A Blog by Jonathan Low

 

May 3, 2020

The People Who Fled Cities Now Want To Come Back. Should They?

While the adherence to health safety such as sheltering in place, social distancing and closing businesses has gone far better than expected, pressure to resume 'normality' appears to be growing. This includes people who fled big cities, especially New York, and now want to return as their perception of the risk has moderated.

The problem is exactly that those believes are perceptions, not facts, and that movement means higher likelihood of virus transmittal. JL

Katie Way reports in Motherboard:

As public health guidance has shaken out, they’re being faced with the full weight of their choices: their presence may impose a burden on the communities they've fled to. But it would also, at present, probably be a mistake to return. Personal responsibility is critical in preserving public health; that’s why it's hard to trust people who acted impulsively at the beginning of the outbreak to conduct themselves with care when the return to “normal” begins. “Any time you have movement of people there’s movement of disease.”
By mid-March, “social distancing” and “flattening the curve” were known ways of combating COVID-19. According to a March 14 report from the Washington Post, public health experts were urging people to help slow the spread of COVID-19 “by avoiding public spaces and generally limiting their movement.”
The report included several simulations of COVID-19’s spread, with the best outcomes resulting from extreme distancing. “Above all, health officials have encouraged people to avoid public gatherings, to stay home more often and to keep their distance from others,” the article said. “If people are less mobile and interact with each other less, the virus has fewer opportunities to spread.”

These basic parameters don’t gel with moving from a city to another area. Anecdotally, it’s easy to list the places where that kind of journey would inevitably result in unnecessary human contact: at a gas station or rest stop, while passing off a rental car, boarding a bus or plane, or upon entering an AirBnB. Given a widespread and persistent testing shortage in the U.S., those who departed had no way of knowing they were not infected, even asymptomatically, when setting out for greener pastures. It also means they had no way to test themselves upon arrival at the doorsteps of new housemates, or even particularly vulnerable parents of a certain age.
Nevertheless, a still-unknown amount of city dwellers have left their primary homes for somewhere less crowded. Some fled to a family lake house, beach house, mountain… house, a vacation residence in a seasonal town generally unoccupied as winter snaps into spring. Others took flight for their childhood homes in the suburbs, often at a parent’s request. At the time, the people VICE spoke with said these moves felt definitively temporary—a few weeks away from home, a month at most.
But now, with the pandemic and its fallout extended indefinitely, those who relocated due to COVID-19 are realizing their prospects for returning to the apartments (and lives) they left behind are more remote than ever.
As public health guidance has shaken out, they’re being faced with the full weight of their choices: it's become clear it was a mistake to leave, and that their presence may impose an unexpected burden on the communities they've fled to. But it would also, at present, probably be a mistake to return. In this situation, some of them are continuing to bargain with the circumstances.

“It felt like everyone was leaving.”

Some of the people VICE spoke with justified their departure by framing their absence as a favor: Giving over more space to roommates, freeing up hospital beds, sparing grocery stores the added weight of their patronage.
Samantha, 24, told VICE she decided to leave Brooklyn for her parents’ home in Connecticut on March 15 when she first learned she’d be working from home through the end of April. (New York issued shelter-in-place orders on March 20.) “I live with three other roommates,” she said via Twitter DM. “It felt like it was going to be chaos for all four of us to work together from home for an indefinite period of time.”
Now, even though her workplace extended its WFH mandate through the end of May, she said she’s eager to return to the city as soon as possible. “Even if I'm still working from home, I miss my apartment and my routine and my plants!!!!” she wrote. “And being able to walk around Brooklyn, even if it'd be with a mask. I miss having delivery/restaurants nearby! It's lonely here.”
Ari, 23, left one future epicenter for another on March 11. “My company went fully remote for the NY office on March 9 and my girlfriend lives in the Bay Area, so I thought it was a good opportunity to go visit her for a couple of weeks,” he told VICE. “If I remember correctly, the Bay Area had more cases at that time... I didn't think that New York would be this bad.” (CDC guidelines issued March 12 urging travelers to consider how the rate COVID-19 was spreading at their destination could increase their own risk of exposure. Shelter-in-place orders were instituted in all nine Bay Area counties starting March 17.)
Now, he’s working from home (or, rather, his girlfriend’s parents’ home) in Los Angeles until the end of May. “I'm happy to be here, since I'm able to support my girlfriend,” who he said works in a COVID-19 research lab in the Bay Area. “I don't think I would be as able to [from] far away.”
Laura, 28, left New York City with her live-in boyfriend on March 16 for his parents’ lake house in Pennsylvania. She told VICE the primary reason for their departure was her partner’s immunocompromised status. “The worry was that if I got sick, there would be no way to quarantine me, and if he got sick, he would probably wind up in the hospital,” she said. “We were looking at projections of the virus and saying, ‘New York will run out of hospital beds FAST.’ We researched hospitals and urgent care facilities in this area before we left.”
Fears of overcrowded city hospitals were fueled by reports coming from Italy in the early days of the American pandemic response. But as the number of people fleeing urban centers increased in the face of general advice to minimize movement, public institutions began to more aggressively and specifically message that, yes, this behavior also qualified as the forbidden "moving around." (The CDC’s travel guidelines, first issued on March 12, evolved to explicitly discourage travel for those in New York, New Jersey, and Connecticut by March 29.)
Reports of tangible negative consequences (and local pushback) from these flight destinations began to emerge as of late March. CNBC noted skyrocketing rental prices in New York’s Hudson Valley and the Hamptons on March 20 due to city flight. The New York Times first reported on protestations from local governments to citydwellers on March 25. The Washington Post dubbed the movement the “Great American Migration” on March 28. On April 1, a Bloomberg reporter lamented her decision to leave Hong Kong for the U.S. in order to “run away from a global pandemic,” only to wind up in New York City a few months later. “I do think the uncertain global response to the pandemic points to tough questions about the borders humans put up around themselves, as well as the tendency to ignore serious problems as long as they seem to be happening on the other side of those borders,” she wrote.
Reporting also suggests COVID-19 epidemic has become a larger, existential threat for hospitals in less populated areas of the country. This is largely due to existing financial troubles driven by the for-profit healthcare system, with the additional strain of the pandemic leading to widespread closures and serious, occasionally fatal, gaps in healthcare availability for people in rural America. Local populations have expressed fear and resentment at the possibility that healthcare resources calibrated for their communities could be used up by part-time residents who generally only visit while vacationing.
Overall, Laura said the decision to leave would have been much harder had she known how long they’d be gone. “When we made the decision, it didn’t feel like it would be this long. I seriously thought it would be the two weeks of getting things under control, maybe a month, and then life could resume,” she said. “It sounds so dumb to say now, but looking back, that’s absolutely what I thought.”

