Going Yellow Isn’t A Green Light:
Know the Risks

Restrictions on work and social interaction ease in the yellow phase of reopening the state. Here's what you need to consider before expanding your social circle.

Today southeastern counties in Pennsylvania, including Philadelphia, moved to the yellow phase of reopening the state. According to pa.gov, in this phase, some of the restrictions on work and social interaction will ease. For example, in the yellow phase, in addition to offering carry-out and delivery options, restaurants and bars may open outdoor dining (Philadelphia itself remains on hold for this until June 12th). Some in-person retail stores will be able to open, but businesses including gyms, hair and nail salons need to remain closed. According to the state, large gatherings of more than 25 people are prohibited, but before you decide to expand your social circle, or host a 24-person picnic in your local park, there are risks you need to weigh.

  1. Lower mortality in the young doesn’t equal unaffected. We know at this point the people most at-risk for dying from COVID-19 include the elderly and those with co-morbidities like hypertension, diabetes, lung disease, obesity, those that are immunocompromised. The reality is that we are also seeing younger people and those otherwise healthy hospitalized, and at times not surviving their fight with COVID-19. 37% percent of the cases in Pennsylvania are 25-49 year-olds, and among those, the hospitalization rate is actually 15%. Considering patients without low oxygen levels, breathing trouble, or other major symptoms aren’t generally hospitalized, 15% is significant.
  2. Know your risks and the risk of those you want to include in your social circle. Before you expand your social circle, keep in mind some reports showing significant proportions of the population could be asymptomatic or pre-symptomatic at the time of your interaction. This is why it’s especially important to make sure you have open and honest conversations about your risks and risk factors among your family and friends before sharing space together. Do you or your friend have health complications that could potentially make getting COVID-19 more deadly? Do you or your friends have close contact with anyone else that is within a high-risk category? These considerations are necessary, and exploring them could be life-saving.
  3. Best to meet friends outside rather than inside. If you do decide to meet up with friends during the yellow phase, I recommend sticking to outdoor, open space areas that you can maintain at least six-foot distance from each other while wearing masks. Remember that six-feet is not an exact science, but we now have data that transmission of the virus that causes COVID-19 is lower with increased physical distance. Therefore, current data suggests more distance means lowers risk and supports community physical distancing guidelines.
  4. Do not lag on safety precautions. Speaking of wearing masks, be sure not to leave home without yours! As it is getting hotter, it will feel more bothersome to wear a mask. As a physician wearing PPE for hours upon hours in the hospital, trust me I know it is uncomfortable. However, recent data also suggests face mask use could result in a large reduction in the risk of infection. Wearing a mask is a clear sign to others that you are taking the necessary precautions for your own health and safety, as well as the health and safety of your community. You may also consider bringing along your sunglasses, as this systematic review of the medical literature also showed eye protection was associated with reduced infection risk (ocular infection route could potentially occur by aerosol transmission or self-inoculation). Also, be sure to keep up with good hand hygiene and remember to bring a bottle of hand sanitizer when you’re out getting groceries or taking walks around the neighborhood.

The take-home message is that while no one intervention appears completely protective in a community setting, combinations of these types of interventions may mitigate the COVID-19 pandemic while we learn more about viral transmission, appropriate treatments, and develop an effective vaccine.

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COVID-19, From the Experts

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