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What A Summer Of COVID-19 Taught Scientists About Indoor vs. Outdoor Transmission

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Here we are, almost eight months into this pandemic, and it’s like you can’t even invite more than 150 people to sit next to each other unmasked in your rose garden without it turning into a major superspreader event. The White House outbreak is now linked to at least 40 cases, including some that led to hospitalization. As autumn settles in and the holidays loom, it’s worth pausing to ponder what we’ve learned about COVID-19 transmission over the last few months. We’re now entering a time of year when many of us will want to bring our communities together, and when the cold and the dark can increase feelings of isolation. So how do we calculate our own personal risk, while also avoiding … shall we say, bad examples? Just what are we in for this winter, anyway?

Making predictions about what will happen in the winter based on what has happened so far is simultaneously simple and difficult, experts told me. It’s simple, in that we already know what we need to know to tell that this virus isn’t just going to magically disappear. “I think winter will be bad, because things are already bad,” said Colin Carlson, a professor at Georgetown University’s Center for Global Health Science and Security. From the beginning of the pandemic through Oct. 17, some 217,000 Americans died of COVID-19 and almost 8 million others tested positive for the virus. There’s no reason to assume that the shifting of the seasons is going to reduce the number of overall cases — so fall and winter are likely to go on being bad.

But understanding how seasons can change the pandemic is genuinely difficult. There are a couple of reasons for that. First, while we know that changes in weather have an impact on this virus, there’s a lot of nuance around those effects.

For example, the virus that causes COVID-19 is sensitive to high temperatures and exposure to UV light. But that doesn’t mean weather is the primary thing determining how the virus spreads. “We don’t need cold weather for significant transmission,” said Dr. Daniel Bausch, a virologist and the director of the United Kingdom’s Public Health Rapid Support Team. “It seems to be propagating quite nicely in hot, humid, close-to-the-equator places.” And studies have found that the weather’s impact on the virus probably plays a relatively small part in controlling transmission. In one study, exposure to UV radiation only decreased transmission by about 1 percent. Summer didn’t make the virus disappear, and the chilly weather isn’t, by itself, likely to drastically increase the severity of the pandemic, either.

The other reason it’s difficult to understand the seasonality of COVID-19, though, is that we are missing some key data. Let’s return to the White House outbreak, which was centered around an outdoor event. There’s only been very limited contact tracing done. And there’s not a lot of clear documentation about how people at either event behaved. How many people spent time inside, versus outside? In general, Carlson asked, if people are moving back and forth from inside to out, how do you know where they contracted a virus?

Likewise, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, we don’t know how much virus makes an infectious dose nor how much exposure is required to reach that point — and because of that, it’s been hard to pin down exactly which circumstances led to transmission. In other words, the difference in transmission between the White House event and crowded bars may not be contradictory at all — it just may indicate that, at the former, people spent more time indoors.

And if there is one thing we can definitively state, it’s that this virus is much, much less likely to spread outdoors than in. For example, in a study of 7,324 Chinese case reports, only two — part of the same transmission event — could be linked to outdoor settings. A database of more than 20,000 cases (including the 7,324 Chinese cases) found 461 that were associated with transmission in completely outdoor environments — predominantly crowded events like markets and rallies. Overall, only 6 percent of all the cases in that database were linked to events that were either totally or partially outdoors. The rest were tied to indoor events. That fact is actually why experts are concerned that fall and winter could lead to an increase in transmission — not because it’s colder, but because people are spending more time inside.

Why does that matter? Some of it has to do with the physics of air movement, said Linsey Marr, a professor of civil and environmental engineering at Virginia Tech. If you’re standing right next to someone else, there won’t be enough time for sun and heat to break the virus down before you breathe it in. But there is enough time for the wind to blow it away. “Imagine someone who is infected as a smoker,” Marr explained. “If someone is smoking, and you want to minimize your exposure, would you rather be indoors or outdoors with them?”

Air circulation isn’t the only thing at play here, though. After reviewing dozens of studies on the transmission of the novel coronavirus in outdoor settings, Mike Weed, a professor of applied policy sciences at the U.K.’s Canterbury Christ Church University, found that outdoors was safer even before social distancing and mask wearing became the norm. He thinks that is because people just naturally behave differently outside. We don’t pack together like we do in a subway car or elevator. Most adults don’t sit right in their friends’ faces when they’re just having a backyard beer. “Risk outdoors is low regardless of social distancing. But it has to be said that in everyday life, when people are milling around outdoors, people tend to naturally social distance,” he told me. “We think personal space is part of why outdoor transmission is low.”

