The Centers for Disease Control and Prevention has issued guidelines for “community mitigation strategies” to limit the spread of COVID-19, the disease caused by the coronavirus, which include recommendations for “social distancing”—a term that epidemiologists are using to refer to a conscious effort to reduce close contact between people and hopefully stymie community transmission of the virus.
But what exactly does “social distancing” look like for a woman trying to go about her life while staying healthy and helping keep the people around her healthy? Even detailed instructions are difficult to sift for actionable advice. If I have a fourth date tonight, do I go? If I’m invited to a wedding in two weeks in another state, is it too late to cancel? If we’re on lockdown, and I live alone, can I walk to my friend’s apartment when I feel sad? If I end up officially quarantined, can I walk around the park at night for some fresh air?
The CDC guidelines acknowledge factors like the size of a community, its population density, its access to health care, and caveats that social-distancing measures can “be scaled up or down depending on the evolving local situation.” There are conflicting messages coming from media and people’s peers: On Reddit, young people are signing a “self-quarantine manifesto” while, at a press conference, the mayor of New York City is telling people to continue visiting bars and restaurants as normal, to protect the local economy.
So I took my personal questions to a series of public-health experts. “I think it’s a hard time because many of the recommendations we’re making are about increasing the distance between people, but of course, being close to people is what makes life a pleasure,” Carolyn Cannuscio, the director of research at the Center for Public Health Initiatives at the University of Pennsylvania said in a phone call. “So this is going to be a very difficult time. No question.”
If you’re confused about what to do right now, you’re not alone—even these experts occasionally disagreed on the answers to my questions. Where there were discrepancies, I’ve included all the different answers as fully as possible, and as the situation has evolved, I’ve allowed the experts to update their answers to questions to reflect new information. This guide is aimed toward those who are symptom-free and not part of an at-risk group, with an addendum at the end for those in quarantine. If you are symptom-free but are over 60 years old; have asthma, heart disease, or diabetes; or are otherwise at risk, experts recommend defaulting to the most conservative response to each of these questions.
There is a general consensus that while young and healthy people who are at lower risk for personally suffering severe illness from the coronavirus don’t have to be locking themselves in their homes for the next month, they do need to dramatically alter their daily lives, starting now.
Cannuscio: People should avoid gathering in public places. People should be at home as much as possible. The measures that have worked to get transmission under control or at least to bend the curve, in China and South Korea, have been extreme measures to increase social distancing.
Albert Ko, the chair of the epidemiology department at the Yale School of Public Health: The CDC recommendations are to keep six to 10 feet away from other people. Bottom line, there’s no absolute indication not to go to bars and restaurants, but in practicing good public health—which is kind of a responsibility for everybody in the country—really think about how we can decrease those close contacts.
CAN I HAVE A SMALL GROUP OF FRIENDS OVER TO MY HOUSE FOR A DINNER PARTY OR A BOARD-GAME NIGHT?
Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security: With few exceptions, now is the time to cancel get-togethers. Dating, family visits, house parties, should all be postponed or held virtually if possible. There are personal situations where you must go out for work, for supplies, or to help someone else in need. In those cases, take precautions to keep your distance from others, and wash your hands frequently. If you develop a fever or cough, don’t go out unless it is absolutely necessary or to seek medical care.
Ko: We’re in a gray zone now. The public-health imperative is to create social distance; that’s the only way we’re going to stop this. Think about having those get-togethers but practicing good public health: not sitting very close, trying to keep distance. Wash your hands; avoid touching your face. There are places on the board game that people are constantly touching—routinely disinfect [those, as well as] doorknobs, the bathroom faucets, those types of things. There’s no absolute rule about what works, but what we do know is that decreasing the size of those gatherings, increasing the distance, practicing good hygiene will go a long way.
Cannuscio: I would recommend that people minimize social contact, and that means limiting all social engagements. That includes intimate gatherings among friends. I think the exception is if two households are in strict agreement that they are also going to reduce all outside contact and then those two households socialize together, to support one another. I can see social and mental-health advantages to that kind of approach.
Ko: Dating is usually one person and another person. What we’re really worried about in terms of public health are these large gatherings where you have people crowded together, and you can have what we call super-spreading events. The risk of those goes up exponentially the larger the size of the gathering. Dating is at the other end. I think you can still date.
Cannuscio: It is a time to be very cautious about initiating contact with new people. This seems like a great time to get creative with your text messages. [Or] take it to FaceTime or a phone call.
Watson:I would not advise people to go to the gym to work out now. I am trending more toward being conservative with social-distancing measures the more we see from Italy and with the changes in guidance from CDC and state and local health authorities. So, I would not advise people to go to the gym to work out now.
