Coronavirus

Headed to Fenway for Opening Day? What doctors say you should know about your coronavirus risk.

“There’s no zero risk once you leave the doors of your house, and so people need to remain vigilant.”

Preparations underway for Opening Day at Fenway Park. John Tlumacki / The Boston Globe

Fans will return to Fenway Park on Thursday for the first time since 2019 when the Boston Red Sox take the field against the Baltimore Orioles for Opening Day, following a season that was disrupted by the coronavirus pandemic.

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The team will allow about 4,500 people — roughly 12 percent of Fenway Park’s capacity — into the ballpark, a development that became possible when Massachusetts moved into the first step of its final phase of reopening on March 22. The easing restrictions, despite a coalition of public health and community groups pushing Gov. Charlie Baker to reconsider, allowed indoor and outdoor stadiums — such as TD Garden and Fenway — to reopen under a 12 percent capacity limit.

Ahead of Opening Day, officials at Fenway warned returning fans that the experience of catching a game will be a little different as the park makes adjustments — including socially-distanced seating and updates to concessions — to help prevent the spread of COVID-19.

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But even with the changes being made by the Red Sox and at TD Garden to allow the public back for games, local infectious disease experts say individuals should think carefully before heading to the stadiums.

“We’re not out of the woods yet in terms of the pandemic,” Dr. David Hamer, a professor of global health and medicine at Boston University and an attending physician in infectious disease at Boston Medical Center, told Boston.com.

Hamer said he’s “moderately concerned” about the potential risks as stadiums reopen. Massachusetts saw a decline in its COVID-19 cases in February and early March, but the numbers have been rising back up recently.

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“It’s really a question of the numbers,” Dr. Erica Shenoy, associate chief of infection control at Massachusetts General Hospital, told Boston.com. “The more people there, the increased risk that there are people infected within the group.”

The Centers for Disease Control and Prevention and other public health authorities are still recommending people avoid medium and large-sized gatherings, advising that attending such events increases the risk of contracting and spreading COVID-19 since cases remain high.

Dr. Cassandra Pierre, associate hospital epidemiologist at Boston Medical Center, told Boston.com she’s feeling both “joy and dread” at the same time as the sports venues begin hosting fans again.

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On the one hand, she said it’s “wonderful” to think about going back out and resuming some of the activities that used to be normal before the pandemic, especially as more and more people get vaccinated.

“There’s always a risk gradient, and so my concern about [Fenway Park] would be certainly lower than being in an indoor entertainment venue or even in an indoor restaurant,” she said.  “People could safely go with their households next to them, physically distanced from other households, especially in reduced capacity situations.”

But on the other hand, Pierre said her concern remains that people will think that just because stadiums have reopened, that it is safe. She’s worried individuals will believe it is all right to resume those activities the way they have been enjoyed or attended in the past, pre-pandemic.

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People may think it’s safe to cluster with mixed households without their masks or linger near bars, she said.

“Or basically revert to contact that feels normal and familiar to them — when in this case, we still do need to keep our guard up, even as we enjoy a game at the stadium,” Pierre said. “We understand that there is reduced risk — there is still some.”

The doctors agreed that outdoor venues, like Fenway, are more appealing and present less risk because natural air currents can disperse potentially infectious aerosols more readily than indoor ventilation systems.

Additional efforts like wearing face coverings, following social distancing, and only going to the events with people in your household will also help reduce the potential risk for spread of the coronavirus.

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“If people are wearing masks and they’re outdoors and there’s some degree of distancing, then I think the risk of transmission between different groups is extremely low,” Hamer said. “Within a group, if somebody is infected and they’re all close together, that’s a different story. But presumably groups would be traveling together with family members or friends who knew their status quite well. If they’re starting to eat and drink and take their masks off, then that really changes the equation.”

“I think if you stick to the basic principles of avoiding those large gatherings, when you do go to those gatherings, being smart about the choice of outdoor over indoor and making sure that you’re abiding by the rules around masking and distancing is probably the best advice I could give,” Shenoy said.