The situations he found where clusters were associated with outdoor transmission tended to be times when people were, as Weed put it, “invited or required to break natural social distance.” These event-specific behaviors might help explain why Weed found clusters associated with farmers’ markets, where people crowd around the stalls, but not with people just hanging out in the park. And event-specific behaviors could also explain other apparent contradictions — like the fact that protests after a Minnneapolis police officer killed George Floyd didn’t seem to have sparked any transmission clusters.

In that case, you’re talking about events that happened mostly outdoors in crowds. The protests also revolved around chanting and singing and yelling — things we know can spread more of the virus further. But it’s not a normal thing for people to stop by the bar on the way home from a protest, or congregate inside before or after the event. Meanwhile, researchers speculated that the protests and riots that followed may have kept a lot of other citizens who weren’t participating off the streets — reducing the overall number of people who could be exposed.

Because human behavior and air circulation probably matter more than the weather itself, the upcoming holiday season won’t look the same in all parts of the country, Marr said. This isn’t about getting colder, it’s about spending more time inside sealed-up buildings. In June, that meant more transmission in places like Texas, as climbing temperatures forced people into air-conditioned homes and businesses. In October, she said, that could flip-flop, with rates of transmission falling in Texas while they climb in places like Minnesota or Maine.

So what does all of this tell you about your hopes for hygge and holiday get-togethers? If nothing else, it should show you that turning data into personal risk choices isn’t cut and dry, Carlson said. Neither “indoors” nor “outdoors” is universally safe. Indoors with a small number of people and a good ventilation system bringing fresh air in at least six times an hour is a different risk than indoors in a large group singing without good ventilation. Outside at a protest, masked up and walking, is a different risk than unmasked and packed side-by-side into a football stadium.

Where you choose to take your risks, and how, tells you something about not just the science, but your own values.

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Toronto FC hoping to make MLS Cup run having spent much of 2020 far from home

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On a recent Thursday in Hartford, Conn., Toronto FC goalkeeper Quentin Westberg pondered the dichotomy of wanting to reach MLS Cup on Dec. 12, but also desiring to see his family again. Meanwhile, Jim Liston, the team’s director of sports science, was planning a trip to Lowe’s to buy 15 garbage cans so players could have an ice bath after training. As for manager Greg Vanney, he was fretting about his team’s health and the lack of practice time their schedule was affording.

Such is the life of a team as it attempts to not only navigate its way through the COVID-19 pandemic, but has been forced to do it away from home.

Due to travel restrictions between the U.S. and Canada, TFC — like the league’s other two Canadian teams, Montreal Impact and Vancouver Whitecaps — set up a “home” base in the U.S. for the remainder of the season; Toronto were stationed in Hartford. (Vancouver Whitecaps took roost in Portland, ground-sharing with Timbers, while Montreal Impact split use of New York Red Bulls’ facilities in Harrison, N.J.) This was on top of nearly every team spending nearly a month inside a bubble back in July at the MLS is Back Tournament outside Orlando, Florida.

The Reds spent about seven weeks back in Toronto as they played a series of matches against Canadian teams. In mid-September, the remainder of the regular season — and the temporary move to Hartford — beckoned. The vagabond nature of the campaign is what led Liston to joke that he was willing to discuss “whatever five seasons” the team has been through so far. But for Vanney and the players, the campaign has required a special kind of focus.

“A lot of what we’ve done here, and what we try to preach here is just control the controllables, and don’t get too drawn into the things you can’t,” Vanney told ESPN. “Roll with it, and make the best out of whatever the situation is.”

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Toronto has largely succeeded in spite of its odyssey. While there was disappointment at missing out on the Supporters’ Shield to the Philadelphia Union, TFC went 7-3-2 during its Hartford sojourn and finished with the second-best record in the league. But the challenges have still been immense. Simply being out of one’s home environment is difficult enough, but the time spent away from family and loved ones weighs heavy on the psyche, even as Vanney has given players the occasional trip back to Toronto — under quarantine — to reconnect with loved ones.

“It’s just very different, very challenging and emotionally exhausting,” Westberg said of his experience while based in Hartford.

Westberg has arguably had it tougher than most. The TFC goalkeeper is married with four children, including a baby girl who was born in June. For that reason, Westberg and his wife, Ania, made the decision at the end of September that it would be better for her and their kids to head back to his native France so they could be surrounded by family. Westberg called it “the least bad decision,” but there are difficulties nonetheless.

