Karen Carson, a nurse at Fairview’s Center for Wound Care and Hyperbaric Medicine, at the Great Barrington Farmer’s Market last Saturday, April 4, providing hand sanitizer to people entering the market and reminding them of their role in limiting the spread of COVID-19. The Market managers have taken many precautions to create the safest possible environment for all.

Keeping the Berkshires safe from a widespread COVID-19 outbreak

We wear masks, we keep our distance in public, most of our businesses require the same. Although sometimes a nuisance, we are getting used to it.

Great Barrington – It is a very worrisome reality to hear of the current surge of COVID-19 cases occurring in many states, as social distancing is being relaxed along a spectrum of risk-taking behaviors. And this concern is not just due to the increase in positive test results, but because of the numbers of serious COVID-19 illness which are threatening the capacities of various health care systems. This concern, of course, was the original and primary basis for efforts to “flatten the curve.”

Dr. Brian Burke, chief medical officer at Fairview Hospital in Great Barrington.

The question I’d like to address is this: Are the current social practices in Berkshire County pushing our residents subtly, but dangerously, along the same slippery slope toward serious COVID-19 disease? Or have our state’s emergency policies, the responses of our health care institutions and business community, and the habits we, as residents, have developed over the last several months, likely to keep our county’s risks at an acceptable level?

We each have our own tolerance for risk based on many factors extending from personal experiences in our past, the stories and cautions of family and friends, and efforts to logically interpret the facts of the pandemic. With so much about the virus that has changed in recent months, and the immensity of what is still unknown, assessing risk is at best a probability.

Even if a sophisticated App were to be developed, loaded with the latest clinical and epidemiological data and asking for individual health and demographic factors, the resulting risk assessment would be approximate. And any risk would still need to be weighed against our needs, such as economic realities, family obligations, the desire for social contact, etc.

Viewing Berkshire’s downward trend in numbers of positive COVID-19 tests, and the reduced numbers of active COVID-19 illnesses, we have done well (including during the early phases of “recovery”). Can we maintain this trend while expanding social gathering?

Let’s look at one example of Phase-2 recovery, the option for restaurants to allow indoor dining. The evidence and cautions are clear that this poses a greater risk of exposure than eating outdoors — the key factor being greater airflow outdoors, and therefore less time potentially being exposed to the virus.

So, is this element of Phase-2 recovery reasonable?

The answer, of course, is – “it depends.” And can the increased risk of viral exposure with indoor dining be reduced, making the balance of risk vs. benefit more acceptable even beyond the commonwealth’s continued regulations?

I can think of several questions to ask. Can my table be 8 feet, not 6, from any nearby tables? Can I be seated next to an open sliding glass door to promote air flow? Is my table large enough to keep a distance from my guest? Can I order my meal in advance? This is just a sampling, and the CDC has many others that are worth noting.

I am not suggesting that risks can be eliminated or equalized, nor am I promoting or discouraging indoor dining, but I believe we can continue to safely, slowly, and carefully expand the occasions of social interactions through: 1) individual initiative advocating for safety and 2) maintaining the good habits we’ve acquired over the past months here in the Berkshires.

We wear masks, we keep our distance in public, most of our businesses require the same. Although sometimes a nuisance, we are getting used to it. But as the risks of exposure increase with relaxation, we can’t let our guard down; we can’t forget those basics, including limiting the time of socializing and self-imposed isolation if we develop suggestive symptoms.

In summary, assuming we are following state and federal safety mandates and guidelines, we should still carefully weigh our own threshold for taking risk against the benefits of any anticipated social interaction. We should request individual accommodations if those would facilitate decision making. And we should wear our masks, keep our distance and limit our time in social situations.

I believe if we do that, we can, through effort, habit and awareness, lower the risks and maintain a reasonable balance between safety and sanity as we move ahead, avoiding the horrific experience in other states.