The lockdown has eased and the UK is emerging into a state of hesitancy. When lockdown was at its strictest, the rules were clear: stay inside as much as you can. Now we are in a post-lockdown hinterland where pubs, shops and restaurants are reopening, but the UK is still reporting hundreds of new cases of infection each day.
In this awkward new era, every decision becomes a risk assessment. I could go eat in a restaurant, but only if I avoid public transport while getting there. I could pop into a shop, but only if I’ve equipped myself with hand sanitiser and a face mask. If I invite friends over to dinner, how do I know whether they’ve been as cautious as I have – or what if it’s me who is putting them at risk?
To help navigate this mire of uncertainty epidemiologists and public health authorities have created charts colour-coding the risks associated with different activities. According to the Texas Medical Association, for instance, I’m at low-moderate risk eating outside in a restaurant, but at a much higher risk going to a hairdresser. Does this mean that if I forgo two weeks of eating out I can get that long-overdue haircut? If I spend a whole month only doing activities in the ‘low risk category’ (opening the mail, getting takeaways and playing tennis) will I have banked enough coronavirus-credit to indulge in the riskiest activity of them all – going to a bar?
There are no easy answers. As one headline in FiveThirtyEight put it: “Every decision is a risk. Every risk is a decision”. But one thing is certain: you’re not going through this alone. WIRED spoke to seven of the most clued-up people when it comes to the coronavirus pandemic – epidemiologists, virologists and public health professors – to find out what risk calculations they are making on a daily basis.
We asked all seven of our experts the same six questions about returning to work, visiting pubs and restaurants, going to plays and concerts, greeting their friends, having people over for dinner and going on holiday. Here’s what they had to say.
Returning to work
Since the UK went into lockdown, the official advice has been that people should remain working at home if they can. Data from the Office for National Statistics showed that just under half of all UK workers reported working from home at some point in the seven days up to June 14. But the government’s stance towards home-working has softened in recent weeks. On July 17 prime minister Boris Johnson announced that from August 1 it would be up to employers to decide whether their employees should come into the office or not.
Almost all of the academics we spoke to are currently working from home. “I live in a different city from where I work, so the key issue that would make me more comfortable [going to work] is a stronger test, trace and isolate system as the fundamental strategy to drive down the number of cases. That would be necessary to feel more comfortable with public transport over extended periods,” says Tolullah Oni, an urban epidemiologist and clinical senior research fellow at the University of Cambridge.
“I would like to visit my office occasionally but feel my need is not sufficient to overcome the risk that I may increase the transmission rate unknowingly during my long commute on public transport,” says Martin Hibberd, professor of emerging infectious disease at the London School of Hygiene & Tropical Medicine.
The day before Johnson’s announcement, the UK’s chief scientific advisor, Patrick Vallance, told MPs that there was “absolutely no reason” to change the guidance on working from home. “Of the various distancing measures, working from home for many companies remains a perfectly good option because it's easy to do," he said.
Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine is also still working remotely. “The downside is that we are spending many hours each day on Zoom. The upside is that we are probably more productive than before. I live in London so I have considerable reservations about getting on public transport, at least until the incidence of infections has come down much more than it has at present,” he says.
Going to pubs and restaurants
In England, pubs and restaurants reopened on July 4, a day dubbed “Super Saturday” by the press, but people are yet to really embrace reopened venues. In the week beginning July 6, pubs had a 39 per cent decline in sales compared to the previous year while restaurants were down 40 per cent, according to data from the consultancy group CGA.
In a drive to get people back to restaurants, the government is offering a discount scheme giving people 50 per cent off on meals out starting from August. “While I’m sympathetic to the need to aim at restarting the economy, I look at the lethality of this virus and its prevalence in the population, and I’m not yet prepared to take my chances in a pub or restaurant,” says Danny Altmann, professor of immunology at Imperial College London.
“I would not go to an indoor pub or restaurant as yet. It would be impossible to appropriately physically distance and the majority of individuals would find it impossible to wear masks when they are eating. Additionally I would have concerns about the risk of fomites – i.e. droplets containing the virus – in the building where we are eating,” says David Strain, a senior clinical lecturer at the University of Exeter’s College of Medicine and Health.