“I’m a very even person, and this year has challenged me a lot,” he said. “I’m still pretty even, but I keep a lot to myself and for sure there’s some difficult days, seeing your family [struggle] from your absence.”

The inability to be home has affected the players and staff in other ways. In Toronto, there are ways of disengaging from the game. Being with friends, loved ones or even in familiar surroundings can be the best medicine in terms of forgetting a bad game or training session. But in Hartford, at the team’s hotel, that escape is nearly impossible even as players try to distract themselves by reading or taking online classes.

“You don’t really unplug,” Westberg said. “You FaceTime family, or this or that, but it’s too short. You’re 100 percent focused on your soccer, and your whole day basically relies on being ready for whatever soccer activity that you have next, whether it’s practice or game. It’s good for your physique, it’s optimal for the way you eat and the way you [train]. But mentally, you’re not as fresh as your body.”

That isn’t to say there are only negatives to the separation. There is also an us-against-the-world mentality that Toronto has adopted, given that their players and personnel are experiencing the season in a way that is vastly different than most other teams. The team staff has done what it can to make their surroundings a home away from home, whether it’s personalizing the locker rooms at Rentschler Field or having hotel staff brand the surroundings in TFC colors. The hotel went so far as to bring in a barista who could consistently give the players their coffee fix. Supporters groups have even sent down banners in a bid to convey the fact that the players are remembered.

The care that TFC takes for players has extended to families back home, with the club supplying meals to loved ones three times a week.

On the logistical side, Liston made sure that one of the gyms used at MLS is Back was brought to TFC’s hotel in Hartford, and he remarked that the food at the hotel is “arguably the best we’ve ever had on the road.”

There have also been efforts to create new routines. Assistant coach Jason Bent, aka DJ Soops, has been in charge of the pregame music selection for the past 18 months — no easy feat for a squad that has a considerable international presence. In Hartford, Bent has set aside Thursday nights to spin music in one area of the hotel. He’ll even go live on Instagram or Twitch for those who prefer to relax in their rooms.

“[We] opened it to players and staff and basically anyone that’s part of our bubble to come relax, listen to music and just enjoy each other’s company,” Bent said. “I enjoy making people happy so if it’s helping everyone even in the slightest, I have no problem arranging the set and spinning.”

For Vanney, the pandemic and operating outside of the team’s home market has meant any number of challenges. He said the team has used three different training facilities in Hartford, with varying field conditions. He recognizes that the trips home are vital for the mental health of his players and staff, but any breaks also mean less time spent on the practice field. The compressed schedule, which at times involved games every three or four days, has had an impact as well. Even the best-laid plans in terms of squad rotation were impacted as minor injuries began popping up.

“We end up with a lot of guys in different positions because they need special kinds of treatment or care to help them get fit and back to health,” Vanney said. “So it ends up being a lot of different things kind of going on all at once, and that’s been the challenge of it.”

Recovery from matches has been complicated by the fact that TFC doesn’t have access to the same level of facilities that it does at home — hence Liston’s emergency trip to Lowe’s to fashion impromptu ice baths for the players. Then there are the different ways the players occupy themselves on the road as compared to home, especially amid the pandemic.

“There’s really no life outside of the hotel,” Liston said. “[At home], you may go walk the dog in the afternoon or go for a walk with your wife or friend or girlfriend or family and you’re out and about. The recommendation [here] is to kind of stay put. So you’ve got a really active population and pro athletes, who we’re asking them to be sedentary the rest of the time, kind of stay in the hotel from a COVID and safety standpoint. That’s not optimal for recovery either.”

There are also the creature comforts of home that are no longer available on the road, which can impact sleep.

“Sleep is the number one tool for recovery, and that’s definitely been a challenge,” Liston said. “We do well-being questionnaires and the scores on quality of sleep, and hours of sleep, just drop.”

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Another change has been same-day travel, which has drawn mixed reactions from the TFC players and staff. Vanney and Westberg are generally in favor, saying it reminds them of when they each played in France. Flying back the same night also means a training day isn’t lost. Liston has a different perspective in that he prefers arriving the day before, and then leaving the same day.

“I think [same-day travel] makes for a really long day,” he said. “And there’s definitely a negative impact on performance, taking three bus rides and a plane ride before your game. You’re getting home — it can be 12:30, but it could also be 1:30 in the morning, and that’s where you know our well-being scores and sleep hours and quality just disappear. When you have so many games in succession, you can’t make up the sleep.”

