versus where it is on this list.  The very highest risk is "Going to bars".  Maybe bars in California are different than in Texas, but California state allowed this a while back (but closed them for 18 counties).   Disneyland (high risk) was going to open July 17 but has backed off that.  Moderate-high risk eating indoors is allowed by California except those 18 counties.  Even once-conservative Santa Clara County apparently is allowing (in ~2 weeks) high risk working out at a gym, moderate-high barber shop and hair salon, moderate-high weddings & funerals.

The state has already denied approval for SCC’s revised orders even though they are no less restrictive than other nearby counties.

RE: Activities and their risk levels for coronavirus - magnus - 07-05-2020

(07-05-2020, 12:08 PM)Goose Wrote:  
(07-04-2020, 11:17 PM)BostonCard Wrote:  Goose, the graphic says that this was “ranked by physicians from the TMA COVID-19 task force”.  In other words, this is expert opinion, and thus, though hopefully informed by data, the ranking was not based solely on data.


BC

I am not sure I would have as much confidence in what the TMA COVID-19 task force believes to be true. While I am sure this is their "best guess" I think there is lts of public confusion already on what is a fact and what is an opinion. This ranking is an opinion. It is an informed opinion (to an unknown degree, because I have no idea at all how "good" the TMA COVID-19 task force is), but it isn't a fact and it isn't directly supported by data. 
Not completely disagreeing with your take.  However,  i think to at least get a set of easy to understand guidelines out there that seem reasonable,  in the absence of hard data will hopefully reduce the number of people listening to their ultra skeptical neighbors/relatives.

Incidentally,  here's a chart from Vox. It appears these risk guidelines are becoming a thing.  =)

[Image: risk0522.jpg]

RE: Activities and their risk levels for coronavirus - JustAnotherFan - 07-05-2020

(07-05-2020, 10:20 AM)magnus Wrote:  
(07-05-2020, 09:12 AM)JustAnotherFan Wrote:  The moderate risk of sending children to school is obviously the risk to the child. Because the risk to the teachers and staff is high.

Are you including post infection outcomes as part of your risk assessment?  From just an infection vs no infection perspective,  aren't all demographics still believed to be about the same?  And one might argue that school kids might be more likely due to their inclination to touch everything including their faces?

Yes, I was taking into account the much higher complication and death rate for adults, especially older adults and adults with other risk factors (a whole lotta teachers).

RE: Activities and their risk levels for coronavirus - M T - 07-05-2020

We don't, but I wish we had a quantitative measure of the relative risks.  

For instance, I believe that going out in Santa Clara County now, you have at least twice the risk that each person you encounter is infected relative to the April peak.  If you encounter (have a meeting, or eat in the same restaurant, or ...) 10 people now vs 10 people in April, it is approximately 1000x more likely that at least one of them is infected.

One moral should be to minimize contacts even more than before.  So, activities that put you in the vicinity of more people are more and more risky as the active infection rate goes up.  That barbecue in the backyard with the next door couple is 4x as risky now, but the eating indoors at a restaurant may be relatively more risky.

Being dependent on your & their masks as offering protection only goes so far.

RE: Activities and their risk levels for coronavirus - Griffins78 - 07-05-2020

For evaluating activities, I tend to use the 4 Cs: closed spaces where air dispersement is limited, crowded spaces where the number of contacts is high (and therefore the probability of encountering a COVID-19 positive person) close contact where social distancing is difficult, and concentration of time where the duration of the exposure is high. That being said, there are many risk factors that can increase or decrease the riskiness of a particular activity. High on the list is the probability that the people I encounter will be COVID-19 positive. Every time we encounter someone outside our bubble, I feel we're exposed to everyone inside their bubble. If they are not careful or the others in their bubble are not careful, then I feel I just expanded my bubble to include all of those people and will be exposing everyone in my bubble as well.

We've considered whether to get personal services, e.g., hair cut, nails, massage, etc. but then we take into account, everyone they're seeing too - people we don't know. Now that the numbers of people testing positive have increased significantly, the likelihood that someone within those bubbles is positive is too high for us to take the risk.

Theoretically, if we have friends that are just as careful as us, we might expand our bubble to include them - perhaps for a visit. But, the jump in positive cases has most recently been frequently attributed to in home gatherings. Makes me concerned about that too.

RE: Activities and their risk levels for coronavirus - BostonCard - 07-05-2020

My general guideline is if someone let one rip and you could smell it, you are at risk of contacting COVID-19 from that person.

BC

RE: Activities and their risk levels for coronavirus - lex24 - 07-05-2020

(07-05-2020, 06:51 PM)BostonCard Wrote:  My general guideline is if someone let one rip and you could smell it, you are at risk of contacting COVID-19 from that person.

BC

LOL.  Plus, it’s as informative as that bullish-t chart.   

I know this virus is serious. Very serious. And I’m taking every precaution I possibly can -I’m 62. But I am really freaking tired of the 2 1/2 billion experts we have who are all coming out with all sorts of different stuff. As far as I’m concerned you just throw it all up in the air and see what lands. Because everybody’s just guessing their way through this thing. I’m not blaming anyone it’s a new virus and they’re trying to find answers. But there is so much crap out there in so many different forums and it’s absolutely impossible to get your arms around this stuff. So either you’re scared shitless or your devil may care. I find myself  being both -  depending upon the day of the week. 

