In early March, when most Americans began social distancing, the hope was that life would get back to normal after just a few weeks. It’s become clear now that some distancing will be needed for many more months, or even years, to keep the coronavirus at bay. But quarantine fatigue is real. Abstaining from all social contact for the long haul won’t be a sustainable option for most people. So, how can we make decisions about socializing during the coronavirus pandemic?
Risk isn’t binary
Public health messaging over the past several months has focused on staying home as much as possible. Staying home alone or with your household members is still the lowest-risk choice you can make with respect to catching or spreading the coronavirus. Being in a crowded indoor environment is the highest-risk choice.
But risk isn’t binary, and there’s a lot in between those two options. Thinking about a spectrum of risk can help you choose the lowest-risk options for socializing that will be sustainable for you in the long term.
How can you assess the spectrum of risk?
The risk of contracting or transmitting the coronavirus depends on many factors. Here are some important considerations when you’re assessing risk to yourself and others.
- Know what’s happening with virus transmission in your community. Try to keep tabs on what’s happening with community spread where you live. For example, pay attention to whether the number of new cases, hospitalizations, and deaths are high or low, or increasing or decreasing. Some regions are opening while these numbers remain fairly high, so you may choose to be more conservative with your social contact than the current recommendations in your area. Just because the hair salon is open doesn’t mean you have to get a haircut.
- Consider vulnerability to the coronavirus. If you or your social contacts are particularly vulnerable to the coronavirus, either because of older age or underlying health conditions, factor this into your assessment of risk when making decisions about interactions outside of your household.
- Evaluate the risk of the activity, which includes its duration and setting. The highest risk for transmission is with close contact, prolonged interaction, and enclosed environments. In contrast, keeping a distance of at least six feet, brief interactions, and outdoor settings will keep risk lower. Sitting indoors a few feet away from a friend and having a long talk is a higher-risk situation than going for a stroll or chatting briefly with that person outdoors. Face coverings can further reduce risk, and are particularly important when interacting with people in close proximity or indoors. It also helps to use other protective measures, including frequent handwashing.
The benefits of being social
Health is more than just disease prevention. For many people, being healthy requires social interactions with friends and family, spending time outdoors, exercise, physical intimacy, and other pleasures of life. When making decisions about social contact during the coronavirus pandemic, you will need to weigh the risk of the interaction against the potential benefits to your overall health.
Harm reduction strategies can help
Unlike abstinence-only messaging, which simply tells people to stay home, a harm reduction approach meets people where they are by accepting that it isn’t always possible to eliminate risk. It supports people in making lower-risk — but not necessarily zero-risk — choices that are sustainable for them, and offers strategies to reduce any potential harms. The abstinence-only and harm reduction approaches share the same goal of reducing illness and death, but from what we know about HIV, substance use, and other areas of health, harm reduction is far more likely to work.
Several examples of harm-reduction approaches to social contact have been adopted outside of the United States. Acknowledging that single people may need physical intimacy, the Netherlands has suggested that people find a seksbuddy, with one consistent sex partner being much less likely to spread the coronavirus than having multiple partners. Several provinces in Canada have issued guidance on “double bubbles,” in which two households agree to socialize exclusively with each other without the need for physical distancing.
It’s true that every additional social interaction increases risk, but with continued social distancing from other individuals and households, harm reduction approaches might help people forego higher-risk activities, like crowded house parties, over the long term. As we enter the fourth month of this pandemic, with many more months ahead, it’s time to start thinking about sustainability.
Follow me on Twitter @JuliaLMarcus
For more information on coronavirus and COVID-19, see the Harvard Health Publishing Coronavirus Resource Center.
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