• Experts are warning people to take precautions this July Fourth weekend amid a surge in new COVID-19 cases.
  • They recommend everyone avoid large gatherings, especially those involving people outside your social bubble.
  • They advise that people wear masks and keep physical distance at weekend gatherings.
  • They also recommend that tables be set up more than 6 feet apart and people go in groups to a separate table to pick up food and drink.

“Safe and sane” is taking on a new meaning this Fourth of July.

The safety guidance usually recommended for fireworks may need to be applied to every aspect of this holiday weekend, health experts say.

This year, a safe celebration will require strategizing everything from where to sit in the park to how to dish out food to whether to leave the house at all.

As the country prepares to celebrate nearly 244 years of independence, it’s under siege from a growing spike in COVID-19 cases.

Part of that uptick is likely due to large gatherings of people, often without face masks, experts have said.

Crowded Fourth of July celebrations or large family gatherings could accelerate it.

California has cited large gatherings as factors leading to outbreaks in several counties.

“One of the areas of biggest concern as it relates to the spread of COVID-19 in this state remains family gatherings,” Gov. Gavin Newsom said on Tuesday.

“If individuals fail to comply with social distancing guidelines and fail to wear masks, then we will likely see a surge in cases similar to what we started to see about 2 weeks following the Memorial Day holiday,” Amira Roess, PhD, MPH, a professor of global health and epidemiology at George Mason University in Virginia, told Healthline.

If done safely, health experts say small, outdoor, face-masked, spaced-out, carefully thought-through gatherings may be possible — at least in some regions.

To mitigate risk, experts recommend taking into account several key factors when deciding whether and how to have a safe and sane July Fourth amid a global pandemic.

Perhaps the chief factor: where you live.

There are several tools to help assess the spread of the virus in your locale, including a new map launched by Harvard’s Global Health Institute in Massachusetts.

On the map, large swaths of counties in the South and Arizona are red, indicating a high number of new cases per day proportionate to the population.

A number of counties are orange in Southern California and Texas, as well as red and orange dots scattered in the Northwest and Midwest. Other regions, like much of New England and upstate New York, are green.

Say you lived in one of the red counties and wanted to have a handful of people over. They were all going to wear masks except while eating. No hugging and tables at least 6 feet apart. Safe enough?

“I don’t think I would go for a cookout right now in Houston or even in Southern California,” Dr. Thomas A. Russo, chief of infectious disease at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences in New York, told Healthline.

“If you live in a state or locality that is currently experiencing increased cases and hospitalizations — stay home,” added Purnima Madhivanan, MBBS, MPH, PhD, an infectious disease epidemiologist at the University of Arizona’s Mel and Enid Zuckerman College of Public Health. “Plan activities for your family that don’t include putting them at risk during this holiday.”

While many countries’ COVID-19 infection rate curves look like a hill, the U.S.’s trajectory is sprouting a new peak after it appeared the curve was being successfully flattened.

Reopening of the economy in places that public health experts hadn’t deemed ready for reopening is widely blamed.

Arizona’s curve is one of the steepest. The number of daily new cases is now about eight times higher than it was at the end of May.

The story is similar in Florida, where new confirmed COVID-19 cases hit a daily record of 10,109 on Thursday.

While some of those increases may be due to increased testing, Arizona and Florida have the highest rates of positive COVID-19 tests among all states. Nevada and Texas have the next highest.

In Texas, some hospitals are filling up. The Texas Tribune reported that one Houston hospital had run out of space for new patients with COVID-19 and that another medical center was seeing a surge of cases.

In Southern California, counties that reopened dine-in restaurants and bars as part of a phased, statewide reopening are now leading the state in new cases.

If a lot of people in your community have the virus, Russo said, then it’s more likely that one or more of the people in the backyard or park will have it.

“So how much disease is in the community is a big part of the relative risk, and how well you execute the (safety) measures is the other part of it,” he said.

Those safety measures include where you go — and even where you put the food.

“The good news is that most of the Fourth of July festivities include outdoor activities like cookouts and watching fireworks outdoors. As long as you keep at least 6 feet away from individuals outside of your family unit or your social bubble and you wear masks if you cannot practice social distancing, your risk remains low for exposure,” Roess said.

She added that “means going to events that are sparsely attended or going to parks or beaches that are sparsely attended.”

She also said to not “share any food or utensils with individuals outside of your family or social unit.”

Russo said you can distribute Fourth of July food as if you’re at a wedding.