Returning “when the time is right”

Not everyone has let the ambiguity of our times freeze them in place. Harrison, who declined to give his age to VICE, left Brooklyn in a $200-per-week rental car on March 9 with his wife and 6-year-old daughter in tow. From there, they split time between AirBnB locations in upstate New York and Pennsylvania, before returning to their apartment on April 13.
“We made it five weeks in two separate AirBnBs and then came back from concerns of blowing so much money and being away from home in such uncertain times,” he told VICE. “I would have gone the rest of the quarantine out there and it was nice for my daughter to get to experience rural life, having a front yard and a lake with fishing and kayaking.”
Harrison’s gratitude for the opportunity to experience a break from city life mirrors a thread running through many COVID-prompted “Why I’m Leaving New York” essays. It also conveniently glosses over the fact that this is really not a vacation—it’s a period of sacrifice that requires us to put aside personal pleasures like the great outdoors and mold our actions to fit public health mandates.
So far, addressing people who left their cities at the start of the pandemic doesn’t seem like a high priority for most federal government or health officials (surely, the correlations between wealth and vacation-home ownership have nothing to do with this). A definitive, topline signal saying “Hey, it’s OK!” does not appear to be on the horizon. As of this writing, no governor has comprehensively addressed COVID-19–related flight from city centers. Some, like New Jersey governor Phil Murphy and Massachusetts governor Charlie Barker have glanced off the topic by addressing owners of second homes and pleading with them not to overburden the infrastructure of seasonal towns with their presence. Florida governor Ron DeSantis was criticized for scapegoating New Yorkers with a mandatory quarantine order to anyone coming from the East Coast epicenter; though critics agree DeSantis has been derelict in regulating his own state, his statement was in tune with the widespread advisories for people in cities to stay in place.
This all means the scattered ranks have no idea when it will be “safe” for them to return to the homes and lives they left behind—which leaves them free to set their own benchmarks, often in the spirit of personal exceptionalism.
“I’ll come back when the bars open,” Andrew, 24, told VICE. He also said he doesn’t plan on quarantining upon re-entry. “I think by the time things open back up it’ll have been long enough that I won’t feel the need to. Obviously that’ll change if I or someone in my house is exposed, but so far that hasn’t been the case.”
Will, 26, told VICE he’s planning on renting a vehicle upon return to New York City. But more likely than not, it’ll be a UHaul. Will left his Brooklyn apartment at his father’s insistence—“My entire life has been predicated on caving to him because it’s just MUCH easier to let him have his way than to fight him”—and since then, he said his landlord raised his rent for next year to an untenable level. “It doesn’t sound like the gyms (I’m a personal trainer) in NYC are going to be opening again anytime soon, so with no source of income and my rent getting bumped by my asshole landlord, my only option is to move out and start over," he said.
Laura said she knows people who have already returned to Brooklyn, but she and her boyfriend have yet to pin down a return date and have cautioned their friends to do the same. “I'm antsy to get back so I'm kind of looking for anything to say, ‘Hey! It's OK!’” she told VICE. “I think once the new case rate starts going down, or other social distancing moves are lessened. I want to be there, but writing all this out, I think the pressures of what caused us to leave would only have continued to grow.”
Aside from their personal wishes to relocate again, people who left their cities against guidance to not move around are now feeling specifically unwelcome as local governments in various destinations have addressed them directly to say their choices to flee were poorly conceived. Some local governments have actually banned non-residents in an effort to ward off COVID-19, like North Carolina’s Dare County (home of the Outer Banks), which is currently being sued by non-resident property owners.
Kelly Hills, a bioethicist who specializes in quarantine, said a coordinated government response is a prerequisite for ensuring population flow back into cities is conducted as smoothly and safely as possible. “The first thing we need to see is an acknowledgment,” Hills told VICE. “Is it a problem? Mm. Is it a situation? Yes. And they need to acknowledge that there has been a fleeing to these other areas, but people do want to come back to what they call home.”

