'We're Backed Into a Corner': Two Experts on the Best Path to Reopening
Scripps Institution of Oceanography scientist Kim Prather and UC San Diego infectious disease specialist Dr. Robert Schooley joined our livestream series Voice of San Diego at Home last week to share what they’ve learned after studying the virus for months and how we can better protect ourselves.
Local officials need to follow the science if they want to get out of the current stay-at-home order and stay out of it, Scripps Institution of Oceanography scientist Kim Prather told Voice of San Diego recently.
Prather and UC San Diego infectious disease specialist Dr. Robert Schooley joined our livestream series Voice of San Diego at Home last week to share what they’ve learned after studying the virus for months and how we can better protect ourselves. They reiterated that wearing masks, getting outdoors and cleaning the air are key to minimizing the spread of COVID-19.
Prather and Schooley are also part of a team helping schools plan for reopening. They touched on those efforts, as well as what they think local officials should focus on in the coming months.
Here are parts of that conversation, edited for length and clarity. Watch the full interview here.
Scott Lewis: What is it that you’re trying to get people to understand around the globe about your work and what you’ve discovered about the virus?
Prather: We’ve been talking for months about this, right? So my expertise, my background, is aerosols. Not the stuff that comes out of a spray can, the stuff that comes out of your mouth when you speak. At the beginning of this pandemic, we were told that it was on surfaces. But it’s in the air, you’re inhaling it. And so the way to protect people is to get people to recognize that this is airborne.
I keep telling people it’s a very fixable problem. You filter the air. It’s simple. You wear a mask. I’m a believer that if people understand that it’s that simple – and it is – then they have a reason to want to listen to all these things that people are telling them to do. It’s been a long saga, but just this week the CDC finally released much clearer guidance. It’s not completely perfect, but all of this is so important for school reopenings to be safe, to reopen our town and to be able to live life and keep it that way. I’ve been on a pretty strong mission with a lot of other people who study the air like I do to help the public understand.
What does it actually mean for your work to be successful? Are we talking about guidance? Like what the CDC comes out with de-emphasizing cleaning surfaces and washing hands, and emphasizing instead ventilation and outdoors? Is that the practical effects of the work that you’re doing right now?
Prather: That’s exactly right. Normally, you think about people coughing and sneezing and spraying this big stuff that will fall to the ground. This is coming out just from people speaking. And this virus has found a sneaky way to get around in that the people who are sick don’t know they’re sick. And so they’re just walking around, going to parties, going to bars, talking and releasing millions of viruses that do not fall to the ground. You have to think about it like cigarette smoke. If you’re indoors with somebody who has it, that room will just fill up. So ventilation is important. Filtration is important. Masks are important. These are the things to focus on instead of on the surfaces. You’re not getting it as much from touching surfaces and then touching your face. You’re getting it because it’s just floating around in the air.
It seems like if you were in charge of California’s messaging, what you’d say is don’t go inside with other people. If you are inside with other people, make sure it’s as ventilated as it possibly can be and that the air is being cleaned as well as it can be.
Prather: That’s exactly right. Like almost all of the outbreaks, we don’t get the data. But I’ll tell you, it’s just happening indoors. There’s rarely a case from outdoors, which is why the playground thing was a little crazy. It doesn’t mean you can’t catch it outdoors. If you were downwind of somebody for an hour and they were talking to you and the wind was blowing in your face, maybe. But the outbreaks where we get 20 people, 30 people, 40 people out of 50 getting sick — you’re seeing this over and over and over — that is in the air. There’s no way all the people at a wedding touch the same dirty surface. But you all share the air.
I’ve heard people say, ‘Oh, someone in my office got sick and I was with them for eight hours, but our desks were six feet apart. So I’m not supposed to go get tested.’ That’s the craziest thing I’ve ever heard. If you’re in the same room with somebody, you are breathing the same air. And if that person is infected and doesn’t know it, there’s a high likelihood that you’re going to get sick as well. So wear a mask when you’re indoors with anyone who’s outside of your bubble, you know, the people that you live with.
One of the things that I said last week that kind of got your attention was that three weeks ago I don’t feel we did anything differently. But three weeks ago there was this incredible surge happening in the Midwest and you could watch the map literally spreading through Utah, through Arizona and then it hit us. So what’s your understanding, as a scientist, when you look at data like that and we didn’t really change our behavior?
Prather: There was nothing here. It wasn’t here. You can get away with bad behavior if the virus isn’t there to breathe it. So I think you’re right. What happened is people used to be more careful and then slipped a little. You just keep slipping. And you’re thinking, ‘I didn’t get sick.’ You start changing little things and you get away with it, is what I say. And so then when the virus appears, when it’s actually there, then the exact same thing you did three weeks ago doesn’t work anymore. You will inhale it. But you can’t get sick if it’s not there.
