STEVE GOLDSTEIN: When Arizona was under the governor's stay-at-home order, the state was in the midst of a cooler than normal spring, at least for a couple of weeks. So social distancing and getting fresh air by jogging or cycling or walking the dog made sense. But with an average high of 107 degrees in the Valley right now and gyms temporarily closed by the governor's executive order, how could the combination of COVID-19 and extreme heat exacerbate the problems? With me to talk about that is Saskia Popescu, epidemiologist for the University of Arizona and George Mason University. Saskia, how does our summer heat impact the health challenges of COVID-19?
SASKIA POPESCU: There was so much hope early on that this would be a seasonal thing, and that the summer would bring fewer cases. And as those of us in Arizona can attest, we're definitely not seeing that. The best way I've heard it for sure is, is by a virologist — Angie Rasmussen, Dr. Rasmussen, actually, and she made a point about that when we focus on seasonality, we tend to forget, what do viruses need? They need people. So it really means that wherever people are, that's where these pathogens can spread. So when we're talking about heat and humidity, there's been a lot of other countries that have high humidity, high heat that still experience a lot of cases and control measures. So we can't really rely on that. But one thing I get really concerned about in the United States is specifically in the southwestern region is that the summer is kind of our indoor time. You know, we all flock inside because it's 110 degrees outside. So when I see really great national recommendations about go outside, eat outside, try to be out as much as you can for social distancing and natural ventilation — I worry that that forgets about places like Arizona and that right now it isn't possible for us to really be outside that frequently, even at midnight it can be 100 degrees sometimes. So I think my concern right now in the face of a very significant outbreak in Arizona and Maricopa County is that people really can't follow those outside recommendations. So we're all flocking indoors.
GOLDSTEIN: Well, when the pandemic was first declared and then Gov. Ducey issued his stay-at-home order, there was the feeling for many of us that it was warm, of course, as it is here in the spring. But it was still — the afternoons, the evenings, the early mornings were very nice and people could still recreate outside. So now we're in a position where [there are] gym closures. So people are probably going to want to go outside more, and yet that is a danger, as you mentioned, because summer is not our outside time here. So are we better off trying to exercise a bit in the heat than we would be to be around 20 other people in a gym?
POPESCU: Oh, that's a tough question, because exercising in the heat carries with it its own health issues, right? So what I always encourage people to do is if you can, try and exercise in your home. I know plenty of people that have turned spare bedrooms into tiny little gyms, and there's a lot of great apps and resources online. So that's really what I encourage. If you do want to exercise outside, get up early and do it, or try and do it safely at night. You know, those are probably ideal for outdoor exercise. If you can, if you have a pool, that's also a great way to stay in fitness or just really engage in those kinds of activities. You know, I'm trying to think what I would do, and I would really just spend some time in my pool or really try and do some videos online that I'm finding. Because the truth is that I don't think going to a gym with 20 other people is a good idea. We know that's not. And that was a real concern when we reopened. And unfortunately, there are some smaller micro-gyms where you're not going to get more than five or six people, and those are being lumped in here as well. So I think this is just a really complex situation, because when we throw out the idea of doing something outdoors, heat stroke is very real, I mean, I'm sure we've all experienced it at one point or another. And my husband hikes, and he was just saying the other day when he was up on the mountain, there were a ton of people up there. So I worry about all of us flocking to the same types of outdoor exercise.
GOLDSTEIN: As I mentioned a few months ago, where we were probably way too close together, there's probably not enough social distancing. But in the cases where there was, there was much less of a risk of actually being affected by the heat because it was still that relatively dry 85 to 90 degrees as opposed to 105, 110, which is a major danger zone here.
POPESCU: Well, and what worries me — and I don't think we're actually spending enough time talking about it — is urgent care. So there have been reports of people lining up around urgent cares trying to get tested. And even with tents and misters and water, people are still passing out. They're still requiring medical care because it's so hot outside. So, you know, when we talk about emergency response, I know in the early stages of this pandemic, at a national level, everyone was like, "Well, we can have massive tents outside for triage in the hospital areas, and set up ... stations." In my mind, I kept thinking, "Well, if this happens in Arizona in the summer, it's going to be an entirely different ballgame because we can't do that." Theoretically, we can set up tents. We have misters. We have cool down measures. But ultimately, it's going to be extremely uncomfortable for people who are already feeling sick, going to triage areas outdoors. So this is a piece that is really complex, and I don't feel we've spent enough time focusing on emergency response measures for these really high temperature climates.
GOLDSTEIN: I wonder, do you think all of that got lost in the shuffle, because of, again, that hope the heat would somehow fight the virus?
POPESCU: I definitely think so. I think so many, you know, we just wanted to be hopeful that this would be over. Unfortunately, I know most people in public health and health care were going with the sentiment of, "It is a marathon. This is not a sprint." I think many in the Southwest were really hoping we wouldn't see surges and spikes in the summer simply because of this complex angle of care. And unfortunately, this is kind of where we're at. So I think ultimately it really does test how we prepare for these events. And I'm hoping that we'll learn from them, because in the summer, especially in Phoenix, [it] tends to be our slow season, right? There's not a lot of people. Most people stay indoors. It doesn't feel that busy. But right now, with the number of cases and people trying to seek care and get tested, I think that really changes how we're approaching Phoenix in the summer at this moment.
GOLDSTEIN: Saskia Popescu is an epidemiologist at the University of Arizona and George Mason University.