As coronavirus cases continue to surge, health officials say residents should double down on their efforts to slow the spread - yet too many people have become more lax, resuming risky pre-pandemic activities without proper precautions.
On Wednesday, the Hamilton County Health Department reported 213 new infections, marking the second straight day of more than 200 new cases. The county is now averaging a record 167 new cases a day and a positivity rate of 13.4% for new tests in the past week.
There are also 111 people hospitalized with the virus, a record high of confirmed patients in the county. Before July 22, the health department lumped hospitalized patients with confirmed COVID-19 cases and patients under investigation together, which made the number of people hospitalized with the virus appear higher. Of those currently hospitalized in Hamilton County, 33 are in intensive care, and more than half live in other counties across the region.
"I think that people are forgetting that the pandemic isn't any different than it was in March. You actually have more of a chance of catching it right now," said Dr. Lisa Smith, medical director of the return to work/school/sports program at One-to-One Health.
Smith believes people might make better decisions to protect themselves if they knew what's at stake.
An online tool developed by researchers at the Georgia Institute of Technology aims to assess the risk that one or more individuals infected with COVID-19 are present in social gatherings based on where they are and how many people are present.
Currently in Hamilton County, there's an approximately 20% chance that at least one COVID-19 positive individual is present if a group of 10 people gather, according to the model's calculations as of Sunday. That chance increases to 42% in a group of 25 people and 66% in a group of 50 people.
While the risk that one or more people with the virus are present increases rapidly with group size, one infected person can easily spread COVID-19 to others - especially when people are gathered in small indoor spaces without personal protective equipment.
Because COVID-19 is so contagious and not all infectious people show symptoms, the researchers wrote that "these risk calculations provide further support for the ongoing need for social distancing and protective measures even in small events."
Another calculator that Smith shares with her clients helps people estimate their risk of infection and mortality from COVID-19 based on a variety of factors, such as age, job, health status and how seriously they follow preventive measures.
Adam Goodie, a psychology professor at the University of Georgia and the director of the Georgia Decision Lab, said one of the biggest challenges in convincing people to adopt behavior changes that lower their risk of COVID-19 infection is the human brain.
That's because human decisions usually aren't based on evidence and logic, but rather rewards and punishments and how direct or indirect they are.
Part of the reason people reacted so strongly to stay-at-home orders in the beginning of the pandemic is because a boost in awareness around certain threats - even unlikely ones - can have an outsized impact on behavior, he said.
"If there's a few shark attacks one summer, that gets huge media attention around the world, and now everybody's afraid of shark attacks," Goodie said. "You should be afraid of shark attacks, but those only hurt a very small number of people every year, and there's lots of other things that don't get nearly so much media attention that also hurt people."
Staff Photo by Matt Hamilton / Vehicles form a line at the COVID-19 testing site at 1125 Riverfront Parkway on Tuesday, Nov. 10, 2020. Now that the risk of contracting COVID-19 is much higher, the novelty of the disease has faded and many people have still yet to see or experience the serious health consequences of the coronavirus.
"Out of sight, out of mind has a lot of truth to it," Goodie said.
At the same time, many of those same people have experienced hardships - whether it be loss of social circles or income. Goodie, whose research focuses on gambling, said that humans often become more risk-seeking when they're trying to make up for losses.
He cited the example of someone losing $1,000 in a card game yet continuing to gamble in an attempt to get that money back. Since many people are grappling with the loss of favorite pastimes due to COVID-19, they may be more tempted to engage in behaviors that put them at higher risk, Goodie said.
"The fact that we're risk-seeking when we're talking about losses might be a really significant thing in COVID. In general, there's so much loss," he said.
Consistent public health messaging and stories from survivors can definitely help influence behaviors, but the greatest impact on behavior comes when negative behaviors are punished, Goodie said. Punishments could be social, financial or one's own lived experience - such as pressure from family members to stay at home, a fine for not wearing a face mask or the loss of a loved one.
"We've had lots of cases at UGA among students, so a lot of them have been inconvenienced and felt kind of sick, but not very sick, and then got over it," he said, which for many isn't enough to punish the risky behaviors. "I would think if students knew about a salient bad case or two, that might be the kind of thing that could change peoples' behaviors."
In her role at One-to-One, Smith helps teach workplaces evidence-based tools that reduce the risk of contracting COVID-19 - face masks, proper hand hygiene, avoiding prolonged close contact, improving indoor ventilation - in order to more safely return to work and other activities. While there are certain activities that can resume as long as proper precautions are in place, she said mealtimes and social gatherings indoors are where transmission is most likely to occur, which is why Thanksgiving poses such a threat.
She recommends that people who must convene always wear a face mask, spread out, avoid crowds, keep conversations short, ventilate areas or go outside, and either get meals to-go or eat and drink alone.
"We need to have repetition of the message, and it's not because we're trying to get you to believe something that's not true - we're trying to get you to remember that it is true. It's not any different than practicing your times tables," Smith said. "So yes, it's a culture change, but this is temporary."
And until there's a widespread vaccine, she said "the best thing to do is to try to lower your risk no matter what you do."
Contact Elizabeth Fite at efite@timesfreepress.com or follow her on Twitter @ecfite.