https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/

Public-health experts have known for decades that an
abstinence-only message doesn’t work for sex. It doesn’t work for substance use,
either. Likewise, asking Americans to abstain from nearly all in-person social
contact will not hold the coronavirus at bay—at least not forever.

#StayHome had its moment. The United States urgently needed to flatten the curve
and buy time to scale up health-care capacity, testing, and contact tracing. But
quarantine fatigue is real. I’m not talking about the people who are staging
militaristic protests against the supposed coronavirus hoax. I’m talking about
those who are experiencing the profound burden of extreme physical and social
distancing. In addition to the economic hardship it causes, isolation can
severely damage psychological well-being, especially for people who were already
depressed or anxious before the crisis started. In a recent poll by the Kaiser
Family Foundation, nearly half of Americans said that the coronavirus pandemic
has harmed their mental health.

But the choice between staying home indefinitely and returning to business as
usual now is a false one. Risk is not binary. And an all-or-nothing approach to
disease prevention can have unintended consequences. Individuals may fixate on
unlikely sources of contagion—the package in the mail, the runner or cyclist on
the street—while undervaluing precautions, such as cloth masks, that are
imperfect but helpful.

What does harm reduction look like for the coronavirus? First, policy makers and
health experts can help the public differentiate between lower-risk and
higher-risk activities; these authorities can also offer support for the
lower-risk ones when sustained abstinence isn’t an option. Scientists still have
a lot to learn about this new virus, but early epidemiological studies suggest
that not all activities or settings confer an equal risk for coronavirus
transmission. Enclosed and crowded settings, especially with prolonged and close
contact, have the highest risk of transmission, while casual interaction in
outdoor settings seems to be much lower risk. A sustainable anti-coronavirus
strategy would still advise against house parties. But it could also involve
redesigning outdoor and indoor spaces to reduce crowding, increase ventilation,
and promote physical distancing, thereby allowing people to live their lives
while mitigating—but not eliminating—risk.

The U.S. is in the midst of an infectious-disease crisis that has wrought global
devastation and taken the lives of more than 75,000 Americans to date, with no
end in sight. But, as other epidemics have shown, trying to shame people into
100 percent risk reduction will be counterproductive. What Americans need now is
a manual on how to have a life in a pandemic. If no one else provides the
guidance that the CDC won’t, each of us will need to figure out our own.

Julia Marcus is an infectious disease epidemiologist and an assistant
professor in the Department of Population Medicine at Harvard Medical School and
Harvard Pilgrim Health Care Institute.