“A backyard barbecue, I think you can do it safely. The way to do it is if people who aren’t living in the home are joining you, you need to assume that anyone and everyone can be infectious,” he said. “So the best attitude is to assume anyone can be infectious and infect you, so be very much in defensive mode here.”

That means everyone in masks, aside from while eating at tables that are at least 6 feet apart and more than that if possible, he said.

It’s also advisable to have a table off to the side for the food and drink. People would go up to that table individually or by social unit.

“When people go grab food from the table, they’d go up like a table is called at a wedding, so not everyone is clustered around the food and drink table,” he said.

Madhivanan told Healthline there are three main recommendations for minimizing risk.

“One, avoid any activity that doesn’t take place outdoors,” she said. “Two, avoid crowds and make every effort to physically distance (maybe that means laying down a large blanket and sitting in the middle of it or finding a remote location where you can view fireworks without having to negotiate crowds). And three, make sure everyone wears a mask when they’re outdoors.”

Newsom painted a picture of a quaint, typical — but in light of COVID-19, suddenly dangerous — barbecue.

“They may walk into that barbecue with masks on. They put the cooler down,” he said. “Immediately, the mask comes off. They have a glass of water and all of a sudden nieces and nephews start congregating around, and then they’re jumping on top of Uncle Joe… And all of a sudden here comes Uncle Bob 2 hours late. He gives everyone a hug. And they’re — ‘Hey, Uncle Bob, where’s the mask?’ — and Uncle Bob is ‘I don’t believe in that.’”

The story highlights several of the unpredictable variables that can make even the most carefully thought-out gathering risky.

Children and personal beliefs are two of them.

Alcohol is another.

“I am worried that amid festivities individuals will forgo taking the appropriate precautions… The July Fourth holiday is associated with an increased consumption of alcohol and other substances,” Roess noted. “Consumption of these often inhibits judgment and, consequently, individuals might think they are abiding by social distancing guidelines when, in fact, they are much closer to each other than the recommended 6 feet.”

And, as Newsom suggested, excited children might, understandably, not follow the guidelines perfectly.

“As a mother, I also think it’s important that we have serious discussions with our children about being responsible during this difficult time,” Madhivanan said.

Who exactly you’re meeting or inviting is also key, even at a safe distance.

Your safety measures are “only as good as the people you invite over,” Russo said.

He noted that “anti-maskers” are akin to “anti-vaxxers” in that their personal choice increases the health risks of the people around them.

How much of that culture is in your region can be a critical factor in deciding whether to be around others, Russo said.

“We all have to remember that wearing masks not only protects me, the mask wearer, but it really does help protect individuals around me. We are all in this together and we have to do our part to take care of each other,” Roess said.

As COVID-19 cases have climbed in recent weeks, some officials have pointed to crowds on Memorial Day weekend and the recent warm weather as potential factors.

“Somewhere around Memorial Day, people just sighed a deep breath of relief and said, ‘Hey, it’s summer, I’m going to act like it’s summer and I’m going to act like this thing was never here,’” Dr. Marc L. Boom, the chief executive officer of Houston Methodist Hospital in Texas, told Good Morning America. “And we’re really paying the price for that now.”

In Texas, the city of Austin as well as Travis County shut down some parks over the Memorial Day weekend because they were deemed too crowded.

In California, a Los Angeles Times analysis found Memorial Day was when California’s success in containing the virus started to be reversed. Two weeks later, the rate of people being hospitalized with the virus began accelerating.

Los Angeles County, where hospitalizations have risen about 70 percent since June 1, is closing its beaches for the July Fourth weekend to try to eliminate crowds.

Beaches will also be closed in Miami-Dade and Broward counties in Florida.

At least two people who were among the crowds of people at Missouri’s Lake of the Ozarks during a Memorial Day celebration that was widely condemned on social media and cable news have since come down with the virus.

The weekend following Memorial Day, a waterfront bar there, Backwater Jacks, posted a message on its Facebook page acknowledging that an attendee had tested positive.

It said that people “who are easily compromised, showing symptoms, have knowingly been in contact with a confirmed case or highly at risk” should please stay home.

However, the statement concluded, “We will continue to take additional precautions throughout the summer to reduce the risk. However, we believe each of our customers should have the freedom to choose whether they want to visit Backwater Jacks or not.”

The bar owners have been promoting a Fourth of July party scheduled for today dubbed “Zero Ducks Given.”

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