A surprise display of fireworks sponsored by Macy's explode over the Hudson Yards area of Manhattan as seen from a pier in Hoboken, N.J., Tuesday, June 30, 2020. The fireworks were not announced until an hour or so before to avoid attracting large crowds. (AP Photo/Kathy Willens)
A surprise display of fireworks sponsored by Macy's explode over the Hudson Yards area of Manhattan as seen from a pier in Hoboken, N.J., Tuesday, June 30, 2020. The fireworks were not announced until an hour or so before to avoid attracting large crowds. (AP Photo/Kathy Willens)

Medical experts have advised Americans to spend time outdoors, practice social distancing, wash and sanitize their hands, avoid large crowds, and limit contact with people outside of their household.

The United States will celebrate Independence Day this weekend under the increasingly grim shadow of a pandemic that is spiraling out of control. Public health officials are warning that Fourth of July celebrations could make things even worse.

“I think it is a critical moment for the public health message to be given out and heard,” Dr. Robert Kim-Farley, a medical epidemiologist and infectious diseases expert at the UCLA Fielding School of Public Health, told the Los Angeles Times. “Traditionally, the Fourth of July has been such a time for large gatherings and beach going. If those same practices occurred, we could be back with even a further spike upon our spike that we’re having now.”

California is one of a handful of states that have reinstituted restrictions amid surging case counts—many of which have been tied to celebrations of the nation’s most recent holiday, Memorial Day, as well as state reopenings, which also occurred around that time. Bars in at least 19 counties have been ordered closed, and Los Angeles County, Long Beach, and Laguna have ordered their beaches closed over the weekend. Arizona, Texas, and Florida have also shuttered bars after they were linked to new outbreaks, while cities in Pennsylvania have canceled several fireworks displays amid rising case counts.

But states like South Dakota appear to be shrugging off concerns about public events. Republican Gov. Kristi Noem said on Monday that people attending the state’s Independence Day event at Mount Rushmore—at which President Trump will be present—will not be required to wear masks or social distance. 

“We will have a large event on July 3. We told those folks that have concerns that they can stay home, but those who want to come and join us, we’ll be giving out free face masks, if they choose to wear one. But we will not be social distancing,” Noem told Fox News’ Laura Ingraham.

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Trump’s attendance at an event that refuses to mandate masks or social distancing flies in the face of advice given by the government’s top infectious-disease expert, Dr. Anthony Fauci. Fauci discouraged people from attending events 

During a Wednesday IGTV interview with Jessica Yellin, Fauci was asked about his thoughts regarding the July 3 event. “You should avoid—whenever possible—gathering in crowds where people cannot maintain physical distance,” he replied. “Avoid crowds, wear a mask, keep physical distance. It doesn’t matter what the reason for the congregation, whether it’s a celebration here, the demonstration there. It doesn’t make any difference—wear a mask.”

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*** Want to receive nightly videos by text? Text “Send Video” to 202.918.3794 *** This is the big one. An interview with Dr. Anthony Fauci! He is the nation’s leading infectious diseases doctor, Director of the @niaid, and a member of the White House Coronavirus Task Force. In the interview, I ask: • Why it's hard for some to still get tests they need. He said, “There seems to be somewhat of a disconnect, ” getting all tests “to the right places.” • Should cities like Los Angeles facing COVID spikes go back to stay-at-home? He said he doesn't “want to get ahead of the mayors,” but that “they may need to then maybe go back to a different phase or there may maybe even go further back.” Well, since Los Angeles is at phase 2, going even further back means…stay-at-home right? Also covered: Is it time to push for a mask-wearing mandate? What’s his advice about the no-mask, no-distance required Independence Day celebrations planned at Mount Rushmore? What standards must be met for schools to re-open? He says public figures with big fan bases can save lives by promoting best safety practices. You’ll notice he deflected some questions as ‘too political.’ In a separate video I’ll talk about politics and public health. If you can, please support this work at patreon.com/JessicaYellin. #newsnotnoise #wegotfauci #drfauci #publichealth #wearamask #publicsafety #July4th #southdakota #mountrushmore #testing #stayathome

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Trump is also holding a July 4th celebration on the National Mall in Washington, D.C., on Saturday, featuring one of the largest fireworks displays ever. As many as 300,000 face masks will be given away, but attendees will not be required to wear them, despite concerns from the city’s mayor.