With the playoffs set to begin for TFC on Nov. 24, the end is in sight, even as it makes for a complex — and even conflicting — set of emotions.

“This is the tricky part. I miss them a lot,” Westberg said of his family. “But in a way I want to see them as [late] as possible in December, because obviously, there’s this idea that we want to do well in the playoffs and we want to keep going. TFC has a history of setting high standards and high expectations. It’s a heavy load to carry but also an exciting one.”

Win or lose, it’s a season they’ll never forget.

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Bettman: NHL is mulling temporary realignment

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The NHL is considering a temporary realignment of its teams for the 2020-21 season due to COVID-19 travel restrictions, according to commissioner Gary Bettman.

Bettman said Tuesday that restrictions on travel across the Canadian border, as well as “limitations in terms of quarantining when you go from certain states to other states” within the United States, could mean the NHL creates a more regionalized alignment for its upcoming season.

“As it relates to the travel issue, which is obviously the great unknown, we may have to temporarily realign to deal with geography, because having some of our teams travel from Florida to California may not make sense. It may be that we’re better off — particularly if we’re playing a reduced schedule, which we’re contemplating — keeping it geographically centric and more divisional-based; and realigning, again on a temporary basis, to deal with the travel issues,” Bettman said during a 2020 Paley International Council Summit panel with fellow commissioners Adam Silver of the NBA and Rob Manfred of MLB.

The NHL board of governors has a meeting scheduled for Thursday which will provide a progress report and possible recommendations for a season format, based on talks between the league and the NHL Players’ Association. The target date for starting next season remains Jan. 1.

Bettman said the league is considering a few scheduling options for the 2020-21 season. Something that’s off the table: playing the entire season in the kind of bubbles the NHL had in Toronto and Edmonton, Alberta, to complete last season. But Bettman said teams opening in their own arenas is a possibility, along with a modified bubble.

“We are exploring the possibility of playing in our own buildings without fans [or] fans where you can, which is going to be an arena-by-arena issue. But we’re also exploring the possibility of a hub. You’ll come in. You’ll play for 10 to 12 days. You’ll play a bunch of games without traveling. You’ll go back, go home for a week, be with your family. We’ll have our testing protocols and all the other things you need,” he said.

Bettman also indicated that the NHL is exploring “a hybrid, where some teams are in a bubble, some teams play at home and you move in and out.”

The NBA’s board of governors unanimously approved a deal with the players’ union that sets the stage for a season that will open on Dec. 22 and with a reduced schedule of 72 games. Silver said that the commissioners are in communication on COVID-19-related issues, especially the NBA and the NHL, since the two leagues’ teams share arenas and, in some cases, team owners.

Silver said he senses that the NBA will have fans in many of its buildings this season.

“We’re probably going to start one way, where we’re maybe a little bit more conservative than many of the jurisdictions allow,” he said. “What we’ve said to our teams is that we’ll continue to work with public health authorities. Arena issues are different than outdoor stadium issues. There will be certain standards for air filtration and air circulation. There may be a different standard for a suite than there will be for fans spaced in seats.”

Silver said there will be standardized protocols that are consistent from arena to arena, such as proximity between players and fans: “In certain cases, for seats near the floor, we’re going to be putting in testing programs, where fans will certify that they’ve been tested — some within 48 hours, some within day of game.” While Silver supported a continued expansion of the NBA postseason through its play-in tournament, Bettman said that he’s not in favor of expanded playoffs or “playing with the fundamentals of the game.” The NHL had 24 teams in its postseason last summer.

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The Battleground States Where We’ve Seen Some Movement In The Polls

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With apologies to The Raconteurs, the presidential race continues to be “steady as she goes,” with little sign of tightening despite a plethora of new polls. FiveThirtyEight’s presidential forecast gives Joe Biden an 89 in 100 shot at winning the election, while President Trump has just an 11 in 100 chance. This makes Biden the favorite, but still leaves open a narrow path to victory for Trump, for whom a reelection win would be surprising — but not utterly shocking.

At the same time, we also have fewer polls from live-caller surveys, which have historically been more accurate and have shown slightly better numbers for Biden, than polls that use other methodologies, such as polls conducted primarily online or through automated telephone calls. Nevertheless, while the overall picture has shifted only a little in recent days, a few battleground states have seen at least some movement in their polls, which has slightly altered the odds Biden or Trump wins in each of those places.

What election stories need to get more coverage | FiveThirtyEight Politics Podcast

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