“Be mindful of where you’re coming from and where you’re going to.”

Hills said the formation of multi-state COVID response coalitions makes her feel more confident that government officials will put together a coherent plan for people looking to return. But, in the meantime, she has her own advice on a safe, transmission-minimizing approach to city re-entry: mandatory, 14-day quarantine upon arrival, not just from the public but from any housemates they’d be living with.
“I know that people are using [quarantine and shelter-in-place] interchangeably, but they're really not actually the same thing,” Hills said. Shelter-in-place or stay-at-home orders still allow for trips to the grocery store or pharmacy for essentials or a jog around a public park. “A quarantine, on the other hand, is you sit your butt down, and you stay in one place for 14 days and you do not go out that front door to guarantee that you have not been exposed,” Hills said.
If people are returning to housemates, the responsibility to quarantine extends further, to everyone in the home. “Basically, bringing somebody back into the house is almost certainly going to involve shutting the entire house down for 14 days,” Hills said. That means if anyone left a shared living space, everyone who lives there should quarantine simultaneously for 14 days with their departed housemate(s).
“You could have somebody stick to a bedroom with their own bathroom and they could stay there for 14 days and never have to share space with anybody, which could be considered an appropriate self quarantine within a shared living space,” she said. “[But] it's going to be pretty hard for that person to come in and then quarantine themselves while you're still going out. And you could still be at risk, both to bring it back in, but also if they're sick and they don't know that, to take it out.”
Individual action is not the single most important factor in containing the spread of COVID-19 (that would be government response, widely regarded as a pretty resounding failure). Nonetheless, personal responsibility is critical in preserving public health; that’s why it feels hard to trust people who may have acted impulsively at the beginning of the U.S. outbreak to conduct themselves with care when the legal barriers to movement relax and the push to return to “normal” begins.
Hills also said re-entry approaches should vary based on transportation methods. According to her, those who are able to drive their own car from point A to point B may want to knock out their two-week quarantine before returning to the city in order to minimize the chance of infecting someone else along the way. Those who’ll be traveling by plane, train, or bus should expect to start their quarantine immediately upon arrival—not after popping into the grocery store for “a few essentials” or visiting a significant other.
For anyone feeling frantic at the thought of an intense 14-day quarantine, at the very least, Hills feels your pain. “I do think it’s gonna be a challenge,” she said. “I wish there was some easier solution to it. But until there is an easy, fast, inexpensive way to verify whether or not people have had the disease, or there’s a vaccine, there is almost certainly going to be a period of quarantining having to happen whenever households are merging.”
Saskia Popescu, an infection prevention epidemiologist, said the inevitable re-entry to big cities will involve strict maintenance of safety measures like social distancing, especially for people who cohabitate with people outside their family units—AKA, anyone with a roommate.
“My big concern would be if everyone is coming back to major cities where they have a shared household with people that they haven’t seen for a while,” Popescu told VICE. “We’d want to be mindful that you’re all potentially bringing in an exposure.”
Popescu recommended heightened cleaning measures upon re-entry. “I think it's important to be mindful of that for the next 14 days, that incubation period, to see OK, did anybody bring anything home?” she said. “Remind people to cover your coughs, wash your hands, do environmental disinfection to keep your household clean.”
Popescu said local health department websites will likely offer the clearest window into when it’s safe to head back and resume (a truncated version of) city life.
“Be mindful of where you’re coming from and where you’re going to,” she said. “Are you going to a place that has a lot of community transmission, like New York City? Maybe not the best time to go back. Are you coming from a place like that, and you’re going to a place with very minimal community transmission? The last thing you want to do is be going from a place of lower risk to higher risk.”
Popescu said it’s hard to say right now what the impact of city flight was on the spread of COVID-19—but that travel, especially if you have any symptoms of illness, and even if you're "pretty sure" it isn't COVID-19, could certainly facilitate it.
“Any time you have movement of people there’s always potential for movement of disease,” she said. “Viruses live in people, it’s people that transmit them that way. We all have to be really good stewards of our role in public health.”

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