Most of the academics said that they would rather eat outside than inside. “I am planning to go out for Sunday lunch and am very much looking forward to it, hoping for good weather as I am more comfortable if we can sit outside,” says Nicola Stonehouse, professor in molecular virology at the University of Leeds.
Socialising at home
It is currently against the law for gatherings of more than 30 people to take place in private homes, unless it's part of an event put on by an organisation following Covid-19 compliance guidelines. Current guidance says that people can only meet indoors in a group of two households, while those in single adult households can form a ‘bubble’ with one other household to be counted as a single complete household. If meeting outdoors, including in gardens, people can gather in groups of up to six, all of whom can be from different households.
“I have a small circle of close friends that we keep as a small network. If any of us show any signs we would be able to isolate immediately without causing large-scale transmission chains. But at the moment we are only meeting in the garden,” says Hibberd. Oni says that she too has had friends over for dinner while remaining outdoors.
Another epidemiologist, who prefers not to be named, says they feel very comfortable socialising in their own home. “[I’ve] done it outside at this time of year already, then it rained so had to go inside, [with] no problems,” they say.
Getting on a plane
The pandemic has wreaked havoc on the travel industry, leaving planes grounded and forcing travel firms to make sweeping redundancies. Since June 8 the government has required anyone entering the UK to self-isolate for 14 days, but this requirement no longer applies to a list of countries – including Greece, Spain, France and Belgium.
“We are planning to take a flight for a family holiday later in the year and are keeping it under review at present,” says McKee. This sentiment is echoed by Stonehouse: “I have had a holiday planned since Christmas and am hoping to be able to go,” she says.
Other experts are writing off their travel plans for the time being. Strain says he won’t be getting on a plane “for work nor pleasure” while Altmann has found the travel restrictions surprisingly refreshing. “We normally spend an immense amount of time, money and carbon footprint travelling the world for meetings and we’ve had to invent more efficient ways of meeting internationally online. This offers a more level playing field to those in isolated locations or without large travel budgets,” he says.
Shaking hands and greeting their friends
At the beginning of the UK’s coronavirus outbreak, Johnson famously said that the virus had not stopped him shaking the hand of everyone he met at a hospital where infected patients were being treated. But at the time other countries – including France and Switzerland – were already recommending against more traditional greetings in favour of elbow-bumps and ankle-shakes.
But some experts wouldn’t be so sad to see the back of handshakes. “Not my thing,” says the anonymous epidemiologist. “After going to Sierra Leone for Ebola handshakes [were] sort of out.”
Oni agrees. “On the scale of things to forgo, I'd be happy to let this one go and ‘shake ankles’ instead. Good etiquette – not just for Covid-19 but for other infectious diseases – might help with the seasonal flu burden that over stretches the NHS annually,” she says.
Others are waiting to see what happens to the overall transmission rate before deciding to go for handshakes and hugs again. Hibberd says he would start shaking hands “when we have a vaccine, or a therapy, or a clear understanding of how to block transmission – or if there was a very effective contact tracing (with phone app) and routine testing for all people”.
Attending plays and concerts
Indoor theatres are set to open from August 1, but they will be expected to follow social distancing guidelines which will mean running at a reduced capacity. In early July chancellor Rishi Sunak announced a £1.57 billion emergency support package for the arts, but with advance ticket sales at UK theatres down by 92 per cent many in the industry worry that not every theatre and music venue will emerge from the pandemic unscathed.
Altmann says he’s unlikely to head to the theatre any time soon. “I probably won’t be doing this until we either have vaccine roll-out or infections at one in tens of thousands,” he says. Strain says more knowledge of local infection rates would let people make decisions on a city-by-city level. “Until Leicester went into a second lockdown we had no idea that the rates were so high there. We need a simplified system that allows people to see what the local risk is,” he says. “If we had a clear idea of what the risk is then we could start taking appropriate steps, or move out to the open and attend concerts. I’d be a lot happier with open air concerts and plays than theatres.”
“It would be helpful to see a clear strategy for the events industry on the use of science to inform strategies to prevent transmission,” says Oni. But Stonehouse – who sings in a band – is looking forward to getting back onstage eventually. “We actually have a gig booked in September. It will be outside and with a very small audience – observing all guidelines,” she says.
Matt Reynolds is WIRED's science editor. He tweets from @mattsreynolds1
This article was originally published by WIRED UK
