At a time of growing fear around the spread of the Covid-19 coronavirus, it’s not hard to tumble into a spiral of catastrophizing. Even the most mundane interactions of urban life suddenly feel like a high-stakes gamble: Gripping a subway strap, a doorknob at the co-working space, an e-scooter handlebar, or a jug of half-and-half at the coffee shop means swapping germs with who-knows-how-many other people. Suddenly, the epidemiological dimensions to the “sharing economy” have become obvious. Even if you’re young, healthy and not as susceptible to a fatal dose of the disease, the risk of carrying the infection to more vulnerable populations is frightening, too.
Along with the virus itself, there’s a ton of viral misinformation circulating. To learn more about the highest-risk urban places and practices, and how to protect yourself and others, CityLab spoke with Martin J. Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers University’s Biomedical and Health Sciences department, and Jason Farley, a nurse practitioner at the Johns Hopkins School of Medicine’s infectious diseases division.
In a March 9 advisory, the CDC recommended that all higher risk individuals — such as older people and those with cardiovascular problems or other conditions that weaken their immune response — avoid crowds and travel, and stock up on food, medicine and other supplies should a nearby outbreak occur. Everyone else is also encouraged to engage in “social distancing” to protect their communities. But city living in the age of coronavirus anxiety doesn’t have to mean complete self-quarantine, as long as you understand the highest-risk places, people and activities. (Also: Bring disinfecting wipes everywhere and wash your hands like crazy.)
The coronavirus spreads via “viral droplets,” meaning the mucus sprayed into the air when someone infected coughs or sneezes. You can get it by breathing those droplets in, ingesting them, or touching a surface that’s been contaminated. This means all “high-touch” surfaces — like doorknobs, trashcan lids, subway poles — pose some risk. The bad news is that being a busy urbanite means touching everything. The good news is, says Farley, any kind of alcohol-based gel or hand-washing product can mitigate the potential of exposure. Scrub surfaces down before you touch them, and/or sanitize yourself after.
“We should be practicing these techniques regardless of coronavirus,” he said. “High-touch surfaces can transmit myriad viruses: The coronavirus is an emerging disease which has got our attention at this point, but influenza can also live on environmental surfaces for some time, too.”
Studies have not yet been conclusive in showing how long the novel coronavirus can survive on surfaces — depending on the strain, a coronavirus can last from 3 hours to 9 days; for comparison, the flu lasts about 24 hours. A recently released peer-reviewed study out of China found that the virus that leads to the disease Covid-19 could “linger in the air for at least 30 minutes” and live for days on surfaces, depending on the material and the temperature, and up to five days in feces or other bodily fluids.
The virus lasts longer on hard surfaces than on soft ones, according to an FAQ out of Harvard Medical School, meaning browsing through shirts at the mall is probably a bit safer than mashing elevator or pedestrian walk-sign buttons. Coming into contact with still-wet mucus is worse than droplets that have since dried in the afternoon sun, says Farley.
Should you avoid doorknobs and railings entirely? Wear protective gear? Try to open doors with your foot? Cower in your bedroom? The short answer is always some variation of, “Do what you need to do; just wash your hands afterwards.” Because the aggression of the virus depends on the dose, exposure from a railing will likely be milder than from direct contact with fluids, says Blaser: “If you had your choice off getting it from touching a railing or someone coughing on you, you’d choose the railing.”
Wearing a face mask can help catch your fluids before they land on someone, but their broader benefits are hotly disputed: It definitely slows your transmission of the infection, if you already have it, but doesn’t do much to stop you from contracting it. Stop hoarding N95 respirator masks, says Farley — they’re not one-size-fits all, and without proper training or fitting, they could be permeated by disease. “If it’s used ineffectively, you’re taking a resource that could be used at a hospital or clinic,” he said.
The CDC says that your odds for picking up the virus go up if you are anywhere within a six-foot radius of an infected person “for a prolonged period of time.” But new research from China estimates that the distance could be up to 4.5 meters, or more than 14 feet.