So BC’s flatulence test works well for me.

RE: Activities and their risk levels for coronavirus - akiddoc - 07-05-2020

I feel like a broken record here. There have been 130,000 deaths from Covid. 30 - 40 of those are in children under 18. 80% of the children who have died had serious pre-existing medical issues. The studies coming out of Europe show that children are less likely to catch it if exposed, far less likely to get sick if they catch it, and less likely to transmit it if infected. 170 kids died of Influenza this season. 500 kids die from Respiratory Syncytial Virus every winter. Coronavirus falls right in that general area of risk. Therefore, the risk to children is not enough to keep them out of school. The issue is how to keep the adults around them healthy. 

If you are afraid to keep your kids out of school due to their health alone, it is not a valid risk assessment.

RE: Activities and their risk levels for coronavirus - JeffInCorvallis - 07-05-2020

If there's a silver lining in all of this (I'm tryin' hard here!) it's that 18 months from now we'll probably know a lot more about how upper respiratory tract infections transfer from human to human. These have been around probably as long as there have been humans and we still don't really know the details of how they spread.

RE: Activities and their risk levels for coronavirus - magnus - 07-05-2020

(07-05-2020, 09:30 PM)akiddoc Wrote:  The studies coming out of Europe show that children are less likely to catch it if exposed, far less likely to get sick if they catch it, and less likely to transmit it if infected.
Less likely to transmit?  I don't think I've heard/read that one.   Do you have a link i can read?  Not questioning.  Just would like to know more. 

Thanks

RE: Activities and their risk levels for coronavirus - M T - 07-06-2020

(07-05-2020, 09:30 PM)akiddoc Wrote:  I feel like a broken record here. There have been 130,000 deaths from Covid. 30 - 40 of those are in children under 18. 80% of the children who have died had serious pre-existing medical issues. The studies coming out of Europe show that children are less likely to catch it if exposed, far less likely to get sick if they catch it, and less likely to transmit it if infected. 170 kids died of Influenza this season. 500 kids die from Respiratory Syncytial Virus every winter. Coronavirus falls right in that general area of risk. Therefore, the risk to children is not enough to keep them out of school. The issue is how to keep the adults around them healthy. 



If you are afraid to keep your kids out of school due to their health alone, it is not a valid risk assessment.



These CDC tables (public labs, commercial labs) indicate there have been 70,000 positive tests of 5-17 year olds in the US (total of 54M 5-17yo in US, rate of 130 per 100K) in the 4 months we've had this disease.

From the same table, and US demographics
70K positive tests in 5-17 (pop 54M, rate of 130 per 100K)
842K positive tests in 18-49 (pop. 135.7M, rate of 620 per 100K)
341K positive tests in 50-64 (pop. 41.8M, rate of 816 per 100K)
255K positive tests in 65+ (pop. 52.8M, rate of 483 per 100K)

While we think of outbreaks in senior housing, it appears that the US has better managed the spread of cases to 65+yo versus younger adults.

We may also have done as well, or possibly better, with school age children:  Schools have been shut down; most summer camps and sports leagues have not been held; this age group rarely works out of the house and doesn't do much shopping in person.  I do expect that some children have had out-of-the-home care, and some (many?) have played with friends.

In any case, it is clear that children 5-17 are not mostly immune to the disease.  They rarely die of the disease,  I don't know whether they may suffer the long term impacts to their health.v

I worry that schools will be like congregate housing and there will be epidemics that will spread to many of the students.  Then, as I see in the SCC congregate housing, those that take care of them will get sick with a pretty high probability.   Virtually all parents will take care for their sick children, even if it means a risk to them.  They will continue to feed them, give them their medications, see that they get treatment, and soothe their emotions.

I believe in private homes, the ratio of care givers (parents) to patients (children) will be higher than in congregate housing.  Parents will generally not have training in how to avoid infection.  They generally will not have access to PPE.  They are on call 24 hours a day, with no days or weekends off.

Fortunately, parents will be in the 25-50 (maybe up to late 50s) age group.  While there are fatal COVID cases in that group, it isn't crazy bad (but the death of one or both parents would be damaging to the child).   However, in some cases (and perhaps more common in families with low incomes), grandparents may be the care givers to the children.

Short of institutionalizing all sick school-age kids (nobody wants that!), I can't think of any way to significantly reduce the chances of kids bringing home COVID-19 from school.

RE: Activities and their risk levels for coronavirus - JustAnotherFan - 07-06-2020

(07-05-2020, 09:30 PM)akiddoc Wrote:  I feel like a broken record here. There have been 130,000 deaths from Covid. 30 - 40 of those are in children under 18. 80% of the children who have died had serious pre-existing medical issues. The studies coming out of Europe show that children are less likely to catch it if exposed, far less likely to get sick if they catch it, and less likely to transmit it if infected. 170 kids died of Influenza this season. 500 kids die from Respiratory Syncytial Virus every winter. Coronavirus falls right in that general area of risk. Therefore, the risk to children is not enough to keep them out of school. The issue is how to keep the adults around them healthy. 

If you are afraid to keep your kids out of school due to their health alone, it is not a valid risk assessment.

If schools were free of adults then there would be little concern.