As states, counties, and cities go their own way and leaders contradict one another on the severity of the crisis, ordinary Americans are increasingly confused about what’s safe and what’s not, and how they can celebrate the Fourth of July and minimize COVID exposure. To address this issue, COURIER put together a guide for how to approach the holiday.

Precautions to Take in Any Situation

Wearing a face mask in any setting outside of your own home is perhaps the best precaution you can take. Studies have shown that wearing a mask can dramatically reduce transmission of COVID-19. In late May, two hair stylists in Missouri had close contact with 140 clients while sick with COVID-19. Everyone wore a mask and not a single client tested positive.

“The absolute best thing is to wear a mask and wash your hands as soon as you get home and don’t touch your face in between,” said Dr. Dara Kass, associate professor of emergency medicine at the Columbia University Medical Center. 

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Medical experts also advised Americans to practice social distancing, wash and sanitize their hands, avoid large crowds, and ideally, limit contact with people outside of their household.

“I would maintain good hand hygiene, wear a mask when in public locations and maintain social distance,” said Dr. Krutika Kuppalli, an infectious diseases physician and Vice Chair of the IDSA Global Health Committee.

What’s Safe

While much of the science surrounding COVID-19 remains uncertain, a consensus has emerged that being outdoors around people not in your household is much safer than being indoors around them. A paper out of Hong Kong found that of 7,324 documented cases in China, only one outbreak occurred outdoors. Another study from Japan concluded that the risk of infection in a closed, indoor environment is nearly 19 times higher than in open-air environments.

Spending time at parks, beaches, or hiking paths are among the safest things you can do, assuming you take proper precautions. But public outdoor spaces are not full-proof. 

“The big risk here comes from public spaces, like restrooms and other gathering areas, where you may be in close contact with others,” said Dr. Robbie Goldstein, a physician and infectious disease specialist at Massachusetts General Hospital.

These places also become far less safe if you’re around large crowds, according to Dr. Pritesh Gandhi, associate chief medical officer for a community health clinic in East Austin, Texas. “Partying on a crowded beach offers quite a different level of risk than taking a walk with your partner on an isolated beach.”

Keeping groups small is also critical. “I would limit gatherings to the least number of individuals as possible. Each individual you have increases the risk you may be exposed to coronavirus,” said Dr. Kuppalli.

What’s Not Safe

Bars, restaurants, movie theaters, bowling alleys, or other indoor entertainment venues are considered to be some of the least safe settings, according to medical experts. They’re all public, indoor spaces that can get crowded and where social distancing is difficult, thus increasing the risk of contracting the virus. 

“Being indoors for a prolonged period of time around people you don’t know increases risk of transmission,” said Dr. Gandhi.

Outdoor bars and restaurants are a little safer because “you are not sharing the same re-circulating air for a prolonged period,” according to Eleanor J. Murray, assistant professor of epidemiology at Boston University School of Public Health. But, she noted, they’re not without risk. “There are still plenty of shared objects and surfaces (including plates, cutlery, and tables, but also restrooms and credit card machines).”

The Bottom Line

  • Wear masks and social distance
  • Outdoors is better than indoors
  • Avoid crowds

Why Taking Precautions This Weekend Matters So Much

Americans typically commemorate the Fourth of July in grand fashion, attending parades and fireworks displays. But this year, the holiday could worsen the nation’s already catastrophic coronavirus outbreak.

The U.S. represents 4% of the world’s population, but accounts for 25% of all cases and deaths from COVID-19, recording nearly 2.7 million cases and more than 128,000 deaths as of Thursday morning. The nation’s outbreak is only getting worse too, as the U.S. reached another bleak milestone on Wednesday, recording more than 50,000 new cases in a single day.  

On Tuesday, Fauci predicted the country could soon see 100,000 new coronavirus cases daily. “I’m very concerned, I’m not satisfied with what’s going on, because we’re going in the wrong direction,” he said. “I would not be surprised if we go up to 100,000 a day if this does not turn around.” 

Fauci said he could not project an estimated death toll, but said it would be “very disturbing.” 

If the Fourth of July draws large crowds and sees Americans descend on bars and restaurants, those numbers could get even worse.