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The physicians said a lot of the potential risk comes down to the level of occupancy and how strictly efforts to reduce the spread — like wearing masks and social distancing — are maintained or enforced. It remains to be seen, Hamer said, whether staff at the venues will be reminding fans to keep their masks on or asking them to put them back on, as flight attendants have been doing for travelers on airplanes over the last year.

Besides behavior, Pierre said she feels uneasy about the opening of the stadiums given the rise in the number of cases of the virus variants that are more highly transmissible in ways that still aren’t completely understood.

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According to the CDC, there had been 686 confirmed cases of the B.1.1.7 variant, which originated in the United Kingdom, in Massachusetts as of Wednesday. The governor has suggested that the official variant numbers are likely undercounted due to limited viral sequencing. Earlier this week, Baker said one local hospital found that the B.1.1.7 variant accounted for 55 percent of the infections that they tested.

“It’s not to say these variants are going to form their own models of gravity and physics and science and cause widespread transmission in an open air setting, that’s not necessarily the case,” Pierre said. “But it takes a lower infectious dose to cause infection than you otherwise might have for a non-variant. Which means, potentially, if you come too close to someone who is infectious you might still have a higher risk of transmission than you would certainly in the past and also had you not gone out.”

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Compared to other activities, Pierre and Hamer agreed that catching a game at Fenway is likely lower risk than working out indoors at a gym or eating indoors at a restaurant, particularly if the eatery is more than 50 percent full.

But the exact risk isn’t entirely clear, Hamer said, since stadiums in Massachusetts haven’t been open to the public for events since March 2020.

“There’s no zero risk once you leave the doors of your house, and so people need to remain vigilant,” Pierre said.

Given where things are now with the pandemic, the BMC doctor said she personally would not go out to a stadium event unless she was vaccinated. The COVID-19 vaccines give a real, extra layer of protection against the virus and confidence to re-engage with “normal life,” she said.

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“From my personal perspective, that would be my precondition for feeling comfortable,” she said.

And if she was going as a vaccinated individual, she said she still would make sure to attend the game with other vaccinated individuals.

“Even though everyone is wearing masks, people are going to be shouting, there will be respiratory droplets in your vicinity potentially, and so you want to try and continue to move in a herd of vaccinated individuals as much as possible,” Pierre said.

People may also want to consider who they have at home if they are attending games and what they could potentially bring home to unvaccinated family members.

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Zip ties are placed on seats in which fans will not be allowed to sit.

Her colleague, Hamer, said if he wasn’t vaccinated, he would be hesitant to attend a game at a stadium.

“I wouldn’t’ absolutely rule it out, but I think I would be very cautious,” he said. “I would try and carry a two or three-ply cloth mask or an N95 or equivalent and wear that most of the time. I would not take it off. If I were going to do food, I would try and do that in a place where I was separate from other people other than my immediate family. And if I did all that, I would think I would feel fairly comfortable.”

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Pierre stressed that individuals should not be cavalier after attending games at stadiums about any potential symptoms that emerge — even if you’ve been vaccinated — and get a COVID-19  test.

“Remain vigilant, especially during this rise of the variants,” she said. “You just want to be as cautious as possible.”

Below, the steps the doctors said individuals should take when attending games or events at stadiums to reduce their risk of COVID-19:

  • If you don’t feel well, don’t go
  • Attend with people in your household, avoid mixing with other groups
  • Maintain social distancing — from the lines to get into the stadiums to concessions stands to being in your seats
  • Wear an effective mask, high-quality mask and make sure the people you are attending with do as well
  • Keep your mask on as much as possible — even for cheering and singing “Sweet Caroline” or “Take Me Out to the Ball Game” (Scientific evidence has shown that singing can project infected aerosols a greater distance, so while a mask might muffle your rendition of the Fenway traditions, it’s an “especially good idea” to keep your face covering on, Hamer said.)
  • When you do take off your mask to eat, try to do so away from people who are outside your household
  • Don’t linger near bars or crowded areas
  • Bring hand sanitizer with you and maintain good hand hygiene during the event
  • Look out for symptoms afterwards and consider getting a COVID-19 test if they emerge

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