The New Normal

by Jennifer Ashton, M. D.

  But everyone is different, and just because I may not feel comfortable working out inside a gym doesn’t mean you won’t be—and can’t stay safe while doing it. To assess your risk in using a gym, I’d start by evaluating your physical health. If you’re in a high-risk group for severe complications with COVID-19 or live with someone who is, I might find alternative ways to work out that don’t involve an indoor environment (see chapter five for ideas).

  If you’re not high-risk, the answer of whether it’s safe for you to work out inside a gym depends partly on the facility. Some gyms require reservations or limit capacity; others may also do temperature checks and/or have members complete questionnaires about possible COVID-19 exposure before working out. Some facilities also open windows or have open-air roofs for increased ventilation. Many have a strict mask policy—whether employees enforce it depends on your individual facility—space equipment more than six feet apart, and routinely disinfect shared areas. The more measures a gym takes, the safer it will be for you to go.

  That said, I would avoid taking an indoor fitness class like spin or yoga with other people. These types of classes typically involve a number of people working out in a small, enclosed room for up to an hour at a time, breathing the same air. In an indoor class, you have sustained exposure to the respiratory droplets of others, which is the primary way COVID-19 (and many other contagious respiratory illnesses) is spread. Consider taking these classes outdoors or online if offered.

  To further lower your risk when going to the gym, consider these additional tips:

  Only frequent fitness facilities that offer a reservation policy or limit total capacity. The fewer people inside a gym, the lower your risk of possible infectious illness.

  If you want to work out at a gym without a reservation policy, go during off-peak hours or call in advance to make sure the facility is not crowded.

  Stay as far away as possible from other people while working out, especially if you or someone else is inhaling or exhaling forcefully. Ten feet is better than six feet when people are breathing heavily, but six feet is also better than two feet.

  Don’t touch your face. This is easy to forget in day-to-day life and even easier when you’re physically exerting yourself.

  Wipe down all equipment before and after each use. Don’t assume the facility’s employees or other guests will do it for you.

  Always wear a mask. I know it’s tempting to remove it when you’re working out, but you shouldn’t, especially when you’re participating in a high-risk activity like exercising inside with others.

  Is It Safe to Eat at Restaurants?

  Before the pandemic, I loved eating out at all the amazing restaurants in New York City and Boston and would do so regularly. Today, though, I don’t eat at any restaurants, whether the tables are inside or outside. While I commiserate immensely with the restaurant industry and try to still support them by ordering takeout and delivery, I simply don’t feel comfortable sitting within six feet of someone else for ninety minutes at a time while we both have our masks down to eat and drink. Given the fact I see patients and work in an office every day, it’s not an additional risk I’m willing to take.

  How do you know whether eating at a restaurant is a risk you can take? Perhaps no other activity is more apt for our four factors of time, place, people, and space than dining with others:

  Time: How long will you be at the restaurant?

  Place: Will you be eating outside or inside? If inside, does the restaurant have open windows or will the front door be ajar?

  People: How many people will be inside the restaurant? Or how many will be in your immediate vicinity if you’re eating outside?

  Space: Is the restaurant large with high ceilings or is it a small room? Are the tables at least six feet apart? Is it a noisy place where people may be talking loudly, thereby exhaling more particles into the air?

  When you assess these factors, you might decide that eating inside at a restaurant is one of the riskier things you can do right now, especially since people don’t (and really can’t) wear masks while dining and drinking.

  Another way to look at it: What is the worst-case scenario that can happen if you do eat at a restaurant? Let’s say you’re seated next to someone with COVID-19 who isn’t wearing a mask. Let’s also say the airflow inside the restaurant or the breeze if you’re outside is just right that it directs his or her respiratory droplets toward you for a period of time. Let’s also assume you’re not wearing a mask either because you’re eating and drinking. That’s a high risk of exposure.

  I want to be clear about one thing: There’s nothing a restaurant can do to make your experience safer other than space tables far apart, put plexiglass or plastic barriers between outdoor tables, require masks, and open windows and doors when allowing customers to dine inside. (Aerosol scientists say that plexiglass barriers at best are helpful only against large droplets and at worst do nothing against smaller aerosol particles.) Otherwise, if someone walks into a restaurant with COVID-19 and takes off his or her mask for two hours to eat and drink, I don’t care how far apart the tables are or how amazing the ventilation is, that’s a significant risk of exposure. The fact that your server is wearing a mask shouldn’t give you a false sense of security: Waiters and waitresses visit tables for no more than a few minutes at a time. Instead, it’s everyone else seated at the restaurant whom you have to worry about.

  Eating outdoors is definitely safer when it comes to COVID-19 transmission, just like all outdoor activities are. But keep in mind that you can still sit in direct airflow of someone with the virus for up to several hours at a time while neither of you are wearing masks.

  In short, there are no easy answers when it comes to eating out at restaurants. I encourage you to consider if the reward is worth the risk. When you do so, try (as hard as it is) to separate evidence from emotion: Most of us, me included, would love to be eating out as often as we could, but that doesn’t mean we should be.