You might think that would make crowded public transportation vehicles like subways and buses ground zero for the spread of disease. Rush-hour commuters are smushed together in far closer proximity than six feet, much less 14, and they’re all pawing the same poles and overhead straps. To ease the congregation of large groups of people on the subway, New York City mayor Bill de Blasio issued guidance to skip trains that look too packed, and take the next one.
But, as Wired pointed out, in denser cities “riders tend to hop on and off transit more quickly, which means they have less time to share viral nasties.” Based on a 2011 simulation of how a 1950s influenza epidemic would have spread through New York City, researchers found that only 4 percent of cases would have been been contracted while riding the subway. And Motherboard transportation reporter Aaron W. Gordon tweeted that, if people are waiting on the track for less-full trains, platforms themselves will then become more crowded, and “dwell times” will increase, slowing service.
“The most effective policy choice that could be made here, in my estimation, would be to maximize peak hour service to reduce crowding AND incentivize off-peak commuting,” he wrote. “Run as many damn trains as possible (no, they are not currently doing that on most lines).”
In San Francisco, virus fears may already be driving down transit ridership. Cities are taking precautions by increasing the frequency of their regular disinfectant routines. New York’s MTA has been running low on cleaning supplies, but the state has come up with a resourceful fix: Making its own New York-branded hand sanitizer. (In a typically dystopian 2020 twist, the product is being manufactured by prisoners who may not be able to take advantage of it themselves; Mother Jones reported that typically, hand sanitizer is banned in state prisons because of its alcohol content.)
Despite the fact that the majority of Americans are at low risk of experiencing a fatal case, Farley urges caution. “Public transportation does one of the major things that we recommend not doing: gathering in large crowded spaces,” he said. “It works against social distancing. That being said, we have to be practical.” For high-risk individuals — those who are older, and more immuno-compromised — “avoiding these spaces is optimal”; everyone else should use best hand-washing and Clorox wipe-down practices.
What if you’re using a different kind of shared mobility to get around? The Global Times, a Chinese newspaper, reported that bike-share use has grown under the coronavirus threat. “The epidemic has highlighted the advantages of bike-sharing — open air and no crowd gathering — which are helpful to curb the spread of the coronavirus,” Liu Ju, an industry analyst, told the paper.
Of course sharing bikes also means sharing germs, though. When you hop on a bike-share cycle or electric scooter, a huge amount of bacteria collects on the handlebars, and sometimes on the seat, says Blaser. Importantly, Covid-19 is a viral disease, not a bacterial one — but if a surface transfers bacteria, it can transfer viruses, too. Avoid soft handlebar grips in a shady space and choose bikes with harder ones that have been out in sunlight. If you’re able, walking or using your own bike are probably the safest bets; otherwise, sanitize the handlebars, wear gloves, or again, just wash your hands once you hop off.
Going to school
Though younger children have been getting the most mild infections from the coronavirus, 300 million schoolchildren around the world have been asked to stay home; some of them are logging into lessons remotely. “The reason to close schools is because children are the big amplifiers,” said Blaser. “The kids have very mild infections, but then they bring them home, then their parents get them, or worse still their grandparents get them.”
But keeping these little germ-monsters home brings a whole cascade of new problems, especially for low-income families. Research from past epidemic-related school closures shows that such households struggle when schools are closed, StatNews reported, because kids don’t get free or discounted lunches, and childcare gaps cause parents to miss work. And the infections often continue to spread, because kids can always find other places to congregate.
As Federal Communications Commission commissioner Jessica Rosenworcel noted on Twitter, remote learning is only a partial — and short-term — solution. And it’s one that is not going to be available to many people. “The #coronavirus is going to expose some hard truths about the digital divide,” she wrote. “If schools close can learning continue online? Only if students have internet access at home. Millions do not.”
Work and play
Here’s a good rule of thumb to apply to every room you’re thinking of entering, whether it’s a grocery store, restaurant, pharmacy, bar, library, or coffee shop: “It’s not about the space per se, but the types of interaction you have in that space,” said Farley. Those interactions start with turning the door handle (a high-touch surface!), and end with turning the door handle again.
