Medical Examiner

Even Epidemiologists Can’t Tell You Exactly What to Do Right Now

So much depends on your specific location and situation. Here’s how to tailor their advice to your life.

A person sits a table under a canopy placed outside a restaurant.
A restaurant in SoHo serves customers seated at sidewalk tables as the city moves into Phase 2 of reopening. Dimitrios Kambouris/Getty Images

For both practical purposes, and general mental well-being, it sure would be nice to have an idea of when we’ll be able to do anything without risking catching the novel coronavirus. If anyone knows the future, it must be epidemiologists, right? That’s why the New York Times surveyed 511 of them, earlier this month, to ask these experts when they think they would do everything from working in an office to attending a play. The possible answers included four time periods: “this summer,” three to twelve months, in more than a year, and “never.”

The survey results, presented in skim-able graphics, ran with major caveats. The art at the top of the piece was an embroidered patch of the words: “well, it depends.” The text explained that the epidemiologists responded “assuming the pandemic and response unfold as they expect.” (What they expected, exactly, was unclear.) But in addition to the 511 epidemiologists who replied, hundreds more declined to participate. And around 300 epidemiologists sent the Times a letter explaining their issue with the survey. The piece quotes a part of it—“Our concern is that your multiple choice options are based only on calendar time.” Their point is that time might not improve the coronavirus situation universally, and in fact—as the piece also caveats—things could get worse again.

As the story circulated, epidemiologists expressed concern. “I would take these results with a big grain of salt,” tweeted Sandra Albrecht, a Columbia epidemiologist who did participate in the Times survey. She’s part of a group of experts who answers questions about the coronavirus under the handle Dear Pandemic. I wanted to know what she thought not just of the one survey, but of all the information we’re getting from experts on how they behave (including one that published on Slate), and how we should think about incorporating that into our own lives. Without clear public health guidance, and with state-level reopening efforts driving spikes in cases, it’s extremely hard to figure out what to do. Our interview has been edited for length and clarity.

Slate: What was your reaction when you received the New York Times survey? 

Sandra Albrecht: When I saw the request to participate, I thought, ‘this is a really interesting way of getting feedback from epidemiologists and presenting information to the public.’ In other diseases that we study, it’s more theoretical for us. With COVID, it’s something that’s affecting all of us. It’s interesting to be able to provide feedback on how we would actually behave in the context of different scenarios, and to help guide the public in terms of how they might behave also to reduce their risk.

But when I opened the survey, I was a bit surprised at the questions—the way they were asked, and the options for responses. It was tough to answer a lot of those questions, because my response depends on a lot of factors. I debated whether or not to stop taking the survey, because I felt like my answers weren’t true to how I would really respond. But I decided to keep going. I was curious to see what the other questions were like, and I was certainly curious to see how the responses would be collated and presented to the public.

How would you have designed the survey? 

If I were administering these questions, I’d want to set up a scenario. I would say, “well, assuming cases and hospitalizations don’t go up in your area, would you engage in this behavior?” Other things I would take into account are the precautions that are being taken at the place I’m going to. For example, at a restaurant, are the tables far apart from each other? Are the staff wearing masks? What are the behaviors of the people going to the restaurant? If I pass by a restaurant and I see diners there are sitting next to each other, in big groups of people, I’m going to be less inclined to go to the restaurant. And then, my risk tolerance is going to be influenced by the availability of treatment. I think providing that context is important when asking these questions.

One thing that’s striking about the survey is the wide range of responses that epidemiologists give on when they’d do things—for example, 14 percent say they’d travel by plane now, but almost 40 percent say it would be over a year before they would. I’m wondering if you think that spread represents a wide range of risk tolerance, or if it’s because people are reading the questions and assuming different basic scenarios? 

I think it’s a bit of the latter. Different parts of the U.S. are in different phases of the epidemic. For example, I’m in New York City, where cases and hospitalizations are looking much better than in different parts of the country. If I were in Texas, Arizona, or Florida, I would respond quite differently. I think part of the variation that you’re seeing in the responses is a reflection of the fact that these experts live in different parts of the country. On top of these geographic differences, people are providing their opinions based on their own personal situations. I think someone who lives in a multigenerational household with high-risk individuals probably will be less comfortable with a particular level of risk than someone who lives alone.

What is your opinion on stories where experts rank activities in terms of risk?

These can be a useful guide, but they’re a rough guide. They’re starting point. You have to take that information and place it into the context where you are. For example, one included libraries. There may be some places where, in libraries, there aren’t as many people there, and it may be a bit quieter, so that’s why it’s ranked as a place that’s lower risk [3 out of 9 on the scale in that story, below pools]. But in a place like New York city, where there are a lot of people, a lot of children interacting, it might not be a low risk location. It depends on the geographic area. The rankings depend on the place where the experts are located. That ranking was out of Michigan, and a humorous inclusion was about pontoon boats. People were asking, ‘Why is this even on this list?’ I think maybe in New York city we’re confused about that. You have to think about where the ranking was developed.

What kinds of questions are your own family members asking these days?

In terms of family, the main questions that I get that are understandable but tough to answer are “when will this be over,” and “when can we get back to normal.” My response, at least right now, is “we don’t know when this will be over, and I don’t think it will be over.” Which is a really negative way to look at it. It’s something that we’ll need to learn to live with in the background,  just as we learn to live with the flu and other diseases. People are having a very hard time with the guidelines that are put in place, and they were used to living a certain way, and now we’re forced to live a different way.

“This won’t be over”—what do you mean?

We’re not necessarily going to get to a place where COVID has been eradicated, and we never have to think about it. We’ll get to a place where it’s not the main subject of discussion, certainly if we have a vaccine and have good treatment. COVID is something we’re going to need to learn to live with in the background, which will involve living our lives in a way that’s a bit different.