Might we be Safer Outdoors Than we Think?

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By Daniel B. Fishbein, MD and Ben Pettit, JD/MBA

Remaining indoors with members of our household (sheltering-in-place) is the best way to prevent the spread of COVID-19 to or from persons outside our homes. But we must not forget that going outdoors has numerous well-established physical and psychological benefits while being confined indoors has substantial adverse effects, including the public health risk of epidemics caused by delayed childhood vaccination.  And there is emerging evidence that our chances of contracting COVID-19 outdoors are likely lower than under similar circumstances indoors.

The benefits of being outdoors are documented in dozens of peer-reviewed scientific publications (summarized here). Greenspace activities are associated with better general and mental health, independent of urbanization, socioeconomic status, and gender. Benefits have been found for all age groups, and are especially essential for children. Time spent outdoors leads to more physical fitness and less sedentary behavior. It is well established that being outdoors can prevent or mitigate the impact of health conditions such as vitamin D deficiency, myopia, multiple sclerosis, and Alzheimer’s disease. Exercising outdoors (compared to indoors) leads to greater revitalization. There are also mental health benefits, especially stress reduction and decreases in tension, confusion, anger, and depression. People report greater enjoyment and satisfaction with their physical activities when outdoors.

The recommendation of maintaining a distance of six feet from others while outside of our homes is based on longstanding (albeit not universally accepted) evidence that transmission of respiratory viruses primarily occurs when we are in close physical proximity. COVID-19 appears much more common in indoor spaces. Although we worry about transmission over longer distances by aerosols, there seems to be only one reported COVID-19 outbreak where close physical contact could not be documented --in an indoor public bathhouse in China.

A recent study from China found no outbreaks of three or more cases originated outdoors, even before the implementation of lockdowns. A study in Japan estimated that the risk of infection indoors is almost 19 times higher than outdoors.

Distance, ventilation, and sunlight matter and most outdoor spaces offer plenty of all three.  CDC recommends outdoor collection when testing for the causative virus when possible, and prioritizes outdoor seating as restaurants reopen. Medical experts have recommend. Even inside hospitals caring for known COVID-19 patients, isolation rooms that prevent aerosol transmissions are reserved primarily for people who have infections known to be airborne, such as measles and tuberculosis. Such rooms are recommended only for COVID-19 patients who are undergoing procedures known to produce aerosols. One needs only to think about persons smoking outdoors versus indoors to understand that exhaled aerosols disperse more rapidly outdoors. Such ventilation is one of the most important means to control cross infection by virus-laden exhalations. We fear that infectious virus particles from people infected with COVID-19 may contaminate surfaces outdoors as well as indoors. However, as with aerosols, no case of transmission from contact with such surfaces has yet been documented, and CDC has now stated the virus does not spread easily in such ways.

In a landmark article, Risk within Reason, Richard Zeckhauser, a Professor of Political Economics at Harvard University, reminded us that humans disproportionately fear improbable events. We suggest that it is likely that with the proper practice of social distancing, handwashing, and use of face coverings when we are within 6 feet, the risk of contracting COVID-19 outdoors is lower than many of us fear.

We will not be in a no-risk situation until long after a vaccine is available, which is likely to be many months away at the earliest. In the interim, we will need to learn to accept some risk, especially those that offer substantial benefits–like being outdoors. Infectious disease experts are suggesting our guidance regarding outdoor activities is too restrictive and Cleveland clinic has issued guidance on how to remain safe outdoors.

People should not be afraid to responsibly embrace the benefits of being outdoors. There’s a reason they call it the great outdoors.

Daniel B Fishbein is an infectious disease and public health physician retired from the Centers for Disease Control and Prevention. Ben Pettit is an attorney in Santa Barbara, CA


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a-1591045516 Jun 01, 2020 02:05 PM
Might we be Safer Outdoors Than we Think?

