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COVID-19 Q&A with Dr. Ken Kirton on South Dakota’s Back to Normal Plan & Navigating Outdoor Recreation

5/22/20
Health and government leaders in our state have advised that we are able to resume many activities that were once not recommended due to the COVID-19 pandemic. This week Ken Kirton, MD, Chief of Medical Staff at Freeman Regional Health Services responded to questions on “South Dakota’s Back to Normal Plan” and how to navigate a “normal” activity that many enjoy as weather improves, outdoor recreation. 
  
Now that we are starting the “South Dakota’s Back to Normal Plan” can life proceed like before COVID-19?
No, the virus is still present in SD and experts believe we will continue to have outbreaks of illness in our state for some time to come. These rapidly changing conditions will result in some degree of uncertainty about how great a risk participating in activities presents at any moment in time. So far the social distancing measures, masks and hand hygiene have been effective in slowing the spread of the disease within a population. These measures slow or make spread of infection less likely, but they do not completely prevent spread. Our state governmental and medical leaders have recommended careful resumption of many modified "normal" activities after studying how the virus has spread up to now, how it effects individuals and our readiness to respond to an outbreak. 
  
Are we prepared to resume modified “normal” activities? 
We have a better understanding of the virus and the disease it causes and are better prepared now than we were three months ago. As our knowledge of the virus increases, the recommendations to protect yourself and others will continue to change. For instance, they are discovering that infectious virus is more likely to spread from person to person versus through touching a virus contaminated surface, so particular attention should be focused on limiting spread by maintaining 6 feet of distance and by wearing cloth face masks when around others. The access to rapid testing equipment has improved the identification of who has the virus. Medical practitioners are getting better at knowing how to take care of the seriously ill. Equipment to protect health care workers and frontline personnel is becoming more available. The likelihood of hospitals being overwhelmed and unable to care for all who need assistance is much less likely. So now the question we all face as a community, is how to safely resume many activities that are a big part of what makes life special and fun in our community. 
  
Is it safe to participate in outdoor recreational activities?
As we have gathered more medical information on the COVID-19 virus, we understand that it is not necessary at this time to eliminate all community group activities nor wise to allow the other extreme of proceeding as we did prior to the pandemic. It is best for us to agree on a set of compromises that allow opening of community activities with guidelines in place to limit the speed and degree of spread of virus from infected to non-infected individuals. Part of this plan includes advising high risk individuals and those who live and work in close contact with high risk individuals to proceed with greater caution in their participation. The SD Department of Health and CDC websites have directly outlined recommended approaches to safely open participation in many types of activities. Outdoor activities with attention to personal distancing and to the use of face masks and good hand hygiene appear to be among the safest forms of community interaction, particularly for healthy individuals in low risk groups. 
  
What precautions should you take when going to a swimming pool?
The CDC has offered detailed guidance on public swimming pool operation during the COVID-19 pandemic. It is not advised that individuals at high risk of complications and those who routinely come in close contact with high risk individuals go to a public swimming pool. Facility managers need to follow their usual safety measures including frequent and strict maintenance of water quality, however additional precautions and signage should also be in place. It is recommended that they screen swimmers and staff to try to exclude participation of individuals who are ill. Facilities are encouraged to limit their capacity to assist social distancing out of the pool. Facilities should take special consideration of bathrooms and concession areas to determine how to maintain hygiene in both of these high traffic places. Swimmers are encouraged to use social distancing, hand hygiene and cloth masks when out of the pool. They are also advised to not share towels, pool equipment and toys. Keep in mind that opening of a pool may be subject to change if the virus prevalence increases. 
  
What advice do you have when going the beach?
Like swimming pools, going to the beach is not advised for those in a high risk group, those in contact with someone who is in a high risk group or sick individuals. If you are choosing to visit a public beach then select one close to your home while recognizing that a crowded beach will prevent you from controlling your exposure to others. Remember to practice social distancing both in and out of the water and consider wearing a cloth mask when out of the water. Avoid touching surfaces that others may frequently contact and use good hand hygiene including bringing along sanitizer. 
  
What should you do when visiting a park or using sidewalks and trails? 
People should be encouraged to take advantage of these activities since they provide individuals exercise and benefit personal wellbeing. Remember to adhere to social distancing of 6 feet separation from others while participating in these activities. Depending on the density of others, it is advised to wear a cloth mask as an additional way to decrease the opportunity for virus spread. It is recommended to carry hand sanitizer for use after coming into contact with frequently touched surfaces such as rails, drinking fountains or public restrooms.
  
What steps should you take when going to a ball field?
There are advised modifications that ball players should consider implementing whether going to a ball field for an impromptu game or as part of an organized sport. The CDC has an excellent, detailed website on youth sports participation. It is advised to incorporate a screening of players to prevent participation of sick individuals. Remind players to cover their face when sneezing or coughing to prevent spreading germs to others. It is recommended to create plans to maintain adequate spacing of participants on the field and in the dugout or bench. Encourage players to bring their own equipment to avoid unnecessary sharing of ball gloves, sport masks and bats, or allow adequate time for sanitizing between players.
  
What advice do you have when watching an outdoor sport?
Spectators should remember to follow social distancing principles when attending an outdoor sporting event. Facilities may present options for spectators to help maintain personal space including alternative seating arrangements in stands and potentially in the outfield or through the use of vehicles. Remember to carefully consider traveling for games since crowded transportation situations could result in close prolonged contact. Keep in mind the distance that needs to be traveled and study the prevalence of virus in other locations along the way when creating any travel plans. 
  
What other recommendations do you have as we resume activities?
Our community has navigated this time remarkably. People have largely remained kind, courteous and respectful towards each other, no matter their personal opinion about masks, social distancing and activity restrictions. After a challenging and unsettling three months many want the opportunity to become involved in normal activities again. Others remain deeply concerned about their own safety and the safety of those they care about. Many feel that any further limitations on how one worships, works and participates in activities poses a threat to their independence and rights. We can navigate how to go forward as a community together. If we are respectful of each other and the individual and community decisions that are made, we can be a safer, stronger and more united community. One size does not fit all people or communities. Yet we all have a shared responsibility to be looking out for each other and working to keep all of us as safe as possible.