As lonely, stir-crazy Americans wait for a coronavirus vaccine to materialize in the distant future, some might be wondering if it’s safe to hang out with friends or rope extra family members into their quarantine bunker. The answer, experts say, will depend on where they live, the precautions they take, and the level of risk each party is willing and able to take on.
“Expand gradually, cautiously at first. As we gain more experience, we can adjust our behavior. Initially, small groups of friends and family, people we trust,” Stephen Morse, a professor of epidemiology at Columbia University’s Mailman School of Public Health, told MarketWatch in an email. “The decision has to be on an individual basis, as everyone differs in their risk tolerance and personal history.”
“ ‘Expand gradually, cautiously at first. As we gain more experience, we can adjust our behavior.’ ”
Morse added, “Unfortunately, we don’t have meaningful tests that could tell individuals who’s ‘safe,’ as the tests are still evolving and we’re still learning how to interpret the results. Some people may have recovered from COVID-19 already, and probably can expand their circles more.”
As many states begin reopening parts of their economy after weeks of COVID-19-induced shutdowns, surveys suggest that Americans — despite their broad support for stay-at-home orders — are starting to venture outside their immediate bubbles. The share of Americans who say they’ve been avoiding small gatherings declined from 84% on April 12 to 63% on May 17, according to Gallup polling. Some 55% now say they’re “completely” or “mostly” isolating themselves from non-household members, a number that has steadily slid from a high of 75% during the week of March 30 to April 5.
Julia Marcus, a professor of population medicine at Harvard Medical School, highlighted the mental-health toll, economic damage and “quarantine fatigue” that mass shutdowns have caused in a recent piece for The Atlantic magazine — suggesting that a harm-reduction approach, which acknowledges that people will take risks and provides support to help them mitigate the fallout, could be an effective strategy.
Public-health professionals and policymakers could “help the public differentiate between lower-risk and higher-risk activities” and provide a roadmap for “how to have a life in a pandemic,” Marcus wrote. Such an approach would be more sustainable in the long run than shaming people into “100% risk reduction,” she said, drawing a parallel to abstinence-only sex education.
“Everyone is just not going to be able — either mentally, or logistically with jobs — to just stay at home and avoid everything,” Tara Smith, a professor of epidemiology at Kent State University, told MarketWatch. “That’s the only way this is going to work moving forward.”
So what activities are OK to engage in? Is it safe to meet up with friends, ask the neighbor to watch your kid, or consolidate households with another family? Public-health experts spoke to MarketWatch about some basic best practices:
Keep an eye on COVID-19 transmission and public-health guidelines where you live
“It’s really important for people to know what’s happening in their communities,” said Amanda Castel, a professor of epidemiology at George Washington University. Are cases in your area trending up or down? Is your city or town currently a hot spot? Is testing available? Weigh all of these factors in your decision, Castel said, and abide by your state and local health departments’ guidance.
Danielle Ompad, an associate professor of epidemiology at the NYU School of Global Public Health, said she hadn’t seen friends in person since New York City shut down in March. “I live in an epicenter, and we know that neighborhoods like the one I live in, where there’s quite a bit of economic disadvantage and predominantly communities of color, have been really devastated by this disease,” she told MarketWatch. “The last thing I need to do is contribute to that.”
Wear a mask and practice social distancing while hanging out with friends
“Even if you’re going to meet up with friends, you still need to socially distance and use masks until we’re basically told otherwise by Anthony Fauci or another person who has the scientific authority and gravitas to make those types of decisions,” Ompad said.
Castel agreed. “[If] you don’t live with that individual, I would still be practicing social distancing with them and I would still be wearing a mask around them,” she said. “Masks and social distancing are now going to be foundational to how we operate when we’re out in the world and in society.”
Outdoor hangouts are better than indoor ones
Experts agree it’s better to interact with non-household members outdoors rather than indoors, as research indicates that it’s far more difficult to transmit COVID-19 in outdoor settings. “We’ve seen multiple studies where people in indoor environments, in workplaces as well as in dining settings, end up being infected because of air circulation and lack of adequate ventilation,” Castel said.
