A summer like no other

This is part of our Coronavirus Update series in which Harvard specialists in epidemiology, infectious disease, economics, politics, and other disciplines offer insights into what the latest developments in the COVID-19 outbreak may bring.

With COVID-19 looming over the upcoming Memorial Day weekend, warm-weather fun is not only possible but also advisable, according to a Harvard healthy-building expert. But he nonetheless warned that, if mismanaged, unfettered gatherings could spark fresh summer outbreaks.

“This is going to be a very different summer,” said Joe Allen, assistant professor of exposure assessment science at the Harvard T.H. Chan School of Public Health and director of its Healthy Buildings Program. “We’re ready for a change, we’re all ready to get out of this. But we don’t yet have the systems in place to manage this effectively. So we should expect that things will be very different this summer. I don’t think this is going to be anything like past summers.”

Allen, who spoke Tuesday at a press briefing, expects there will be less travel — though he’s written recently that airlines are relatively safe — and that regular vacation areas will have fewer visitors. But what summer winds up looking like will vary not only by activity but also by location. The summer of 2020 will look a lot different in Montana than in Manhattan.

“[It doesn’t] have to be totally restrictive, where you can’t get enjoyment out of going to a park, going for a run, seeing people but at a little bit of a distance. … [But] will this be a normal summer? Definitely not, nor should it be.”

Joe Allen

Allen has been a proponent of keeping parks open and getting outside, safely, even during the strict social-distancing phase now waning across the U.S. He said getting outdoors has multiple benefits, both physical and mental, and — due to the “unlimited dilution” of viral particles in a breeze and the virus’ low survival on sunny surfaces — lower risks than remaining indoors.

But even with travel, camping, and beach-going on the summer agenda, COVID and the potential to become infected or to infect others should always be taken into consideration, and steps should be taken to minimize risk. In many cases, he suggested, a phased approach to reopening outdoor spaces will allow managers and workers to ensure that the systems in place can control crowds and keep people safe before inviting in larger crowds.

The safest summer activities will occur within established personal networks, involving in many cases the people with whom you share a household. Allen said the onus will fall most heavily on individuals and their willingness to take the now-familiar steps to ensure safety. He recommended people think of access to a park or a beach not as a right but a privilege, one that not only can be revoked quickly, but that should be if laxity sparks outbreaks.

“There’s this great urge to get back to the way things were despite what we know about this virus — that it’s easily transmissible,” Allen told the media during the conference call. “It’s not like other disasters, like a hurricane where you pick up the pieces and march on, step by step. This hurricane is sitting just offshore of every city waiting for us to let our guard down, and then it will strike.”

That could mean that a summer wedding planned for 300 people packed into a hall instead has 50 — if gatherings of that size are allowed — all wearing face masks and sitting outside on chairs spaced 6 feet apart. It may mean that a family visit, as Allen himself has planned, takes place on a spacious deck instead of in a living room, and with everyone an adequate distance apart.

As people flock to their favorite outdoor locations, it means understanding that you may not even get in, since lower capacity limits may be needed to ensure that parking lots, visitor centers, trails, and even mountaintops have adequate room for people to enjoy the scenery without risking their lives.

Beaches, Allen said, could be particularly difficult to police. Cheek-by-jowl blankets are traditionally common on hot days by the sea, and most people also think nothing of walking over someone else’s blankets to reach an open spot or the water. Local officials will have to think carefully about how to keep people an appropriate distance apart, perhaps by creating open sand lanes that let people reach blanket-worthy spots. That may demand greater enforcement, as well as necessary cooperation by those enjoying beaches, Allen said.

What’s important is reducing risk while enjoying summertime activities, Allen said. That means continuing to keep your distance, wear a mask, have hand sanitizer nearby, wash your hands frequently, cough or sneeze into your elbow, and stay home if you’re not feeling well. Any version of summertime fun will require each person to do his or her part to keep everyone safe.

“The prudent course of action for personal risk, but also for population risk, is to maintain these sensible controls. [It doesn’t] have to be totally restrictive, where you can’t get enjoyment out of going to a park, going for a run, seeing people but at a little bit of a distance. That can and should all happen, and I hope it does,” Allen said. “[But] will this be a normal summer? Definitely not, nor should it be.”

While Allen was looking at the months to come, another Harvard Chan School faculty member was looking farther ahead, into the fall. Howard Koh, the Harvey V. Fineberg Professor of the Practice of Public Health Leadership, former Massachusetts commissioner of public health, and former assistant secretary for health at the U.S. Department of Health and Human Services, said that better coordination is needed among federal, state, and local COVID-fighting efforts.

Koh, who spoke Tuesday at a Facebook Live event sponsored by The Forum at the Harvard T.H. Chan School of Public Health and PRI’s “The World,” said that although America’s early epidemic response was marred by a lack of coordination among authorities, such coordination is nonetheless still needed if future challenges are to be met. Even the eventual development of a vaccine includes within it a massive challenge: how to get doses distributed as widely as possible to those who need them. Koh called the pandemic a marathon that, for better or worse, gives planners time to make needed changes before an expected second surge of cases in the fall.

One place to look for guidance, he said, is beyond the U.S. borders. Countries that have already reopened are providing lessons on how the virus behaves and on the effectiveness of different policies. In that sense, President Trump’s challenge on Monday to the World Health Organization (WHO) and threat to reduce funding couldn’t involve worse timing, Koh suggested. With a global challenge, he said, it’s imperative that nations work together and learn from each other.

“Right now, we have a common enemy; that’s the virus. This is the time to build global health organizations like WHO and build global partnerships in health,” Koh said. “Working together as a global community is more important now than ever.”