Outdoors is healthier but what matters is how close you are

After reading way too many articles, I’ve concluded that wearing a face mask when not at home is the kindest thing to do with others. People can quibble about the effectiveness of one variety over another but I am impressed by the very low positive test results of medical personnel who use them as compared to the overall population. That’s good enough for me.

You’re less likely to catch the coronavirus outdoors, but the amount of time you spend near other people matters most

Aylin Woodward May 17, 2020, 9:02 AM

Tennessee restaurant reopening coronavirus
Customers are seen at Puckett’s Grocery & Restaurant on April 27, 2020 in Franklin, Tennessee.

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As states in the US start to loosen shelter-in-place orders and the weather warms up, people are flocking to beaches and parks. That outdoor time is likely low-risk, according to some preliminary evidence, as long as you’re on your own or with the members of your household — and far from everyone else.

“This virus really likes people being indoors in an enclosed space for prolonged periods of close face-to-face contact,” William Schaffner, a professor of preventive medicine at Vanderbilt University, told Business Insider. 

But just because the virus spreads better in indoor environments doesn’t mean clumps of people should congregate on the beach.

“It’s people coming together in groups that matters,” Schaffer said.

The place a group gets together is beside the point if people don’t stay far enough apart.

“There are no safe ways to do things; ‘safe’ implies something absolute. Instead, it’s all about risk reduction,” Schaffer added. 

Most coronavirus transmission occurs indoors, some research suggests

brazil coronavirus A woman wearing a protective face shield walks along the Copacabana beach in Rio de Janeiro, Brazil, on April 29, 2020. Pilar Olivares/Reuters

The coronavirus primarily spreads via droplets that fly through the air when an infected person coughs, sneezes, or speaks. So your risk of infection primarily has to do with how close you get to people, and for how long.

It’s not surprising, then, that evidence increasingly shows that the risk of infection is higher in poorly ventilated, crowded areas.

The worst clusters of coronavirus cases around the US are all tied to spaces that force people into close quarters for extended periods of time. According to a live-updating New York Times page that tracks outbreaks around the country, all but one of the 12 hardest-hit US locations are prisons, jails, and meat-processing facilities. Several nursing homes are also high on the list.

Offices and restaurants can be infection hotspots, too. A study of an outbreak in a call center in Seoul, South Korea, revealed that almost half the employees on one floor got infected. Nearly all of them sat in the same section. 

By contrast, a pre-print study that examined 318 coronavirus clusters in China found that outdoor coronavirus transmission is rare. In all but one of those outbreaks — which each involved three or more cases — the virus jumped between people indoors.

“The general principle should be: Outside is better than inside; open is better than closed; fewer is better than more people; and stay away from sick people,” Dr. Erich Anderer, a neurosurgeon and founding member of the North Brooklyn Runners group, previously told Insider.

According to Schaffner, the reasons your chances of infection might be lower outside are that it’s easier to maintain social distance outdoors, and the virus has to navigate wind, heat, and humidity to jump between people.

But he warned that the findings of the pre-print study from China (which has not been peer-reviewed) need to “be taken with a pound of salt,” since most of the incidences the researchers analyzed occurred while much of China was under lockdown. That quarantine limited opportunities for residents to go outside, “so of course all the outbreaks happened indoors, among families,” Schaffner said. 

Avoid any gatherings that put people in prolonged, close contact

sweden coronavirus at the bar
People have lunch at a restaurant in Stockholm, Sweden on April 21, 2020.

According to Schaffner, behavior matters most when it comes to coronavirus risk.

“What you do becomes the single most important thing, less so the environment,” he said.

He suggests being very careful when in or near gatherings of people of any size, and “when in doubt, don’t be stubborn and wear a mask.”

Masks protect other people from any germs the wearer might be carrying, so are imperative in situations where it’s difficult to maintain 6 feet of distance, Schaffner added.

Open-air market - Paris - May 2020
People wearing protective face masks walk through the Saxe-Breteuil open-air market next to the Montparnasse tower on May 14, 2020, in Paris, France.

He also tells people to avoid religious services and parties, even if they’re outside. People who golf, hike, or visit the pool shouldn’t linger in locker rooms or parking lots, he added, since that’s where people are more likely to stand around and have conversations without masks. And when it comes to visiting family, blow kisses to grandparents instead of hugging them.

“Go visit them, but do it in a modified fashion,” Schaffner said. 

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