Before the coronavirus pandemic, it was relatively easy to spot a sick person: coughing, sneezing, red eyes and a runny nose are all classic tells. Recognizing a sick building, however, takes a lot more expertise, explains Joseph Allen, a professor of exposure sciences at Harvard University’s T.H. Chan School of Public Health. The thing is, sick buildings are inextricably linked with the unhealthy people who inhabit them, and as America flirts with the idea of “opening back up,” it’s impossible to keep people safe without taking a hard look at how we behave in these spaces.
“I’ve seen the worst of the worst, but the good news is the worst of the worst can be turned into some pretty good buildings with just a little attention,” says Allen, who co-authored the recent book Healthy Buildings: How Indoor Spaces Drive Performance and Productivity. Improvements in ventilation, air filtration and disinfecting are all important for the buildings themselves, he adds. “But I don’t think environments are inherently risky, it’s our behaviors and how we handle those environments that makes them risky.”
In other words, we need to dramatically change our behaviors inside of them by wearing masks, social distancing and hand-washing.
Yet, no matter what we do when we all crawl out of our respective bunkers, some public places will be more dangerous than others. Which ones? Allow Allen to rank them for you, from best to worst.
1) Parks. Based on emerging research about COVID-19 and other coronaviruses, much of the spread is happening in indoor environments, making outside comparatively safer. But again, our actions make a big difference. “In my opinion, parks should be open. If people behave appropriately, they can stay open, too. But it’s a privilege that can be revoked,” Allen says.
Playgrounds, on the other hand, have highly touched surfaces that may not be regularly disinfected and should be avoided for obvious reasons. “In terms of opportunities for disease transmission, that’s an obvious one that can be curtailed,” Allen says.
Overall, though, the more fresh air there is, the less risk for disease transmission — just don’t go near anyone or touch anything.
2) Grocery Stores. The dangers associated with grocery shopping are unavoidable for anyone who cannot afford to have food delivered. The good news is, despite the high volume of people shopping everyday, “the risk is relatively low if managed correctly,” Allen says. This doesn’t mean you should go back to daily trips to the supermarket for a few items. But with the help of masks, gloves, social distancing and limits to the number of shoppers allowed inside at once, grocery shopping doesn’t have to feel like a game of Russian roulette. The real challenge will be maintaining these habits for the foreseeable future.
3) Restaurants, Bars, Salons and Gyms. Again, as with grocery stores, given the right safety measures, the risk of viral spread in these non-essential businesses can be managed once the curve is better flattened. The reason non-essential businesses are presumably lower risk is no one has to go to the gym (no matter how much protein they’ve had), which decreases the volume and frequency of exposures, naturally lowering the chance of infection.
Also, Allen points out, if they want to keep their customer base, they’re gonna have to market their cleanliness (e.g., the regular disinfection of ventilation and air-filtration systems) as much as anything else. “These decisions are good business decisions,” Allen says. “That cost-benefit analysis was wildly in favor of creating healthy building conditions before COVID. Now it’s a no brainer. If you don’t have a healthy building, you might not have customers.”
4) Hospitals. Hospitals aren’t low-risk environments by any stretch of the imagination, but they aren’t as dangerous as many people think either. After all, they’ve been equipped to deal with infectious disease for a long time. “They have the controls in place to minimize risk from airborne infectious diseases,” Allen explains, citing regular disinfecting and sterilization practices. Plus, he adds, “Hospitals use high-efficiency filtration, so you’re not blowing germs out into the common areas.” If anything, then, hospitals are a model for how other public spaces should operate, whether people seem sick or not.
5) Ubers. Because there are so many variables at play — how many people are around, for instance — it’s hard to definitively say that cabs and ride shares are safer than public transit. But being able to open a window can make a car ride less dangerous than one of the bus or train varieties. “Just cracking your window three inches can go a long way into reducing the amount of viral load in the air if someone is sick and shedding virus,” Allen says.
6) Public Transportation. Subways, of course, are petri dishes on rail tracks. And so, even nightly disinfecting of rail cars in cities like New York is only a modest start. Beyond no longer running their trains and buses 24 hours a day, seven days a week, municipalities can also work to improve their public transportation’s ventilation and air quality. But again, it mostly depends on the behavior of the individuals on those trains and busses. Best practices on that count would involve avoiding rush hour (if that’s ever a thing again), as well as wearing the aforementioned face masks and gloves at all times.
7) The Post Office, DMVs and Other Public Buildings. The issue here is the high volume of people coming in and out. Not to mention, they’re typically older buildings; thus, they don’t always have the most up-to-date ventilation and air-filtration systems. Allen, however, can’t say any of that with certainty because there haven’t been any studies on the air quality of public buildings. Which, he says, “probably tells you we’re not looking at it carefully enough.”
8) Schools. When it comes to eventually reopening America, schools present a huge dilemma, not just because of the amount of asymptomatic carriers they’d be welcoming into their hallways, but because the oft-rundown buildings are set up to help the virus spread. “Schools across the U.S. are chronically under ventilated,” Allen explains. “Study after study shows this. It’s been known for a long time that we could do a lot better there.” Other precautions include staggered pickup and drop-offs, smaller classrooms, outdoor P.E. classes and no more eating in the cafeteria or assemblies.
9) Theaters, Auditoriums and Stadiums. “Any place that has a crowd of people would be the hardest to manage right now,” Allen says. Individual behaviors are important, but “the challenge is really the sheer number of people in a shared space.” While baseball stadiums are open-air, which may reduce risk, many other venues are enclosed spaces with varying ventilation. Moreover, Allen refers to them as “super-spreader events,” where hundreds of asymptomatic people interact, and then return home to their families, leading to devastating outbreaks.
Still, Allen is confident that with more testing and a decline in the number of coronavirus cases, we’ll be able to play ball again — eventually. “If we’re smart about it and take slow, measured steps, we can get back to doing what we like when the time is right,” he says.
As for if we’ll ever be able to relax enough to enjoy these things again, well, that remains to be seen.
Lauren Vinopal
Lauren Vinopal is a writer and stand-up comedian based out of New York City, who writes mostly about health, science and men. She is the host of the Mid Riff Comedy Show in Brooklyn, a frequent podcast guest all over, and lives the life of a teen who looks like they haven’t slept in years.
