Being outdoors doesn’t mean you're safe from COVID-19 – a White House event showed what not to do

Former New Jersey Governor Chris Christie hugs another guest; Kellyanne Conway (left); and Notre Dame University President Rev. John Jenkins (right) later tested positive for COVID-19.
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If you think you are safe from the coronavirus just because you are outdoors, think again.
While the wind and the large volume of air make the outside area less risky than the inside area, circumstances play a role.
Someone who is contagious may cough or sneeze or just talk. If you inhale these respiratory droplets or they plop in your eye, you can become infected. If you shake hands with an infected person and then touch your eyes, nose, or mouth, there is also a risk of infection. You don't have to breathe the air of an infected person for a long time. What matters is the dose.
As an infectious disease doctor, I get a lot of questions from patients about COVID-19 risks. Here are some answers about the risks involved in the outdoors.
Doesn't wind make outside safer than inside?
It is true that the wind helps dispel droplets of breath that viruses can transmit.
When you're indoors, one of the big problems with the spread of the coronavirus is aerosols - tiny, light droplets that people release along with larger droplets when they breathe. These particles can linger in the air and the concentration can build up in closed, poorly ventilated rooms. In open outdoor areas, there is less risk due to the volume of air and space available for physical distances.
At least one study that has not yet been peer-reviewed found that COVID-19 patients were almost 20 times more likely to be infected indoors than outdoors.
But that doesn't mean you're in a protective bubble outdoors.
What behaviors could you endanger outside?
To get a feel for how easy it is to put yourself at risk outdoors, check out the photos of the crowd in the White House rose garden on September 26th. About 200 people attended this ceremony and at least 12 tested positive for the virus within days, including President Donald Trump and two senators. When and where each person was infected is not known, but various behaviors during the rose garden ceremony increased the risk of contracting or sharing the virus.
The first problem with this scene: very few people wore face masks.
Without a mask, infectious people can shed the virus when they speak, and there is nothing that can stop the breath droplets. For people who are not yet infected, no mask means that the virus has multiple ways of entering their bodies - nose and mouth, as well as eyes. The lack of masks also increases the risk of a larger dose, and higher viral loads can mean a higher chance of serious illness.
Only a few people at the rose garden event wore protective masks. Chip Somodevilla / Getty Images
People also sat close together. And before and after the ceremony, they mixed - indoors and outdoors - shaking hands, leaning forward for close conversations, and hugging.
Remember that only breathing releases droplets of breath, and loud, lively speech such as laughing or screaming is more emitting. We don't yet know how much virus it takes to cause symptoms, but those doses add up. So you could get a small dose from someone sitting next to you, but if that person hugs you tightly or shakes your hand later, they might give you another dose. Or you can talk to someone else who has been contagious for a few minutes and inhale more virus particles.
It only takes one person in the peak of the infection period - 24 to 48 hours before and after the onset of symptoms - to trigger a superspreader event.
When do I have to wear a mask outdoors?
Face masks reduce the risk of infection and the amount of virus you spread when infected.
Carry a mask with you when you run or walk. When you are around other people, put it on.
When sitting in a sidewalk cafe, try to hide between bites and swallows, especially if your age, health, or weight makes you prone to severe COVID-19.
The likelihood of temporary interaction from someone walking past a table is small, but still possible. The safest place to eat outside is a table away from high traffic areas and against the wind of everyone else.
Is six feet of social distancing enough?
Depending on your location, maximize the distance between you and others. There is nothing magical about staying three feet apart. Particles created by sneezing can move much further.
Twelve or 15 feet is safer.
It's about minimizing the risk. You can never zero this risk while out in public.
Can I still have people outside for a party?
Think of the coronavirus like a sexually transmitted disease - everyone claims to be safe, but do you really know where they've been? It only takes one infected person. Rapid COVID-19 tests are also not 100% accurate and are not currently available to most people.
To ensure safety for an outdoor meeting, set up tables for every social bubble - a family, for example. Keep the tables at least 15 to 20 feet apart. Put food on individual plates in a central location and let people or each bubble rise individually. Do not share utensils, food, or glasses. Wear masks as often as possible and don't forget to physically distance yourself.
We don't know much about the coronavirus, including long-term damage. No matter how old you are or how healthy you are, do whatever you can to avoid the virus until there is a vaccine. Even if you overcome the disease quickly, we don't know what the long-term consequences will be.
[Research on Coronavirus and Other Scientific News Subscribe to The Conversation's new scientific newsletter.]
This article was republished by The Conversation, a non-profit news site dedicated to exchanging ideas from academic experts.
Continue reading:
When COVID-19 super spreaders are talking, where in the room you sit is important
Aerosols pose a greater threat to coronavirus than suggested by WHO guidelines. Here's what you need to know

Thomas A. Russo does not work for any company or organization that would benefit from this article and does not consult any stocks or companies that would benefit from this article, and has not disclosed any relevant affiliations beyond their academic appointment.

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