I was on a research trip just a few miles from home in Portland, Oregon, when my partner arrived home from a visit to see her family in North Carolina and then a work trip to New Orleans, (a journey that began in late February, well before the implementation of nationwide lockdowns now in place.) The day after she landed, she developed a low-grade fever. I was still away from home, so I hadn’t seen her yet. And I couldn’t help but immediately wonder, should I go home?
The experts are unanimous: If you can, stay home. But what if home isn’t safe?
I asked my doctor, and he hedged. “It’s a judgment call,” he said. “The question really is where do you want to be?”
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Millions of Americans with alternative options for lodging—a cabin in the woods, parents in their hometowns, a van to drive off in the desert, a tent to pitch by a river—are asking themselves similar questions at the moment. Am I more at risk in a densely populated city or a small town? In the mountains or at the beach? In cooler climes, or muggy ones?
I have often pondered this question while binge-watching guilty pleasure television shows like the Walking Dead, imagining myself paddling out to a small island on the Oregon coast with a boatload of camping gear, rice and beans, a fishing pole and some seeds to plant. The novel coronavirus pandemic isn’t a zombie apocalypse, by any means. But it still has me pondering these impossible calculations of risk, and even modes of transport. Do I abscond from civilization in a car with a mountain bike on the back and a kayak on the roof? Would a motorcycle be smarter, in case the roads close and the only way I can get back home again is by jumping curbs and skirting around locked Forest Service gates?
Most of that ruminating is wildly unnecessary, of course, at least until civilization completely breaks apart. But I did have to decide in the near term whether to go home or stay away. So I made some calls. Most of the experts I talked to were clearly reticent about passing out advice that might inspire people to travel, when the unified message at this point is pretty clear.
“Stay home,” William Hanage, associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, wrote me in an email. “Or if not that, try to cut the number of close contacts you make in half. If everyone did that, it would make a difference.”
“My public health response is ‘Don’t,’” added Danielle Ompad, an epidemiologist at New York University. “If your partner has tested positive, or if they’re symptomatic, they’ve probably had it for awhile and you’ve already been exposed. Taking yourself somewhere remote is to remove you from easy access to health care.”
COVID-19 has reached all 50 states and the District of Columbia, Ompad pointed out. “I’m not sure there’s anywhere you can go that would be better,” she said. “There’s no evidence that climate matters — I have family in Hawaii, and they reported a case at the Kohala Ranch. If you go somewhere more isolated, you’ll be in the catchment for a rural hospital, which won’t necessarily have the surge capacity to take on people from outside of the community. It’s not in anybody’s best interest to get off the grid, for a variety of reasons. You’re probably safer in your home community.”
What if you have no home community? Peter Holcolme has spent the last six years living out of an RV with his wife, Kathy, and 15-year-old daughter, Abby. When the virus struck, they were kayaking on the Chattahoochee River in Georgia, then traveled to Alabama to give what became a virtual presentation at the annual RV Entrepreneur Summit. Where to next?
“We’re kind of up in the air,” he said. “Like everybody, we’re trying to limit exposure to other people. Now we’re limited to how much traveling we want to do. Are we better off just parking it somewhere? A lot of places we go don’t have cell service, and it seems like a good time to be connected. We’re a little more hesitant to be totally off the grid when there’s so much going on in the world. But then those places I think might be some of the best places to be. We’re kind of reeling.”
Gabriela Andujar Vazquez, infectious disease physician at Tufts Medical Center, also focused on staying put. But the way she talked about it assumed that you’re already home and your roommate or partner develops symptoms, or tests positive. In that case, ideally that person would have a bathroom only they use, would wear a mask if they’ve got a cough, and that everyone in the household makes a twice-daily routine out of disinfecting surfaces and doorknobs. If it’s not possible to designate a bathroom to the infected, clean it regularly, she advised, especially the toilet. “If your family member is sick, you might not necessarily want to be away from them completely,” she pointed out. “You want to be sure they’re OK.”
There are also health benefits from staying home and of companionship with a partner, Dr. Nina Vasan, the executive director of the Stanford Lab for Mental Health Innovation said. “After basic needs and safety, good mental health—which includes belonging and relationships—is critical for survival,” she said.
Right, but can’t I keep tabs on loved ones via text? What if the safest way for me to avoid contracting this virus isn’t to go home at all?
“It’s a valid concern,” says John Swartzberg, a clinical professor emeritus of infectious diseases at UC Berkeley’s School of Public Health. “This is a very transmissible organism.”
Of people who were at home with symptoms but not sick enough to require hospitalization, the transmission risk to other family members was 10 percent. “That’s pretty significant. It’s reasonable to assume if you live with somebody who has symptomatic COVID-19, no matter what they do, there’s a substantial risk of you contracting it. The safest thing to do would be to not live in that home.”
Maciej Boni, an associate professor of biology at Penn State, suggests there are three different scenarios to consider. One, my city isn’t safe. Two, my apartment isn’t safe. Three, everything is safe (relatively) but I want to go see my partner who lives somewhere else.
In the first scenario, maybe your parents live in a town of 50,000 people, you live in a city of 3 million, and you have the option to drive straight there without stopping at crowded rest stops and gas stations. “That’s completely appropriate,” Boni told me. “It’s not a very risky thing to do, unless you yourself have symptoms.”
In the roommate-is-sick scenario, the calculus is different for a healthy 25-year-old versus a 75-year-old. If there’s a vulnerable person in a sick household, “it’s a matter of life and death. These people have to be separated,” Boni says. If you’ve already been in the household with the person who gets sick, though, you must consider yourself exposed if not infected and go somewhere that doesn’t involve other people. “Can you go on a hiking trip where you’ve got a tent and it’s just you?” Boni says. “Sure.”
In the third scenario, of wanting to join a partner in another city, there are variables to consider, Boni said. If your drive is short enough to not require multiple stops and human contacts, “maybe you’re OK, you’re not adding any risk.” Going from a big city to a small city is probably better than the other way around.
I made the call on Tuesday afternoon, asking my partner (who has been symptom-free since Saturday) to disinfect everything in the house and hide out in our bedroom while I did a quick repack. We said goodbye in the backyard, 12 feet apart. I headed to the coast, to Lincoln City, where no cases of COVID-19 have been reported and where my only in-person interactions so far have been the guy who handed me a takeout burger and the hotel clerk who handed me a room key. I washed my hands for 20 seconds after each exchange.
