Maggie Cassidy: Learning to manage the COVID risk

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As Vermont businesses continue to open, and as the state itself gradually opens to visitors, suspicion of out-of-staters - and even outright hostility to them - has been showing up here and there in conversation, in news articles (and comments on them) and on social media. At the same time, Vermont's economy is heavily dependent on tourists and second-home owners, as it has been for decades.

What's different now is COVID-19. The only three states with a lower infection rate than Vermont are Alaska, Hawaii, and Montana. The first two are geographically isolated from the American mainland, and Montana is sparsely populated and relatively remote from states hit hard by the virus, while Vermont is a tiny island surrounded by tens of millions of potential visitors coming from areas with much higher infection rates. Vermonters have kept the rate of COVID-19 infection extraordinarily low by respecting the state's guidelines - sheltering in place, observing social distancing in public and wearing masks in indoor spaces. Now some Vermonters fear that visitors may carry the virus and may not respect the norms that have protected us so far, and their fear sometimes morphs into anger directed at people coming from out of state.

Both that fear and that anger are counterproductive. The Vermont economy is simply unimaginable without free-flowing traffic in and out of the state: we depend not only on visitors, but also on workers who come into the state to work in our hospitals and stores, and truckers who bring goods in and help export our goods. Furthermore, while the virus is rare in Vermont, it is here, so even if we could legally - magically - close our state borders totally, we would still have to take responsibility for protecting ourselves.

Of course all of us need to wash our hands carefully and often, respect social distance, and wear a mask in the presence of others - but that's not all. In a press conference last week, Dr. Mark Levine, Vermont Commissioner of Health, explained how we can identify and manage our individual risk as we consider which activities to engage in as the state opens and we can eat at restaurants, attend public meetings, visit state parks, and play some sports. Dr. Levine suggested that each of us develop a "risk budget," based on a level of risk that makes sense for ourselves. The budget's "bottom line," how much risk a person is willing to accept, will depend on that person's situation. He noted that in addition to advanced age, lung disease, a heart condition, and a compromised immune system, the Centers for Disease Control and Prevention has recently flagged chronic kidney disease, obesity, sickle cell disease, and Type 2 diabetes as underlying conditions that increase the risk for serious illness with COVID. In developing a risk budget, it's important to consider not only whether we ourselves are especially vulnerable, but also whether anyone in our closed circle of family and friends may have any of those factors.

A financial budget includes categories like rent, food, transportation, and communication; a risk budget allows us to balance the various elements contributing to exposure to the virus. Focusing on COVID's most dangerous transmission mode - inhaling microscopic droplets containing thousands of viral particles - suggests four related elements: contacts, contact density, time, and air circulation. Outside our closed circle of family and friends, how many people do we come in contact with on a given day, and how long is each contact? For a customer, an hour with a hairstylist is more risky than a three-minute interaction with a cashier in a store, but the cashier's serial contacts with many customers in a workday are much more risky for him or her than the hairstylist's contact with a few customers. Fresh air and efficient ventilation give the virus space to dissipate: while extended time with a group of people in a confined space - at a concert, a choir rehearsal, a bar, or even a family dinner - can pose dangers for all, meeting outdoors, or in a large space with excellent ventilation, can mitigate the risk.

We may applaud or deplore the measures that Vermont is taking to protect both residents and visitors, and while we may applaud or deplore the willingness or reluctance of both Vermonters and visitors to respect those measures, we can't control anyone else's behavior, no matter where they come from. So it's up to each of us to do whatever we can to protect ourselves and one another. That's the real bottom line.

Maggie Brown Cassidy is a teacher and writer living in Putney. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.

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