By Peter Schelden
They are not using public transport; No buses, trains, or airplanes. They are not nurses, doctors, or other essential workers. Many have been sheltering at home for months.
Why, then, are two out of every three people infected with COVID-19 at home?
How people who seem to be following sheltering guidelines can contract coronavirus remains a perplexing problem. A recent New York survey found that 66% of people with COVID-19 infection are sheltering in place.
In an announcement, Andrew Cuomo called the news “shocking.”
“We thought maybe they were taking public transportation,” the New York governor said. “But actually no, because these people were literally at home... We were thinking that maybe we were going to find a higher percentage of essential employees who were getting sick because they were going to work. That these may be nurses, doctors, transit workers. That’s not the case, and they were predominantly at home.”
The numbers rise even higher for people in their 60s, he said. For that group, the percentage of infected who stay at home was found to be 84%.
Why Are Most People With COVID-19 at Home?
Cuomo offered possible reasons why. Maybe residents aren’t wearing masks as they should. Maybe they aren’t using hand sanitizer. Maybe younger people, who are at lesser risk, were being careless and spreading the virus to older friends, neighbors, and relatives.
But it could be that people are becoming more careless than they think over time, said Charles Patrick Davis, MD, PhD, an emergency medicine doctor and microbiologist who sits on MedicineNet’s editorial board.
“One of the reasons that they may still be getting infected is that they let their guard down a little bit,” he said. “Essentially we’ve been on shut down for over two months now, and people get stir crazy.”
Although we think we are taking care to prevent infection, it may not be so, Dr. Davis said. For example, the masks available to the public today are not the same quality that would stop an infection.
“Even if they are wearing a mask, they’re not wearing an N-95 mask,” he said. “They’re wearing a mask that’s a bit less effective if they run across somebody shedding the virus, so there’s still a possibility they’re coming down with the disease.”
There could be other reasons as well.
For one, the novel coronavirus affects every person somewhat differently.
“The problem is that we don’t have a perfect handle on this virus. This virus works differently in almost every person,” Dr. Davis said.
He said the range of reactions is enormous, starting with those who become infected but show no symptoms—the so-called asymptomatic carriers—all the way to those who ultimately die from COVID-19 after a grueling struggle on a ventilator.
High-Density Urban Areas May Make COVID-19 Easier to Spread
This may be a particular problem in tightly-spaced urban landscapes like New York City, said Michael Bohl, MD, MPH. He points out that even people who stay home may need to use elevators to do their laundry, or they may share the same circulated air.
If you are worried about catching SARS-CoV-2, the coronavirus that has infected nearly 5 million people worldwide, Dr. Davis advises that you do your best to follow the advice of health experts.
“Continue to take precautions,” he said. “That’s the best that you can do at this point in time. We don’t have a definite drug that will take care of the virus, we don’t have a vaccine available, so the best you can do is to avoid trying to get the virus.”
For that, he recommends keeping your distance, avoiding crowds, and following good hand-washing techniques.
But Dr. Davis also recommends keeping your worry in check.
“It’s OK to be a little bit worried, but that should not rule your life,” he said. “You should try to make the best you can of your sequester time.”