I’m 77 years old and I want/need to walk. The two buildings in my complex have a basketball court between them. I have previously taken the freight elevator down 36 stories at 5:30 a.m., meeting no one but armed anyway with mask, gloves, wipes and hand sanitizer. I walked for 35 minutes and went back upstairs, again meeting nobody. Should I force myself to continue? I am simply afraid to go outside.
BARRIE MOTOLA
New York City
Ms. Motola’s world has mostly shrunk to one room. She lives by herself in a studio apartment high above Manhattan, with a piano, books and a narrowing set of routines. Her longtime habit of swimming laps is on pause. So are her dates with her children and grandchildren.
“The walking was truly helping me keep it together,” she said on the telephone. But she stopped a week ago and hasn’t left her building since. “As this ramped up, I kept weighing anything and everything I was thinking about doing outside, and saying: ‘Is it worth getting sick for? Is it worth dying for?’”
She’s not the only one asking. The outdoors is now contested ground. Parks and trails from Los Angeles to the Great Smokies are being closed. (Too many people were socially distancing in the same places, and therefore not at all.) Authorities are patrolling others, warning people to disperse. This week, India’s prime minister told 1.3 billion people not to set foot outside their homes. “Stay Home Save Lives” has become a rallying cry and a pressure point on social media.
“If you’re still not sure about an activity, skip it,” said Kate Brown, the governor of Oregon, one of 22 states and counting where residents have been told to keep to their residences.
While some continue to congregate, many others are now worried about venturing outside at all. “Can we sit on an open lawn with a family member?” a reader from India wrote to ask.
The unpleasant truth, especially for city dwellers, is that is every time you step outdoors, your risk of infection rises. Last week, scientists established that coronavirus droplets could linger in the air for a half-hour, raising new concerns about what is safe. Then there’s every surface you encounter on your way outside and back: doorknobs, keys, elevator buttons, gates, the carton of eggs you pick up at the deli that’s still open.
“The safest way to prevent the spread of this virus is for you to stay at home,” said Dr. Craig Spencer, a global emergency medicine specialist at Columbia. “This virus won’t infect you if it never meets you.”
But when we posed Ms. Motola’s dilemma to Dr. Spencer and other public health experts, along with scientists who study the virus’s behavior in air, each one recommended that she resume her dawn walks.
“We’re all struggling with a greater degree of ambient risk than we’re used to,” said Dr. Tim Lahey, an infectious disease specialist and ethicist at the University of Vermont. Each day is an exercise in trying to lower risk: avoid this, scrub that.
Public health practice is as much about reducing risk, as eliminating it — which is often impossible. The AIDS crisis was not stemmed by persuading people to quit sex, Dr. Lahey said. Instead, people adopted tolerable rules like choosing partners carefully and wearing condoms. The term “safer sex” worked because it seemed doable, he added.
The safer-sex equivalent of an outdoor walk, most medical authorities say, is one that involves six feet of distance from others. (Linsey Marr, an engineering professor at Virginia Tech who studies how particles move through air, says she gives it 10 feet just to be cautious.) Governments are beginning to put in place rules to encourage people to spread out. This week, Gov. Andrew M. Cuomo announced a pilot program in New York to close some streets to traffic in order to give pedestrians more space. As of Tuesday, the French must follow new restrictions on outdoor exercise: It can be done alone, for up to an hour a day, within a one-kilometer radius of home. Walkers and runners must carry permission slips that can be checked by authorities.
If the distancing rules are too strict, prohibiting excursions entirely, people could give up, said Dr. Carlos Del Rio, a public health and AIDS specialist at Emory University. “I want to be sure that people don’t get frustrated and say, ‘We won’t be able to defeat this,’ because we can,” he said.
“Our mental health is going to be so important,” added Dr. Spencer, who was treated for Ebola in 2014 and endured 19 days of near-total isolation. “This is only going to get worse.”
“Telling people to stay inside works right now, but in two or three weeks, it’s going to be a tough message to hold up,” he said.
Walks and runs are signs of life to which even doctors and scientists on the front lines are clinging. Amandine Gable, a postdoctoral fellow at the University of California, Los Angeles, is a co-author of that study that raised alarm last week about how the virus lingers in the air. She walks near her home in Santa Monica every day. She finds complete adherence to the six-foot rule challenging, she said, and if someone crosses her path, she does not panic.
Dr. Spencer spends his days treating Covid-19 patients at Columbia. When he comes home, he laces up his sneakers and goes jogging, sometimes late at night.
“It’s one of the only ways I can decompress and disconnect completely from coronavirus,” he said.
We called Ms. Motola to share what the experts had advised. She wasn’t convinced.
“I do have to sit and calculate the risk,” she said. “As soon as I contemplate putting on my sneakers, my anxiety goes right up.”
“One of these mornings I will be brave enough,” she said. “I have to be brave.”
Lauren Messman contributed research.
Dilemmas is a new column about dealing with the human quandaries presented by the coronavirus pandemic. Please send yours to dilemmas@nytimes.com.