  One thing you can feel good about if you do decide to eat out: There’s absolutely no evidence of COVID-19 infection because a server breathed on your food or carried a dish through air with viral particles. There’s also no evidence that you can contract the virus from food that’s been handled by someone infected with COVID-19. Again, this is a respiratory virus, and the primary means of transmission is through respiratory droplets in the air.

  Is It Safe to Use a Public Restroom?

  Public restrooms are petri dishes, as most people know. They’re small enclosed spaces with a lot of high-touch surfaces. What’s more, the virus has been detected in urine and stool and has been shown to aerosolize into the air when the toilet flushes. That said, if you have to use a public bathroom, you shouldn’t feel afraid. Wear a mask, minimize the time you spend there, and wash your hands well before you leave. Remember, too, that you likely didn’t think twice about using a public restroom before the coronavirus pandemic, even though it harbored (and still does) plenty of nasty illnesses like rotavirus and norovirus, both of which can be spread through contaminated feces.

  Is It Safe to Go to the Salon?

  Before the coronavirus outbreak began, going to the salon was an integral part of my self-care. I’ve always found it relaxing to have my hair done or get a manicure or pedicure—they’re activities that make me feel like I’m taking care of myself and nurturing myself. (Plus, it helps me not scare my patients or our ABC viewers!) But in our new normal, I’ve had to rethink whether these activities are worth the risk. In doing so, I’ve explored whether there are viable alternatives to being in a public place with other people. I’ve done this with other activities in this chapter, too. For example, instead of eating at a restaurant, I can get takeout—and for me, that’s a very viable alternative with a much, much lower risk.

  But with salon services, I haven’t found many viable alternatives. While I’ve learned to take care of my own fingernails and live without manicures, I can’t seem to maintain my feet no ma
tter how hard I try—these babies need professional help. And doing my own hair isn’t really an option because I’m on TV every day. For these reasons, I’ve made the decision to go to salons occasionally to have my hair done and get a pedicure.

  That said, I’m not running into every hair or nail salon I see in the city whenever my hair looks dull or my toes seem a little ragged (despite the fact there are hair and nail salons on almost every city block and my toes always seem to look a little ragged). Instead, I try to be selective about when, where, and how often I go.

  Whether you’re already at the salon regularly or thinking about a visit, here are the tips I use to make the experience safer:

  Rethink how often you go. Can you use a special product to touch up your hair color or your manicure at home to help it last longer? Could you try an at-home facial or beg your spouse for a shoulder massage? As a bonus, the longer you go between appointments, the more money you’ll save.

  Call salons in advance to find out what safety measures are in place. Some offer plastic or plexiglass barriers between guests and/or between you and the nail technician. (But note that some aerosol scientists consider these barriers “useless,” since particles can go around and above them.) Additionally, some businesses do temperature checks and/or limit guest capacity. The more safety measures in place, the lower your possible risk.

  Book an appointment during off-peak hours if your schedule allows. Even if a salon limits capacity, you’re more likely to encounter fewer people on a Monday morning than a Friday or Saturday afternoon.

  Don’t wait inside before your appointment. Ask the receptionist, stylist, or technician to call you when they’re ready for you.

  Ask your masseuse, facialist, stylist, or technician to open windows and doors to increase ventilation. Most businesses are happy to comply, especially if you explain it’s safer for everyone.

  Wear a mask and eye protection.

  Use contactless payment like Venmo or Apple Pay whenever possible and leave cash tips in envelopes.

  Is It Safe to Go to Houses of Worship?

  For centuries, houses of worship have helped fuel the spread of infectious disease—and the coronavirus pandemic is no different. Churches in South Korea, for example, helped spark the country’s initial outbreak, along with a second wave months later.9 A church service in Arkansas sickened thirty-five congregants, three who died, at the very beginning of the pandemic in the United States.10 As of July 2020, 650 cases of COVID-19 had been linked to nearly forty religious services and events nationwide.11 What’s more, published reports suggest that some infections occurred in houses of worship where congregants wore masks and followed social distancing guidelines.12

  What makes houses of worships so risky in our new normal? Churches, mosques, and synagogues by nature bring a lot of people together in one small space at the same time. They often include loud sermons and singing, both of which have been shown to transmit more viral particles. In addition, people often hug, kiss, or shake hands at religious services, even in our new normal when doing so is not advised.

  When you apply our four factors—time, place, people, and space—the answers often stack up that a religious service will be moderate to high risk. Most services are at least an hour long and are held indoors, often in poorly ventilated spaces, where people are often singing, forcefully projecting viral particles into the air. For these reasons, epidemiologists have ranked religious services as high risk.13

  I understand that religious services are a fundamental part of many people’s lives—and giving them up, for many, is simply not an option. If you choose to attend a religious service, acknowledge the risk and wear a mask and eye protection. Find a service that enforces a mask policy and social distancing measures. If you can, choose a service that doesn’t feature singing and/or prioritizes silent prayer over loud oratory. Don’t share hymnals or other worship items. Finally, speak with church or synagogue leaders about opening windows and doors, if they aren’t already, even in colder months.