Outdoor meet-ups are not without risk, Smith said, especially if you’ll be in contact with someone for hours at a time — but they do seem to be less risky than doing the same activity indoors. Besides, your mental health will benefit from your getting outside for some air, Castel added.
Activities that don’t involve food or drink are best
You can’t properly wear a mask while you’re eating or drinking, pointed out Emily Landon, the medical director for infection prevention and control at University of Chicago Medicine. She recommended finding an alternative activity, such as a lawn-games tournament that allows everyone to wear masks, run around and maintain physical distance.
If you do choose to eat with friends, get together in an outdoor space that will allow for social distancing (like a backyard) and wear masks as much as possible, Castel said.
“Have people bring their own food and utensils, so that you minimize the risk of sharing contacts and surfaces but you’re still able to see each other and have that sense of community,” she said. “If you get to the park and see it’s overcrowded with no way to socially distance, then you may have to reconsider.”
Choose your contacts wisely
The size of a person’s existing social circle, as well as their potential exposure from working outside the home, should figure into your decision, Smith said. Choose people whom you trust to be honest about their potential exposures to the virus. “Remember that once you introduce them into your network, you’re basically sharing your network and their entire network amongst your groups,” she said.
Consider people’s ages and underlying health conditions, Castel added. “Are the family members that you want to interact with those that are at higher risk for a COVID infection?” she said. “If so, maybe you need to consider an alternative way to connect with them that might be safer.”
Take into account where people are traveling from — do they live in a high-transmission area? — as well as how well they’ve been practicing social distancing, Castel said. It also matters what mode(s) of transportation people are taking in order to meet up, Ompad said: “If your buddy is negotiating the rest of the world in order to come and see you, then they are potentially going to be exposed,” she said.
Keep any gatherings small, Castel said, and tell people that if they or someone in their household isn’t feeling well, they should stay home.
If you want to expand your ‘quarantine family,’ understand the risks
Not every public-health professional is on board with the idea of merging quarantine households. Ompad, for her part, said that such a decision would depend on each household member’s potential exposure to the virus. “To the extent that you don’t have to do that, it’s probably a better idea not to,” she said.
But some families juggling work, child-care and/or homeschooling responsibilities might find it helpful to have an extra set of hands during this time, Landon said. She and her son have such an arrangement with the family of four that lives across the hall, with whom they’ve been close for years. (Landon isn’t currently exposed to COVID-19 patients.)
“Teaming up with another family is not a bad idea, and it can be done safely and carefully in order to ameliorate some of those issues,” she said. “You’ve got to acknowledge that there’s a risk, but it may be a solution to a problem that’s been plaguing people.”
If you do commit to being around another family or individual without taking social-distancing or masking precautions, all parties need to be vigilant about their interactions with everybody else, Landon said. You might choose a person or family with whom your household will now interact regularly — maybe cousins who visit weekly, or your best friend and her kids — but otherwise maintain your quarantine. That way, if someone were to get sick, the infection wouldn’t spread beyond your slightly widened circle.
“Everybody’s entitled, as the situation is improving, to have a few more contacts — we don’t have to stay locked up forever,” Landon said. “Either have careful, casual contacts where you’re wearing a mask and keeping a distance, or absorb someone into your family so that you have a group where you’re basically all like household members — so if someone gets sick, transmission will stop with your household members.” Try to minimize your casual contacts with others, she added.
Some people might want to get tested and/or self-quarantine for two weeks before joining someone else’s bubble. Discuss in advance what you’ll do if someone in the group develops COVID-19 symptoms, Landon said; it’s particularly important in this situation that everyone understands and agrees to the risks involved.
“If you don’t want to take on all of that person’s risk onto yourself,” Landon said, “then you need to wear a mask and keep your distance.”