Dr. Schooley, I followed your press conference a few months ago about wearing masks and how that can limit the spread or at least the severity of the infection that somebody might get. If there’s one thing you wish people understood and incorporated into all of their guidance about the virus these days, what would you say?
Schooley: It would really be masks. They help you both indoors and outdoors. I think the most destructive message that has gotten out through the public health community has been that this magic six feet is something that protects you. When you’re indoors, whether you’re six feet away or 10 feet away with someone that’s not in your family, you should be wearing a mask. And these days, if you have someone in your family who’s vulnerable and you’re out working, you want to try to protect them too. If my grandmother was still alive and I were out working, I’d want to try to wear a mask around her at home because this virus is out there right now. We need to get it down to a low level.
I want to also pile on and agree with exactly what Dr. Prather was saying. We are in a situation right now where we have a lot of virus in the community, and we’ve been trying to skim along just below the surface to keep things barely open. When you get down to a situation where a case is an unusual event, then we can start beginning to do the kinds of things we’ve all been wanting to do. But this business about saying, ‘We’re almost to the threshold. We’ll try to make it another week.’ That’s just gotten us in trouble over and over again. It just makes it harder to fall back to where we want to be by waiting until the last minute.
Last week, Dr. Prather, I talked about schools and I think I hinted, I didn’t mean it this harshly, but I hinted that maybe your time had been wasted working with some of these schools because it appears they’re just going to wait until the vaccine is in place. Maybe put into perspective the way you’re looking at that sort of quandary.
Prather: I think they’re waiting for the community. Right now, the numbers, where they’re going, you don’t open a school anywhere. There’s a bunch of us, there’s a network of us that are helping schools worldwide. For San Diego Unified, I told them what to clean, what to buy, what to use. They did everything that I said, and they’re serious. They’re contacting me, sending me data. They really put a huge amount into getting ready to open. They want to open. And so I didn’t feel like my time was wasted because they literally did everything I said. I think they even went beyond what I said.
This has not happened in other school districts. I have so many friends, so many teachers that are so upset with what they’re being sent back into and not being given a choice, which is really scary. That won’t happen here. We’ve got to bring the numbers way down, then the schools are ready to open. I can’t read minds, but I think if we can do that soon, I don’t think we’ll wait for the vaccines.
Schooley: I think we all feel very good about the vaccine, but the vaccines have to be produced and they have to be gotten into people’s arms. And that’s going to take some time. We probably won’t get to K-12, in terms of the supply availability, until summer. So we’re really talking about whether we want to have the schools open in the fall and in the winter and spring. I would also say that the things that Dr. Prather has been talking about, ventilation and so forth, are also things that keep influenza down. They keep other viruses and infections down.
Here’s a question from a viewer: How safe is an outdoor mask activity like dance or gymnastics class?
One thing that happened in the latest stay-at-home order is that the governor did encourage people to do outdoor fitness classes, to go outside and to walk their dogs. He basically made the determination that you should not go out of your house except to take care of your body. Is that what you would say as well? Kids that are gathered in an outdoor class are OK?
Prather: Outdoors is a million times better than indoors. The air just dilutes. But still, the most important thing for outdoors is distance. You still need distance. If you can’t, right now with the spread so high, if you want as low of a risk as possible, you’d still wear a mask. Although people laugh at me when I wear a mask outdoors, but again, I’m trying to be as sure as I possibly can. My take is that outdoors is much safer, but you still have to do distancing.
Another question from Twitter: Do scientists feel that current science is being reflected in the state health orders?
Prather: Well, the latest health order is just trying to stay at home. That’s just because we’re backed into a corner. Where I would like to see people do better in the state of California and the county of San Diego, in terms of paying attention to the science, is the order of reopening. They’re trying to force the businesses open. I understand that we need the economy going again, but if you do it in the wrong order, we just keep doing the start-and-stop. If we had just knocked this virus dead back in March, we would be living our lives right now. But we keep not quite getting there and then opening the wrong thing, the riskiest things. You make money for two weeks, but then you shut everything down until you can recover.
And now we’re really backed into a corner because the numbers are skyrocketing. So my answer is twofold. We have to do the shutdown. That’s kind of where we are. We don’t have a choice. But I want to see us get out of this and stay out of it, and I think they can follow the science better here than they have.
Schooley: I think we know what works. And we know that if we do this we’ll see the curve bend. I think the good news now though is we see that over the next six months this vaccine is coming and is going to have a massive impact on what we’re going to be able to do. But in the meantime, we have to be able to live to get to that vaccine, not just us, but our grandparents and our other colleagues who have underlying health conditions. We need to be responsible in that interval. We also need to support those businesses during this period of time so that they’re around at a time when we can reopen and do what we want to do and get back to our society.