  If you don’t have to attend in person, consider virtual services, which is how I’ve chosen to worship since the pandemic began. Since many services are now live-streamed, you can feel like you’re right inside your church, synagogue, or mosque, but without any of the risk. If you miss interacting with other congregants or spiritual leaders, attend an outdoor function like a church picnic instead.

  Is It Safe to Go to Museums, Theaters, and Concerts?

  First, some good news: No other category in this chapter may provide more safe, viable alternatives to in-person events than the arts. Museums, theaters, dance companies, Broadway performers, musicians, filmmakers, and other artists or art organizations have all stepped up in our new normal to offer a ton of online exhibits, shows, and performances. Virtual is obviously not the same as seeing these things live in person, but it can certainly help scratch the itch while keeping you and your family safe. Similarly, you can now find lots of outdoor exhibits and performances, which are much safer than their indoor counterparts.

  Your next safest bet if you’re craving a culture shot may be to go to a museum. In a museum, you can move from place to place, finding areas that are less crowded and also avoiding breathing in the same air of the same people for an extended period of time. There’s almost never any loud talking or singing in a museum by rule, and you can easily choose to visit during off-peak hours. Personally, I find museums magical at night, which is usually when they’re the least crowded.

  Theaters are trickier—and potentially riskier. In a theater, you’re sitting in the same spot for up to three hours at a time, and you might be in direct airflow of someone with COVID-19, even if they’re more than six feet away from you. Everyone should be wearing masks, however, which makes the activity hypothetically safer than dining at a restaurant. That said, I’d avoid going to a theater that sells food or drinks so that no one is pulling down his or her mask to munch or sip. Call in advance to make sure the theater you want to visit has closed its concession stand for this reason.

  Of all the arts, live concerts may be the riskiest in our new normal because, similar to houses of worship, many feature loud singing and talking. Concerts held with theater seating carry the same risks as regular theaters, while floor seats include the very real possibility that people won’t remain standing at least six feet apart for the entire show. If you’re craving live music, look for outdoor venues where the risk of transmission is much lower. Some famous concerts have been held outside at various amphitheaters and can be a safer alternative, especially if you wear a mask and follow social distancing measures.

  Using the information in this chapter, you can feel empowered to make the best decisions for you and your family about how to stay safe in public places. While you can never negate the risk of getting sick from COVID-19 or any other infectious illness if it exists in your town or city, you can learn how to navigate shared spaces more safely. You can also make decisions about what you do and don’t do in public spaces from a place of knowledge rather than one of assumption, misperception, or fear. Remember that COVID-19 will be with us for years to come. Learning to live safely with the virus—and any other pathogen that might come our way—while continuing to enjoy your life will allow you to stay happy and healthy in our new normal.

  Chapter 11

  Silver Linings

  There’s been no shortage of silver linings born out of the coronavirus outbreak. You’ve likely heard about some of them, if you haven’t experienced a few yourself: families spending more time together, friends reconnecting, everyone cooking more, millions finally finding time to slow down, take a breath, and discover new passions that have helped transform their lives or livelihood.

  If you’ve lost a loved one, you may have a hard time finding any bright breaks in the clouds—and understandably so. The same is true for anyone who’s lost their job, home, or business. Nothing can compensate for these losses, I realize. But without any loss at all, silver linings couldn’t exist
. By definition, it takes some dark clouds for a sun-edged periphery to appear, which is where silver lining gets its name. And looking for the silver linings is certainly better than remaining in the gloom without any sun to illuminate the dark.

  In this chapter, I don’t want to twist anyone’s arm to try to find a silver lining. And I don’t want to retell the personal stories of the pandemic’s positive outcomes, as amazing as they are, because they’re unique to each person. What I want to do is share with you the silver lining lessons that the pandemic taught us. What are the silver lining lessons? They’re the tough realities that we learned during the outbreak, and while they may have been difficult to grasp, we now have an opportunity to take advantage of the adversity and leverage of these lessons in order to improve ourselves and our lives.

  Let me tell you what happened to me. Several months into the initial outbreak, I was on set preparing to tape GMA3 when I looked over at Amy Robach, the show’s co-anchor and my friend for almost ten years—as long as I’ve been at ABC News. By this point in the pandemic, we had been working overtime for weeks, along with dozens of others at ABC News, to report on the virus, despite what was happening all around us in New York City and the rest of the country and world.

  As I glanced at Amy, the slide show of our friendship flashed through my mind. I was with her in a mobile mammogram truck, for example, when she had her first mammogram that detected her breast cancer. Years later, she was one of the first people at work whom I told I was getting a divorce from my then-husband, Rob. Several months after, she became one of my rocks at work when Rob ended his life. We were also both shocked by the death of one of the Good Morning America camera operators due to COVID-19. She constantly inspired in the early outbreak and motivated me, both professionally and personally.