April 7, 2020 - 10:30 a.m. EST

On Apr. 4, 2020, Coronavirus Response Coordinator Dr. Deborah Birx made an important announcement to the country. “The next two weeks are extraordinarily important,” she said, “This is the moment to not be going to the grocery store, not going to the pharmacy, but doing everything you can to keep your family and your friends safe.”

One day prior, the Centers for Disease Control and Prevention (CDC) updated COVID-19 recommendations, now encouraging everyone to use cloth face coverings in certain public settings. At first glance, the new recommendations appear to be a reversal from what the CDC had previously said about mask use.

Put together, these two things can seem pretty alarming. Last week, masks were unnecessary for most people and going to the grocery store may have been okay; this week, the CDC suggests face coverings for everyone and the White House doubles down on staying home. What’s going on? Has something about COVID-19 changed?

The answer is, yes and no. While the virus that causes COVID-19 probably hasn’t changed in any meaningful way, our understanding of the disease — and the current situation — has.

One thing we’ve always known about COVID-19 is that it spreads exponentially. Exponential growth can sometimes be difficult to visualize, but it essentially means that the number of new cases diagnosed every day isn’t constant — it’s growing. Exponential growth is also why graphs showcasing the number of cases of COVID-19 can look like they’re getting much worse, even if measures to combat the disease are actually working. 

Cases of COVID-19 are expected to peak in hotspots like New York, Detroit, and New Orleans this week. Other areas, like Pennsylvania, Colorado, and the District of Columbia, are also expected to experience a rapid increase in the number of diagnosed cases in the coming days. And this is the context in which Dr. Birx made her comments.

These next two weeks, more people will be infected with the COVID-19 virus than in any two-week period prior. And in these next two weeks, hospitals will be even more full of COVID-19 patients than in any two-week period prior. Dr. Birx’s statement was a warning: Do everything you can to make sure you don’t become one of the people infected during this peak, and do everything you can to make sure you don’t become one of the people who needs to go to the hospital during this peak. Two ways to do this are to avoid going to the grocery store and avoid going to the pharmacy.

If you were following social distancing and stay-at-home orders to begin with, you shouldn’t need to change that much. From the very beginning, these orders emphasized minimizing contact with others and reducing trips outside the home — except to access essential services. This is the same now. Grocery stores will still be open, so if you are actually out of food, you should still go to the grocery store. And pharmacies will still be open, so if you actually need to fill a prescription, you should still go to the pharmacy. But beyond what is absolutely necessary, you should not be going out. Dr. Birx’s statement isn’t so much a change in policy as a strong reiteration of what people should have been doing in the first place.

As for the CDC’s new recommendations: The virus that causes COVID-19 hasn’t gotten any better at spreading (at least, not that anybody has noticed). Instead, the recommendations cite a growing body of evidence that shows a significant number of infected individuals are asymptomatic (meaning they may not know they have the disease). Even more worrisome, asymptomatic people can still infect others. So it’s not that the virus has become more dangerous, it’s that we are more aware than ever about how it has been silently spreading.

Except for in certain circumstances (e.g. in a healthcare setting), wearing a mask is more about protecting other people — not about protecting yourself. The CDC’s new recommendations are still in line with this fact. They recommend wearing cloth face coverings now, not to protect yourself, but to protect other people. The CDC is asking you to consider that you may be the one who is infected, asymptomatic, and spreading the disease to others without even knowing it.

To sum things up: Experts have come out with new recommendations because the next two weeks are likely to be among those hardest hit by COVID-19. The recommendations may seem alarming, but their purpose is to convince people to practice an abundance of caution and reduce any unnecessary exposures to the virus. If you still need an essential item  — really need it — get it (and wear a cloth face covering as you do so). But reduce the urge to make that extra trip to the store just to “stock up,” and if something can wait, leave it for another day.


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