In a characteristically lengthy Twitter thread Sunday afternoon, Wachter broke down his reasoning, estimating that his chances of dying from an indoor meal without a mask are about 1 in 200,000 — “in line with other risks we all take to do some things we like.” Just three weeks ago, Wachter, who has built a huge following on social media for his COVID-19 advice, tweeted that he wasn’t ready to lose his mask or dine indoors. That he now feels ready to take both steps signals that the local COVID-19 situation has improved to the point where even some of the most cautious are comfortable re-engaging in pre-pandemic hobbies. That same day, President Joe Biden said the pandemic was “over” on “60 Minutes” while walking the Detroit auto show. The US government continues to designate COVID-19 as a public health emergency, which ensures that expanded Medicare coverage, telehealth services and other pandemic measures will remain in place. “We still have a problem with COVID. We are still doing a lot of work on it. But the pandemic is over. If you notice, no one is wearing masks. Everyone seems to be in very good shape,” Biden said. Cases are stable or declining in almost every state, although about 400 people in the US still die from COVID-19 each day, according to New York Times figures. Last week, the director-general of the World Health Organization, Tedros Ghebreyesus, said that the end of the pandemic is “not yet there” but “apparently”. Wachter will still wear his mask in crowded or poorly ventilated indoor spaces or on an airplane — “probably forever,” he wrote. In a group of 150 people on a crowded plane, there is a 78 percent chance that at least one person is infectious, Wachter wrote. “I guess, why risk it in situations like this?” Wachter said. Wachter’s threshold for “liberating” his behavior is when daily cases fall below 5 for every 100,000 in the region, Wachter reiterated in Sunday’s thread. San Francisco is at 6 per 100,000 according to New York Times data, a 64 percent drop in the past two weeks, Wachter noted. After accounting for home testing, 5 cases per 100,000 is “really” about 25 cases per 100,000, Wachter said in his thread. California is at 12 cases per 100,000 people, while the US is at 19 cases per 100,000, according to New York Times data. Covid (@UCSF) Chronicles, Day 915 As I had hoped, US cases are steadily declining. Until now, I avoided eating indoors and wore a mask in all crowded indoor spaces. Now I’m ready to eat indoors & (selectively) remove the mask. Here’s why: (1/25) — Bob Wachter (@Bob_Wachter) September 18, 2022 The positivity rate for asymptomatic tests at UCSF hospitals is now 1.6 percent — up from 4 to 6 percent in early August, according to Wachter, another sign of improvement in the local COVID-19 situation over the past month. That equates to about 1 in 100 people in San Francisco being infectious, or about a 10% chance in a group of 10 people that at least one is infectious, Wachter said. “So if I dine at a restaurant in San Francisco today, there is a 1 in 10 chance that at least one infectious person will be around,” Wachter wrote. The risk of “exposure to an infected person during a meal” depends on many factors—ventilation, distance, vaccination status—but Wachter estimated it to be about 10 percent. Together, that’s about a 1% chance of getting infected during an indoor meal. That translates to about a 1 in 1,000 chance of getting long-term COVID from eating indoors and a 1 in 200,000 chance of dying, Wachter said. What to do about these odds? It depends on each individual’s risk status and tolerance, Wachter wrote. Ultimately, he said he’s sharing his reasoning to help others consider their situation. “If you were in cautious mode, as I was, are these risks now low enough to enjoy dining indoors in SF? It is for me. Are they low enough to put the mask away when you walk into an empty indoor space or have a small group work meeting? To me, yes,” Wachter said. “For you? Your call. I hope this helps you think about it,” Wachter said. Claire Hao is a staff writer for the San Francisco Chronicle. Email: [email protected], Twitter: clairehao_
