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What's the COVID-19 risk of different summer activities in Connecticut?

Those who are strict about social distancing and cautious about going out during the COVID-19 pandemic, but still want to enjoy themselves, may want "experts" to tell them exactly what they should and shouldn't do.

But it's not that simple.

In her response to a survey for The New York Times, epidemiologist Melissa Sharp noted she embroidered "Well, it depends" in needlepoint — one of her quarantine hobbies — "because that's really our slogan."

"Evaluating risk is not a clear-cut exercise," the cooking website Delish wrote in June, noting that the recommendations that followed from experts on the risk level of 23 summer activities should be taken with a grain of salt. "Activities don't fall neatly into 'risky' and 'safe' categories, especially because there are typically dozens of factors at play."

Still, we wanted to know what some public health and medical professionals thought of certain summer activities one can do in southeastern Connecticut, and to see where there was and wasn't consensus.

The Day sent a list of activities and got input via email from Dr. Oliver Mayorga, chief medical officer for L+M Healthcare; Dr. Faiqa Cheema, assistant director of general infectious disease at Hartford Hospital; and Karl Minges, chair of the Health Administration and Policy Department at the University of New Haven.

Mayorga clarified that all his responses assume social distancing. Not everyone responded to all activities The Day listed, while some added others.

Renting a kayak or stand-up paddleboard

What the experts say: All three rated this as low risk, with Minges providing the caveat that the person renting the equipment is wearing a mask, practicing social distancing and making hand sanitizer available. He also suggested asking how boats, boards and paddles are cleaned.

Where you can go: Adventure MysticBlue Heaven Kayak Paddle Board Rentals in Mystic, Stonington Marina, Mechanic Street Marina in Pawcatuck, Three Belles Outfitters in Niantic, Black Hall Outfitters in Old Lyme and Cove Landing Marine in Lyme.

Outdoor mini-golfing

What the experts say: Mayorga and Cheema both said low risk, as did Dayton Children's Hospital in Ohio, in a graphic of risk levels for family activities.

Where you can go: Copper Creek Mini Golf at Nature's Art Village in Montville.

Picking fruit at an orchard

What the experts say: Mayorga and Cheema both called this low risk, with Cheema giving the caveat that you're with immediate family and the orchard isn't crowded.

Where you can go: You currently can pick blueberries at Holmberg Orchards in Ledyard and Scott's Yankee Farmer in East Lyme, and peaches are coming soon at both.

Going on a ropes course

What the experts say: Mayorga and Cheema both rated this low risk.

Where you can go: Fields of Fire Adventure Park in Mystic.

Eating at an outdoor seafood shack

What the experts say: Mayorga and Cheema said low risk, with Cheema saying that if people have to stand in line, they should wear masks and stand 6 feet apart. Minges rated it medium risk, depending on how far apart the tables are and whether one must go through the restaurant to reach the patio.

In a ranking that physicians from the TMA COVID-19 Task Force and the TMA Committee on Infectious Diseases completed of 37 activities, the Texas Medical Association marked eating at an outdoor restaurant as low to moderate risk.

Where you can go: Restaurants are open up and down the shoreline.

Going to the beach

What the experts say: The risk of a beach trip depends on how crowded it is, which depends on parking lot capacity, whether you go on a weekday or weekend, and what time you go.

Mayorga, Cheema and Minges all considered going to the beach on a weekday or at night to be low risk. Cheema categorized going on a weekend day as high risk if it's a crowded beach day, while Mayorga put a weekend beach trip as low risk and Minges said it's low risk if the beach doesn't exceed capacity.

Minges said one "must arrive early, as most public beaches reach capacity by (10 a.m.) on the weekends. If possible, save beach days for the weekdays."

The Rhode Island Department of Health calls "spending the day at a beach or pool" a lower-risk activity, noting that beaches are safer than pools and it's better to go in the morning or late afternoon to avoid crowds.

Where you can go: State and town beaches are open at limited capacity.

Doing an outdoor yoga class

What the experts say: Mayorga called this low risk if people are social distancing, while Cheema called it medium risk with limited people, saying class size should be limited to seven to 10.

Saad Omer, professor of infectious diseases at the Yale School of Medicine, told TODAY that even when outdoors, people should focus on low-impact exercises like yoga and Pilates. He also said instructors should make themselves heard without yelling to avoid spreading droplets farther.

Henry Raymond, associate professor in the School of Public Health at Rutgers University, said solo exercise still is preferable. But he told The Washington Post the risk drops to a tolerable level if participants in group classes avoid clustering, mark off personal exercise areas and wipe down equipment.

