Editor’s Note: Metro Atlanta is in the midst of a massive shutdown of major events and institutions in response to the new coronavirus and its COVID-19 pandemic disease. Many local governments and groups have struggled with deciding what and when to shut down. The Reporter asked an infectious disease expert for her opinion on how to handle public events at this stage. Dr. Phyllis Kozarsky is a recently retired professor of medicine at Emory University in its Division of Infectious Diseases and a consultant at the Atlanta-based Centers for Disease Control and Prevention in the Division of Global Migration and Quarantine and its Travelers’ Health branch. She is also a Buckhead resident. She wrote on March 12; information about the coronavirus is changing rapidly, so for updates, see cdc.gov.

Dr. Phyllis Kozarsky. (Special)

Community spread of COVID-19 in some regions in the U.S. means that cases are occurring without direct links to others who have been in “high-risk” areas. Previously, most concern was about the acquisition of illness from individuals who traveled from China and who were ill with a respiratory infection. Now with illness transmission in the U.S. occurring without known links to China or links to those individuals coming from countries defined by the Centers for Disease Control and Prevention as “highest-risk,” it gets progressively more difficult to trace back and determine where an ill person was first exposed to COVID-19.

Thus, we must all take appropriate steps toward community mitigation —  not only in an effort to protect ourselves and our families, but also try to best protect our greater community. We don’t want to risk spreading infection to others, particularly to the most vulnerable.

So, borrowing words from others, “it is with an abundance of caution” that larger gatherings be cancelled and/or postponed and rescheduled.

The tricky question is, “What represents a large gathering?” There’s no good answer.

In general, gatherings in our community that tend to host many who are at highest risk of severe disease – the older population, those with underlying diseases, or those who are immune-compromised — should be postponed. Yes, they should. Certainly, a most important aspect of community mitigation is making sure that those who are ill with a respiratory infection remain home and call their healthcare provider if symptoms worsen.

Different countries and various parts of our country (and even state) may have differing triggers to limit gatherings, close event locations, and recommend online communications, such as what some workplaces and schools have done. Social distancing is recommended. However, we are a close community and mandating that people communicate at a distance has never been favored.

This is a unique time, and unfortunately now is the time to be cautious and limit exposures. I recently read an appropriate recommendation in a National Geographic letter suggesting that we now “enjoy the beauty of our own backyards.” Makes sense.