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Even if we all behave in ways that limit our exposure to COVID-19, we should expect a few cases at a time for several months. People catch COVID from a family member or coworker. According to a recent CDC survey, 54% of people do not know where they caught the virus or from whom. The virus is everywhere and impossible to avoid completely.

These impossible-to-avoid cases are traced, managed, and eventually resolved. While a case or two a day is very dangerous and disruptive to the people infected, it is a manageable situation for the state's hospitals and contact tracers.

Outbreaks of 30 or more cases create greater risks, not just for the individuals but for the state and local health system, as well. Many cases could overwhelm healthcare workers and tracers. Large outbreaks usually relate to several different, sometimes overlapping, circles all engaging in high-risk activities. The highest risk activities include parties, watching or playing live in-person sports, and dining out, especially indoors. Each of the highest risk activities has a few things in common, all of which increase their riskiness.

It's our nature. When we get together, our lifelong cultural training overrides our COVID concern. We end up closer than we should be. COVID is very contagious and makes its way steadily around the group until many people are infected.

Alcohol. We all know that drinking alcohol lowers our inhibitions. It allows us to loosen up and have a good time. Just as our nature as social beings is pulling us together, alcohol—often found at parties and in restaurants and bars—makes us forget COVID precautions entirely. We completely forget to stay apart, which makes COVID's circulation even easier.

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Kids. As much as we love them, kids have a very difficult time staying apart from their friends and their adult family members. They simply cannot remember to keep their distance. While kids are not usually affected as severely by COVID, they can pass it to adults.

It would be easy to pass judgement on those who are currently involved in a large outbreak. I would like to advise against that. Honestly, many of us have tried safe, socially distanced gatherings and failed, gratefully without consequences. We are all doing our best trying to balance our risks and our desire to have a fun and fulfilled life.

Instead, I would like to recommend that you seriously reconsider having or going to parties or other events. Let's be honest about our own human capacity to reverse generations of cultural expectations and avoid the other distractions that come with those situations. Sometimes, we just can't stay apart, unless we stay really far apart. That seems like the best course of action, for now.

Donna Barron, RN, is Southwestern Vermont Medical Center's infection preventionist.


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