Cannuscio: No. In the coming days, as the crisis escalates, our freedom of movement may be restricted, so people will have to get creative about exercising at home. Can someone please host virtual dance parties? Create a playlist to get us through the pandemic? Our family has felt some relief after blasting music and dancing around the kitchen—not to deny the horror of what is happening now, but to deal with it. Our daughter actually thanked us when we threw a dance party. Highly recommend.
Cannuscio: For now, walking, running, [and] biking outside, in uncrowded locations, seems like a healthy thing to do. Our family has driven to the woods in the past few days, in search of green and open space. For urban dwellers, finding an empty path is challenging. For people in more remote areas, being outside is a great way to cope. Walking outside with a friend, while keeping distance, is likely to be a relatively low-risk activity. With every additional social contact, the risk of encountering an infected person goes up, so strictly minimize the number of people you interact with. I wouldn’t pick a new friend every day! Stick with one friend, and preferably one who limits their other social contacts, too.
Watson: If you don’t have symptoms, going out in nature where you are not within six feet of other people is okay. We need to look after our mental and physical health, and fresh air, nature, and exercise are really important for that. However, meeting people is risky and could undermine our collective sacrifice to reduce viral transmission, especially if you don’t keep your distance. If you do go out with a friend, stay at least six feet away and avoid physical contact.
Cannuscio: I would say try to shop at times when there are very few other shoppers there. That [could mean] going first thing in the morning when the store opens, or late at night. I think many people will rely on delivery, and that’s just the nature of our lives right now. For delivery workers, I would say, leave the food on the doorstep and ring the bell, rather than interacting face-to-face with the person who’s ordered the food.
Cannuscio: First of all, people who have the opportunity or the option of working at home should absolutely use that option right now. For people who have essential functions and have to be at work, if they have any flexibility in their schedules they should try to ride at non-peak hours. On subways or buses, people should try to stand as far away from other people as possible. I think it’s important for planners to think about, for example, putting more buses on the most heavily traveled routes, to maybe thin out the crowds on those buses. In cities where it’s possible to walk, that would be a better option.
For people who can afford to use ride-sharing services, you’re limiting the number of people you’re in contact with as the rider, so to me that seems like a reasonable step to take. Of course, I worry about all those drivers who have people in and out of their cars all day long.
And of course, everyone should be using good hand hygiene and respiratory etiquette. If you have to cough, cough into your elbow. And I can’t believe I have to say this, but I’ve been in public places where people have been spitting, in parks or on the sidewalk. I would ask people not to spit!
Watson: It’s hard to say “Don’t take public transit,” because a lot of people rely on it to get to work. If you don’t have to and you can drive, it’s probably a good idea. It will help other people who have to take public transit for their livelihoods to do so and do so more safely.
As of March 15, the CDC recommends that all gatherings involving 50 people or more be canceled for at least the next eight weeks.
Cannuscio: One of the best ways we can show love to the people we care about is to step back and to stay away. In many cases that takes courage, and it takes speaking out over these social norms that dictate that we should be polite and we should be together and we should celebrate and gather.
Watson: I think we should start limiting visitation to people who are in assisted-living facilities and nursing homes. I know that’s really tough, and maybe setting things up so you can visit them virtually is a good idea. [That way], they can see you and say hello, [without putting] them at extra risk.
Cannuscio: I think if we are fortunate enough to live near our elders and we get into the mode of seriously isolating our own families, then one person should be designated to go and visit. If we’re not in a situation where we can truly limit our own social contact, then we will be putting that elder at risk by going to visit.
Watson: Those are more one-on-one interactions. I think there’s a lower likelihood that exposure is going to occur that way. I don’t think that’s a big concern.
Cannuscio: I would say hold off on your haircut and then when you go back, when it’s clear that we have vanquished this foe, everybody please give your hairdresser extra, extra tips. I hope that policies will be put into place to protect the paychecks of people who will suffer during this period.
Cannuscio: Try to schedule your use of those common spaces so you’re going at times when other people aren’t around. If you know there are not a lot of people in the laundry room or mailroom at 6 a.m., go at 6 a.m. People will be inconvenienced, but it’s important to try to spread ourselves out.
Ko: That’s really hard to do. Again, what we’re really worried about is large gatherings. In the home, close contact is almost inevitable.
Cannuscio: I would say if you’re in a steady, monogamous relationship and you and that other person are limiting your social contacts, then be as intimate as you want to be.
Watson: If you get sick, try to maintain some distance. Otherwise, households should go about their normal business.
Cannuscio: No, quarantine means “stay away from other people.” You shouldn’t have visitors.
Ko: Under quarantine, people really shouldn’t enter the home or be in the same physical space.
Cannuscio: For people who live in areas that are not densely populated, walking around in their yard is probably safe. The idea is that they should not come into contact with any other people. They need to be strict about it. We are not going to defeat this and halt transmission if people loosely interpret what it means to self-quarantine or self-isolate.
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