It has been a very trying year as we all get through this pandemic. After enduring a spring of lockdowns, establishments increasingly started to open. Navigating regulations and safety protocols has been difficult for many businesses as they struggle to comply while still generating enough necessary profits to remain in business. For those who have been in favor of lockdowns and a more restrictive approach generally, their mantra has been "Listen to the science!" We can get into whether the restrictionists are legitimately concerned about evidence-based practice or whether it is a guise to amass more power and control. I can say that I have expressed concerns about coronavirus-related restrictions not being empirically-based since I criticized the lockdowns last May.
For those who thinks that being libertarian automatically means "have everything open during the pandemic," it really does not. For one, I called for a limited face mask mandate. I also was okay with a subsidy to pay for people to take the vaccine, provided that a) it is proven to be safe, and b) there is compelling case to be made to ensure that enough people will take it to create herd immunity. At the same time, I looked at the evidence for school closures in July and found it to be lacking.
On the one hand, I am glad that many jurisdictions are treating the "shut things down" more like a dial than a switch. On the other hand, if a certain government entity is going to shut a certain type of establishment down, the burden of proof is on them to provide a conceivable set of facts that such a provision would protect the public health before disrupting the livelihood of hundreds. As the second wave has kicked in, we have seen two such establishments targeted either with more severe limits or downright shutdowns: restaurants and gyms.
I want to see if the evidence out there merits shutting down either one or both types of establishments, but before jumping into that, a word on risk assessment in general. There is never going to be a scenario in which we eliminate risk. Why this pandemic brought about the delusion in many thinking we could is beyond me. As I will bring up again shortly, costs need to be weighed against their benefits. We know that contamination through surfaces is unlikely, and COVID-19 is most commonly spread by respiratory droplets.
This has a few implications when assessing risk. One is that being outdoors is safer than being indoors because of how bacteria and viruses dilute and decay much more rapidly outdoors. The second is that social distance less likely spreads COVID-19 than being right next to someone else. The third is that larger gatherings are more likely to spread COVID-19 than smaller gatherings (and certainly smaller than being by oneself). There are more factors, but these are the main ones that help us determine the likelihood in which COVID-19 is transmitted to others. If I had to make an educated guess based on these factors, I would guess that gyms and indoor restaurants would fall somewhere on the range of "Medium Risk."
This side-conversation about restaurants and gyms is important since gyms and restaurants are more commonly indoors, not to mention that there can be multiple people together in what arguably could be construed as adequately close enough for major spreading. This gets even more important as winter weather kicks in, which means that outdoor gym classes or dining become less viable of options. Even if we did not have studies explicitly covering the specific topics at hand, we could at least see other past epidemiological studies to make an educated guess. However, since there are at least a few studies out there, I would like to see whether gyms and restaurants are such super-spreaders that we should be shutting them down as we get through this second wave.
Are Gyms Major Spreaders of COVID-19?
Gyms did not exactly have a reputation of being a haven of sanitation pre-pandemic. At the same time, we already pointed out that COVID-19 is not commonly transmitted by other surfaces. Intuitively, whether gyms are super-spreaders largely depends on such factors as ability to space out the machines and treadmills, ventilation and airflow, face mask compliance, whether group classes are halted (see South Korea study here), local infection rate, and protocols on checking members for symptoms. As an epidemiologist from Arizona University, Saskia Popescu, put it, "it is hard to put them [all gyms] into a single box."
There was one study from MXMetrics based on 49 million gym check-ins that showed a 0.0023 percent likelihood of contracting COVID-19 from the gym, but it was commissioned by a sports club association. Another study that is to be released by Oregon University in the near future looked at gym usage in the state of Colorado. While they did not find a statistically significant correlation between weekly gym usage and weekly incidence of COVID-19, they also did not conclude that gyms are safe. At the end of its press release, Oregon University discussed safety procedures that it could use to minimize spread of COVID-19. Additionally, a November study coming from Norway found that provided there are good hygiene and physical distancing measures, gyms and training facilities do not provide additional risk (Helsingen et al., 2020).
What About Restaurants?
This is a good question, especially given scant data. An oft-cited CDC study is a limited study in Guangzhou, China saying that substandard ventilation is more likely to spread COVID-19, but that study had no scientific controls (Lu et al., 2020). There have been other similarly limited studies with similar results, but because they are so limited, it tells us next to nothing. Not many jurisdictions release such granular data. Even so, we do know, for example, that in New York State, 1.4 percent of cases were caused by restaurants and bars (compared to the 73.8 percent from private social gatherings). Similarly, the state of Minnesota found that since June, only 1.7 percent of COVID-19 cases were associated with restaurants.
One study I found helpful is from Stanford University, in which it shows that targeted efforts (e.g., capacity limits) are more effective than blanket closures (Chang et al., 2020).
Postscript
The limited evidence base that currently exists has not proven that gyms or restaurants are super-spreaders. How do we move forward? Do we err on the side of caution by shutting things down or do we allow restaurants and gyms stay open with such protocols as capacity limits, social distancing, and checking for symptoms before entering? I could ask how well lockdowns generally have worked (another discussion for another time), but I can say that restaurants and gyms across the country have been implementing protocols to make it safer, even if those vary from state to state or city to city. No activity is 100 percent free from risk, and that includes staying at home all the time.
Let's remember that when people solely focus on the risk for contracting COVID-19, they are only asking about one important part of the equation. I'm not here to diminish contracting COVID-19. I myself have already had it. At the same time, it does not paint the full picture. Extolling and playing up the benefits while ignoring or downplaying everything else is incomplete at the least, if not downright deceptive. It does not get into the benefits of keeping the establishments open (e.g., gyms keep people healthier) or the costs of keeping the businesses closed (e.g., how unemployment adversely affects finances or increases depression and suicidal ideation). Especially since we are almost a year into this pandemic, the government should show with evidence how keeping gyms and restaurants are harming public health before they needlessly go harming the livelihoods, and by extension, the quality of life, of thousands upon thousands of Americans.
Aside from each establishment having different levels of protocol, we each have our own level of risk. An 85-year-old with asthma is going to have a different risk tolerance than a healthy twenty-something. In the case of gyms, it is safe to assume that healthier people are going to the gym (especially now) than those who have conditions that could make them likelier candidates for contracting COVID-19. Even in a pandemic, we should not have one-size-fits-all solutions, but have the ability to voluntarily make our own decisions based on evidence and our own risks.
No comments:
Post a Comment