Life is dangerous. Risk is inevitable. Let's get out and LIVE! Quit ruining the economy and the lives of people in assisted living by being afraid. Yes, people will die, maybe me. But let's live while the living is good! We live in one of the most beautiful places in the world. Let's enjoy it. Shop, eat, swim, run, fly, hug, kiss, be free and enjoy your lives together. These riots are worse than ever because people had their lives shut down for 2 and a half months!!!!

"For every 1 pt US unemployment goes up, 36,000/yr more people die of heart attacks & deaths of despair (suicide, homicide, overdose, alcoholism etc). They first did this study in 1976. It has proven fairly consistent in subsequent studies."~Toby Rogers, PhD, Political Economist

Tee Gee May 31, 2020 05:47 PM
Might we be Safer Outdoors Than we Think?

When I was a young hippie in the early '70s I hitchhiked around Europe for a year. I went to a bullfight in Estepona, Spain. The handsome matador came out and faced the bull. He flashed a red cape, which enraged the bull, who charged, but only gored thin air. Then the picadores came out on horses and stuck barbed prongs into the neck muscle of the bull, weakening him. The matador continued his dance; the bull continued to focus on the red cape. Enraged, he would charge, yet not connect with anything tangible, anything solid. At last, when the bull was weakened enough, the handsome matador drove his sword into the heart of the bull, killing it.
I write this in response of what DTOM posted.
Since the U.N. already has a website touting the benefits of a new world order, and we the people are focused on the red cape of Covid19, I believe we have a problem.

Gtownie Jun 01, 2020 06:58 PM
Might we be Safer Outdoors Than we Think?

Pitmix science doesn't show any positive effect from cloth masks, in fact they can be harmful to the wearer. Turn off your TV and think for yourself!

PitMix Jun 01, 2020 10:18 AM
Might we be Safer Outdoors Than we Think?

Tee Gee, You can barely get a majority of the US to wear a mask, and you think some nebulous conspiracy is going to take our guns away? Highly doubtful.

shorebird May 31, 2020 05:40 PM
Might we be Safer Outdoors Than we Think?

Someone who says that they got Covid 19 in January and didn’t get very sick doesn’t have the ring of truth. NO ONE was testing for Covid in January.

bigone May 31, 2020 10:07 PM
Might we be Safer Outdoors Than we Think?

Looks like the birds are out tonight, if Alfred Hitchcock was right. Yes, no one was tested for Covid in January because no one had even heard about it at the time for the most part, thanks to the CCP and the WHO. So what do you think people had in January when they had a headache, high fever, loss of sense of smell and taste, dry cough that lasted for weeks afterwards like many people did? Many people who have since been confirmed "didn't get very sick", including a local doctor I know who got sick and WAS tested positive and told me "it wasn't that bad" - just like myself. We know there were unreported cases in January - that is a fact. But a lot of people seem to doubt there is "no ring of truth" in those facts and all they had was "the flu". Probably the same people that think they could get the virus from their mail or standing downwind from someone 100 yards away.

Bird May 31, 2020 06:36 PM
Might we be Safer Outdoors Than we Think?

I agree, Shorebird, but it's possible they had antibody tests subsequently and, somehow, those showed the virus present since January. Since I don't think that happens and because present antibody tests are about 50% accurate, it's more likely, imho, that the virus they had in January was the flu, not the novel Coronavirus.

hz May 31, 2020 02:56 PM
Might we be Safer Outdoors Than we Think?

we shall all see what happens after all the riots and protests this week..if numbers and deaths go sky high..we will all know it..if nothing changes or numbers go down..we can all go back to work in our slave jobs, low pay, no vacation pay, no health care etc? Lets see what happens next..and make your own choice...

a-1590961272 May 31, 2020 02:41 PM
Might we be Safer Outdoors Than we Think?

