When the US entered the early stages of the pandemic, federal and municipal leaders maintained that the best way to prevent the spread of the pandemic was for as many people as possible to "Stay Home." Technically, that advice was sound: the only surefire way to prevent illness is to eliminate contact with all possible vectors. Still, that advice was impossible to heed perfectly and indefinitely, and people almost immediately began taking risks to fulfill their basic wants and needs. Unfortunately, as a public health strategy, "Stay Home" offered no guidance for how to most safely take particular risks — as a consequence making already high-risk behaviors even less safe.
For public health professionals whose work involves sex safety, drug and alcohol use, and HIV/AIDS prevention, the discourse surrounding coronavirus — the absolutism, the moralism, the shaming and the open hostility towards public health recommendations — is familiar. As epidemiologist Julia Marcus wrote in a recent piece for The Atlantic, the "Stay Home" edict bears striking resemblance to that famous mantra preached by abstinence advocates: "Just Say No." In this podcast extra, Marcus and Brooke consider the shortcomings of an abstinence-only response to the pandemic, and how harm-reduction approaches could better serve the public.