Though there have been no known transmissions in restaurants, says Farley, employees have some control over public health. “I’ve seen a lot of food-service workers using gloves: That’s a good way of protecting themselves,” said Farley. “But those gloves can take the virus from money or a credit card, put it back on your food, and give it back to you. They don’t do anything to protect the consumer.” Having a healthy workforce helps the consumer and the broader community, but what he’s noting is that the outside of a glove can become as dirty as a hand very quickly.
Open-plan offices are the scourge of many, and the rise of the coronavirus offers another reason to hate them. “Open office spaces are among the worst for Covid-19, particularly if they are sealed office spaces without open ventilation and the air is just recirculated within the building,” E Hanh Le, M.D., senior director of medical affairs at Healthline, told the public relations firm Bospar, which did a survey on coronavirus fears. “To reduce the risk of spreading infection, concerned companies should enforce work-from-home policies to keep contagion down.” Dozens of companies have already taken that advice.
For those remote workers looking for a safe space place to plug in laptops: Look for quiet rooms, not loud ones, recommends Blaser. A coffee shop or library where everyone’s silently reading or typing away will get a lot less spray than a noisier coffee shop or bar where everyone’s yelling over the music to be heard. (Note: At Starbucks, they’ve started turning away your reusable cup.) Places of worship provide no sanctuary from the coronavirus: Faith practices like sharing sacramental wine and communion wafers are coming in for increasing scrutiny, especially after a prominent D.C. pastor revealed he had tested positive for the disease.
For gym-goers freaked out by the prospect of sharing sweaty fitness equipment and yoga mats, remember that the gym has its own built-in protection system: Those alcohol-based hand sanitizer and gym cloths you’re supposed to be using to wipe down equipment before and after using. “A good sanitary practice in general that you clean when you’re done,” said Farley. If you don’t, it’s time to start.
Friends, furry or otherwise
The most important site of transmission may not be outside in the world at all. “You’re more likely to get it from a family member than a stranger,” Blaser said.
Of course, as Farley notes, even if you get it from a family member, they must have originally gotten it from someone else. But once the virus does enter a household, it’s hard to avoid getting it. “The microbiome of a house is similar amongst its inhabitants, because you share that space all the time,” he said.
Still, transmission isn’t guaranteed, says Farley, as evidenced by a man on the Grand Princess cruise ship who avoided transferring the disease to his wife, even as they lived and slept in close quarters.
As for pets, the risk of dog-kiss transmission is apparently low-to-nil, and there has been no evidence of human to animal transmission or vice-versa. Still, Farley says that if you’re quarantining yourself from other people due to the virus, that should include your cat.
The good news
This might be a novel coronavirus, but the best countermeasures are tried-and-true. “All the disinfectants that we can use against standard viruses work very very well against this Covid-19 virus,” said Andrew Stanley Pekosz, a professor at the Johns Hopkins Bloomberg School of Public Health, in a press conference on March 6. “Almost irrespective of how long a virus can survive on a surface, if you do a good job of trying to clean these common areas — areas that people are touching on a regular basis — you will be reducing your risk [of] getting infected.”
Besides, drastically changing your lifestyle in an effort to evade infection might not make much of a difference. “Right now, everybody’s concentrating on how can I avoid that exposure, but this virus is coming our way,” said Blaser. Up to 100 million people in the U.S. could be infected within the year, he says, if efforts to slow its spread do not work and if its trajectory resembles that of other influenza strains. “It’s going to be amongst us: It is good to try to protect ourselves, but we don’t have to go crazy about it, because chances are we’re going to get it anyhow.”
Besides washing your hands frequently, Blaser says what’s most important is having a healthy life: getting enough sleep, not drinking too much, not smoking, and exercising. And if you’re lucky enough to be considered low-risk during this outbreak, it’s a good time to think about neighbors who aren’t.