Strange that the opening sentence is opposite of what this article is suggesting before it reverses position to state being outdoors is far more advantageous in slowing spread than staying indoors. Numerous recent studies, including "tracing", have discovered between 60-80% of COVID contraction occurred among people who stayed indoors and never ventured outside; that obviously includes the large number of cases reported in nursing homes and care facilities. I had the virus and was sick back in late January for a few days with COVID; I suspect I got it at COSTCO Goleta due to the numerous Chinese students who shop there. It took me about 5 days to fully recover and really wasn't that bad in my case, nor my wife who got it from me about a week later. I have never worn a mask whether indoors at stores or spending the vast majority of my time outside. I'm happy to say both of us have been the picture of health since early February and we are both very active outdoors, even in our late 60s.

a-1590980226 May 31, 2020 07:57 PM
Might we be Safer Outdoors Than we Think?

7:34: What is racist about the fact the virus came from China and students coming and going from there would not be suspect, just like other non-Asian travelers you mention? I have a friend here who owns a Chinese restaurant - he has told me that many of his Chinese customers who are students at UCSB, and some at SBCC, travel to and from China all the time. And to say that unless you get tested, then say those tests may only offer a 50% chance of being accurate, is mind-boggling, to use your words. As many doctors have stated throughout this, is you exhibited the symptoms associated with this particular virus, you probably did have it, whether you were tested or not. Please get that examined.

a-1590978876 May 31, 2020 07:34 PM
Might we be Safer Outdoors Than we Think?

Talking about your racist profiling while the US in the mists of national riots due to systemic racism in the United States is mind-boggling! But, back to the topic of the post...
Unless you got a test and it said you had the Coronavirus I don't buy that you actually had the virus. And the antibody testing is a 50-50 chance of it actually working. So, if you actually got tested and it was positive you still have a significantly high chance of not having had it. Meanwhile, you state that it was the Chinese students that gave it to you. So, I will refer you back to your original racist post. You contend that some Chinese students gave it to you while you were in Costco. I struggle with this on many levels. First because your first thought was that it came from the Chinese students that you might have bumped into in Costco. Second because we know by now that any traveler, including tourists or business people who visited from China and any other country almost in Europe was exporting the virus to the US in January. Do you think no one else from Santa Barbara could have bumped into you in Costco had recently traveled to China or Europe? do you think any other person who traveled through an airport like LAX or on a plane could have picked it up and brought it to Santa Barbara? They could have. But more likely, the idea that you and your wife had the coronavirus is all in your head. Please get that examined.

a-1590970637 May 31, 2020 05:17 PM
Might we be Safer Outdoors Than we Think?

"I suspect I got it at COSTCO Goleta due to the numerous Chinese students who shop there." Ha ha ha!!!! SMH. Didja ask those assumedly Chinese students when they had last traveled outside the SB County area?

a-1590952398 May 31, 2020 12:13 PM
Might we be Safer Outdoors Than we Think?

A Doctor and a Lawyer write an opinion piece together......

Amateurish at best. The benefits of the outdoors are widely known. The problems come with those not following social distancing. I wonder if these two have any business interests in town that involve sports or being outdoors?

DTOM May 31, 2020 12:40 PM
Might we be Safer Outdoors Than we Think?

Daniel BF, retired from CDC...the least trustable "gov" agency, historically embroiled in the most controversy...look it up. Covid 19 is nothing more than a ploy to instigate global new world order...www. unnwo.org . World Economic Forum has the plan in hundreds of layers deep to combine all nations and herd people right on into the depopulation agenda. Be informed not sheepish.

1002110 May 31, 2020 11:12 AM
Might we be Safer Outdoors Than we Think?

" And there is emerging evidence that our chances of contracting COVID-19 outdoors are likely lower than under similar circumstances indoors."

Lower not negligible. You'd think a doc and a JD would chose their words more carefully but they obviously have an agenda.

a-1590947345 May 31, 2020 10:49 AM
Might we be Safer Outdoors Than we Think?

this is kinda obvious and from the start, getting outside for exercise has been recommended. Its the lack of social distancing that is the problem. Too many people feign at the efforts but then stick their nose out of their mask or get too close to others while occasionally maintaining distance. I predict cases will spike over the next 3-5 weeks thanks to social pressure to relax precautions and nationwide protests causing lots of close-quarters contact. I hope I'm wrong.

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