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Officials were able to control COVID-19 delivery rates by enforcing policies that encourage residents to eat and drink, exercise and spend time with friends and loved ones in a safe environment. distance outside.

But health experts are worried cases could rise again as cooler temperatures in the fall and winter hardiness get people back indoors.

Leading infectious disease specialist Dr. Anthony Fauci coming holiday celebration that could increase delivery rates and advised Americans to skip any big Thanksgiving plans.

Speaking to “CBS Evening News” Wednesday, Fauci warned against “gathering in an indoor area” with large groups of out-of-town guests. “It’s unfortunate because it’s a sacred part of American tradition – family gatherings around Thanksgiving,” he said. “But that’s a risk.”

Some experts suspect internal migration is what accelerated the summer COVID-19 cases in the southern state as residents retreated to public areas with aircon to escape the heat. The three most popular states – California, Texas and Florida – each had more than 500,000 infections during the peak of the surge in August, according to Johns Hopkins data.

“Indoors in public spaces is one of the places where the greatest amount of risk and transmission is most likely to occur,” said William Hanage, associate professor of epidemiology and a faculty member at the Center for Communicable Disease Dynamic at Harvard TH Chan School of Public health.

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‘A minority of infections lead to most transmission’

Dr. Lewis Nelson, professor and head of medical medicine at Rutgers New Jersey Medical School, said one of the main factors with an increased risk of transmission indoors than outdoors is lack of ventilation.

Natural air currents on the outside are faster and more efficiently dispersing virus particles than inside. There is minimal no air circulation inside the house, allowing the particles of the virus to linger in the air or fall on high contact surfaces.

“If I smoked a cigarette (inside), you would see small amounts of smoke,” he said. “Because outside the smoke is kind of leaves.”

In addition, indoor public areas have more surfaces. As droplets drop respiratory or aerosol particles, they reach the tops of tables, chairs, door handles and other objects that people often touch.

“The ones on the outside have fewer surfaces,” Nelson said. “No one touches the ground and then touches their eyes, nose or mouth.”

People also tend to be closer indoors because they are confined to walls. Hanage said bars are a major source of delivery in communities because people tend to congregate there for long periods of time because judgment is ruined by alcohol consumption.

According to the U.S. Centers for Disease Control and Prevention, adults with confirmed COVID-19 are twice as likely to eat in a restaurant within 14 days before getting sick than those who tested positive.

Positive patients are more likely to report going to a bar or coffee shop when the test is limited to those who do not have close contact with people known to have coronavirus.

“A minority of infections lead to most transmission,” he said. “Obviously if you’re in a bar and that cluster tends to be bigger because a lot of people are gathering.”

How to increase airflow and ventilation indoors

Experts agree that increasing air flow in an indoor setting is important for reducing transmission risk because it prevents virus particles from hanging in the air for too long.

Ventilation rate is the amount of outside air supplied per unit time and air change rateis the ventilation rate of a space divided by the volume of that space, according to Shelly Miller, professor of mechanical engineering at the University of Colorado Boulder.

Most aircons and heating systems circulate about 20% of the fresh air in a building, while reversing the remaining 80% or more for energy efficiency.

However, ventilation can be increased by opening a window and turning on a fan. Most portable air filters cannot filter out airborne virus particles, but it still speeds up the air circulation that spreads the virus. HEPA-filtered air cleaners remove more than 99 percent of airborne particles regardless of particle size and also speed up air circulation.

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“If you clear up any airborne virus quickly, you will reduce the risk of transmission,” Miller said.

While UVC devices are useful for commercial buildings such as offices and schools, experts recommend sticking to a simple fan or portable air filter for residential use because some disinfected gadgets may dangerous if not used properly.

Another great way to reduce the risk of transmission is to limit the number of people in a room, which contributes to better indoor air quality in general.

“If I drop the number of students from 35 to 17 now, ventilation provides twice as much air outside per person and that’s great,” Miller said.

Building consultant company BranchPattern has developed an online calculator that determines delivery risk by inputting space characteristics such as heating, ventilation, how many people are in the room and how much long. The user can also add parameters such as wear mask and portable filters.

Returning to the basics: Masks, social distance and hand hygiene

Experts say the best way to stay safe indoors is through three basic mitigation efforts: masks, social distance and hand hygiene.

“If you combine all these things and put in decent practice, it should slow down the (delivery) rate,” Hanage said.

Masks are especially important. CDC Director Robert R. Redfield told a Senate panel in mid-September that a vaccine may not be available to the American public until the summer or fall of 2021 and that masks are “most important, powerful. public health tools we have ”- possibly more effective than a vaccine.

Dr. Sunil Sood, a specialist in infectious diseases at North Shore University Hospital of Northwell Health in Bay Shore, New York, said eaters should wear masks even when eating out.

“It’s tiring … (but) you just have to do that,” he said. “The only time you should remove the mask is when it really bites and chews.”

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This means keeping the mask on while chatting at other eateries, waiting for food and talking to your waiter.

Dr. Chad Asplund, professor of family medicine and orthopedics at the Mayo Clinic, said these rules also apply to the gym.

She recommends wearing a mask at all times, wiping machines and washing your hands. He also advises against using some gym equipment, such as yoga mats and blocks.

“If you make gaps, it’s harder to wear a mask,” Asplund said. “You may want to be creative in the hours that normally go because there are definitely times (which are crowded) before work and after work.”

For social distance, the Colorado state health department has developed an online tool that calculates delivery risk using total square footage of space and room items to determine how many people can be safely there. there at one time.

Keep an eye on community delivery rates

Although wearing a mask, social isolation, hand hygiene and increasing air flow can reduce the risk of indoor delivery, these mitigation efforts are not 100% effective, especially if the community delivery rate.

Barry Bloom, professor of public health research and former dean of the Harvard TH Chan School of Public Health, recommends residents keep an eye on delivery rates in their area to determine if it is safe to go to an indoor public setting.

“When (rates are) high, as in many parts of the state, it only begs for trouble,” he said.

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Bloom said this is happening in Britain, where the number of confirmed COVID-19 cases in the country has more than tripled in the last three weeks, with infection rates rising across all age groups and regions.

British Prime Minister Boris Johnson unveiled a new system on Monday setting stricter measures to slow the spread of the virus, three weeks after a nationwide ban on gathering more than six people and requested that pubs and restaurants close early.

“It makes a big difference whether in a low delivery environment or high delivery environment how much flexibility to stay safe,” Bloom said.

Contributing: Ramon Padilla, USA NOW; Associated Press. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

The coverage of health and patient safety in the USA TODAY was made possible as part of a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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