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Interview With Dr. Monica Gandhi: ‘Arbitrariness of Shutting Down Completely’ Is Disturbing to P

A recent USC survey shows that even as officials have ramped up calls to restrict activities in recent weeks, at least in Los Angeles the percentage of people staying home hasn’t changed much since June.

UCSF infectious disease specialist Dr. Monica Gandhi has been critical of the current broad statewide stay-at-home order. The California Report’s Lily Jamali spoke with Gandhi this week about the wisdom of the current restrictions and what we’ve learned about the coronavirus since the beginning of the pandemic.

The following has been edited for length and clarity.

Given how much we’ve learned about COVID-19 since March, does the current lockdown make sense to you?

It doesn’t make sense to me in the same way it did in March. So when that happened, we had no idea what was going on. The spread was rapid and it was terrifying. We didn’t understand the nature of this virus and there was a lot to learn. Complete lockdown was absolutely indicated because we didn’t know if it was spread by surfaces, by fomites. I mean, there was something about it that was spreading so quickly.

So what have we learned about the virus? We’ve learned that it spreads very quickly because it spreads from asymptomatic individuals. Even when you feel well, you can have shedding of this virus from the nose and mouth and it can go out and infect others. That’s what led to the widespread universal masking recommendation, which is profoundly unusual for this country.

Then we learned that outdoors is safer than indoors. Ventilation matters when you have a mixture of airborne- and droplet-spread infection.

It matters to keep people apart — distancing —  and it also matters to do hand hygiene. Those four nonpharmaceutical interventions, masking, distancing, hand hygiene, ventilation, all of those come into play to keep people more safe.

And so taking what we learned when we want to reduce spread, what we have to do is close down things where there can be unsafe spread. But be cognizant that the public is aware that we have more knowledge about what’s safe, what’s not safe. So the arbitrariness of shutting down completely can be really disturbing to the public. And you don’t want to erode trust.

What should be the messaging around this virus, especially on a platform like Twitter?

The message that seems to be appealing to a wide range of people  is that we want to think about a harm reduction approach. But I don’t want that to be misunderstood. The coronavirus is really scary; it’s a true viral illness that causes suffering and death, and we have to do what it takes to minimize spread. So that’s the message.

However, the nuances get lost in whatever the tweet length is that you can send out. You message to someone acknowledging their pain, acknowledging their sense of loss, and acknowledging that they may choose to not just consider the pathogen when they make decisions for themselves. There are counties that are messaging that way, by the way. I mean, San Mateo is messaging in a different way, which is acknowledging that kind of pain.  And so it is possible within even the nuances of different counties in our system to message differently.

Copyright 2020 KQED