Where you can go: Blissworks Yoga and Healing Arts is holding yoga classes at Harkness Memorial State Park in Waterford. The Kula Project is holding classes at duBois Beach in Stonington Borough. Sara Kimball is teaching yoga classes on the deck at Mystic Seaport Museum on Wednesdays in August, while HOMEyoga is holding yoga classes at Washington Park in Groton. Baptiste power yoga teacher Julia Reid is leading free classes in Wilcox Park in Westerly on Tuesdays.

Hosting or going to a backyard barbeque

What the experts say: Mayorga and Cheema both said the limit should be 10 people, and respectively classified this as low risk and medium risk.

Calling it low to medium risk, Minges said, "Research has shown that people are more likely to engage in risk behaviors in familiar or informal settings, such as a backyard barbeque. What this could mean, is people will be less inclined to wear masks, wash hands, and maintain a social distance."

The Rhode Island Health Department referred to a "BYOB backyard gathering with one other household" as a lower-risk activity and advises people to avoid sharing food, drinks and utensils. The department also said limiting alcohol consumption reduces the risk, since alcohol "makes people less careful, increases need to go in house to use bathroom."

Danbury Hospital said that "attending a small backyard gathering where all participants maintain social distancing, wear face masks, and bring their own food, beverages, and supplies" would be low risk, whereas "a large backyard cookout with shared food, beverages, and supplies where participants do not social distance or wear a face mask" would be high risk.

Walking around a museum

What the experts say: This has people split. Mayorga called this low risk if people are masked, Cheema said high risk and Dayton Children's grouped going to the zoo, museums and aquariums together as medium risk. The Texas Medical Association marked going to a library or museum as moderate-low risk.

Where you can go: Lyman Allyn Museum in New London is open and free all summer. Florence Griswold Museum in Old Lyme, Mystic Seaport Museum, Mystic Aquarium and Children's Museum of Southeastern Connecticut in East Lyme also are open.

Doing karaoke

What the experts say: Mayorga called this moderate to high risk indoors, Cheema said high risk and Minges said it's high-risk regardless of whether it's done inside or outside.

The microphone "has the potential to become contaminated if someone is singing without a mask," Minges said. "Moreover, singing has the potential to produce a significant amount of aerosol, which is the primary mode of COVID transmission. If proper facemask use if maintained, and the mic is disinfected after each use, the risk can be lowered to 'medium.'"

The Centers for Disease Control and Prevention found that after a 2.5-hour choir practice 61 people attended in Washington state in March, there were 32 confirmed and 20 probable COVID-19 cases; three were hospitalized and two died.

Some other activities

Mayorga and Cheema each added some other activities. Mayorga categorized tennis as low-risk, going to a church wedding as moderate risk, and going to a reception or bridal shower in a restaurant as moderate to high risk. Cheema believes that going to casinos, attending a service at a place of worship, going to bars, and eating at a buffet indoors are all high-risk.

Dayton Children's Hospital categorized amusement parks, movie theaters, bounce houses, trampoline parks and vacation with air travel as high risk.

The Texas Medical Association ranked going to a bar, attending a religious service with more than 500 worshippers, going to a sports stadium, attending a large music concert, going to a movie theater, going to an amusement park, working out at a gym and eating at a buffet as high risk.

Dr. Hilary Babcock, infectious disease specialist with BJC HealthCare in Missouri, told Delish that having a drink on a friend's porch is "one of my favorite ones because you can usually sit six feet apart pretty easily, and you're outside and you can chat and have a lovely time."

NPR also put together a guide in May of how experts rate the risk of 14 summer activities.

Difficult to rate

Sue Dubb, public health nurse for Uncas Health District, said in an email that she and district Health Director Patrick McCormack believe the risk level depends more on how these activities are executed — meaning that social distancing, wearing masks and frequent hand-washing "should be enough to protect people."

"I think right now, our biggest enemy is complacency ... people will take their masks down 'just for a minute' because it's too hot out during the activity, items might not be cleaned as vigorously as they were a few months ago," Dubb said.

In a phone call last week, Steve Mansfield, director of health for Ledge Light Health District, also declined to rate the risk of individual activities, saying they're opinions and not science based. Referencing the 37 activities the Texas Medical Association ranked, Mansfield said he agrees with a lot of things but strongly disagrees with others.

He also noted he has "no idea how to rate a ropes course because I've never been to one," and generally said he'd "much rather attend a well-structured event that has strict protocols in place" than walk in downtown Mystic on a weekend.

Mansfield said his key message is, "The more you can reduce the amount of time with people not in your immediate household, the safer you're going to be."

e.moser@theday.com




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