You can see friends and relatives during the pandemic surge — but do it careful

Reviewed by James Ives, M.Psych. (Editor)Jul 14 2020

Cooped up too long, yearning for a day at the beach or a night on the town — and enticed by the easing of restrictions just as the warm weather arrived — many people have bolted from the confines of home. And who can blame them?

But Houston — and San Antonio and Phoenix and Miami and Los Angeles — we have a problem.

COVID-19 is spiking in Texas, Arizona, Florida, California and other states, forcing officials once again to shut down bars, gyms and the indoor-dining sections of restaurants.

But that does not mean we can't spend time with the important people in our lives. Our mental health is too important to avoid them.

You can expand your social bubble beyond the household — if you heed now-familiar health guidelines and even take extra precautions: Limit the number of people you see at one time, and wear a mask if meeting indoors is the only feasible option or if you can't stay at least 6 feet from one another outdoors. Disinfect chairs and tables, and wash your hands, before and after the visit. If food and drink are on the agenda, it's best for all involved to bring their own, since sharing can raise the risk of infection.

Arthur Reingold, a professor of epidemiology at the University of California-Berkeley's School of Public Health, and his wife, an epidemiologist for the Centers for Disease Control and Prevention, have begun spending time with another couple around their age who have a large patio. "They have us go around the back; they don't have us go through the house," says Reingold, 71. "We sit on chairs that are a good 10 to 12 feet away from each other, and we talk. We bring our food, and they bring their food."

And they don't wear masks. "I personally believe the risk from that situation, even without a mask, is pretty minimal," Reingold says. "But if people wanted to try to do that and wear a mask, I don't think that would be unreasonable."

And while we are on the topic of masks, please remember they don't make you impervious to infection. "Your eyes are part of the respiratory tree. You can get infected through them very easily," says George Rutherford, a professor of epidemiology at UC-San Francisco. If you are medically vulnerable, or just want to be extra careful, consider wearing a face shield or goggles.

Most of us have wrestled with the question of how big a gathering is too big. It's impossible to give an exact answer, but the smaller the better. And keep in mind there is no such thing as zero risk.

In the U.S. as a whole, the average infection rate is currently about 1% to 2%, which means one or two people in a group of 100 would typically be infected, says Dr. Yvonne Maldonado, a pediatrician specializing in infectious diseases at Stanford University's School of Medicine. In any individual setting, however, these percentages don't necessarily apply, she says. And a gathering in an area where the COVID-19 rate is surging — or already high — is more dangerous than one of the same size in a place where it's not. So stay informed about the status of the pandemic in your area.

Be wary even of friends you've known and loved a long time. That may sound callous, but you need to know something about the behavior and recent whereabouts of anyone with whom you plan to visit. Don't be shy about asking where and with whom they have been in recent weeks. If they are a close enough friend for you to want to see them, they should understand why you are asking.

A chart from the Texas Medical Association that generated controversy on Twitter in recent days listed numerous activities, ranked from lowest to highest risk. Among the riskiest behaviors: going to a bar, a movie theater or any other crowded venue — and eating at a buffet. You could ask questions based on that list, or a similar one, to determine if it's safe to visit with someone.

With regard to play dates for your children, public health experts say you should apply the same safety precautions as for adult get-togethers. "Children can play together, especially if their families have been socially distancing, the activities do not involve physical contact, and they can engage in the activities with sufficient physical spacing," says Stanford's Maldonado.

Another question, never far from my mind, is whether it's risky to let a plumber or electrician or handyman into the house. I've put off needed house repairs for several months because of my uncertainty about it.

I put the question to the public health experts I interviewed for this column, and they agreed: As long as you both wear masks and stay a healthy distance apart, the visit should not pose a significant threat. But ask the person what precautions he took on visits to other homes. If he works for a company, check its policies for employees who go from home to home.

Shannon Albers is hugging loved ones again - with certain COVID-inspired modifications. "After 89 days I finally got to hug my mom, and she started crying," Albers recalls.

Because I have two large dogs, I have also wondered whether they could be potential virus spreaders — not through their respiratory droplets, but because the virus might land on their fur. When I'm out walking them in the evening and see neighbors with their canines, we usually keep our distance, but once in a while somebody wants to pet one of my dogs, and I've been tempted to pet theirs — but have resisted.

My experts say I shouldn't worry. It is theoretically possible to catch the virus off a dog if somebody just sneezed on it, but that's an unlikely scenario. The dog's owner poses a bigger risk.

For those of us who have craved more human contact, it may come as a welcome surprise that some public health experts think it can be safe to hug people (though not dog owners you don't know) if you follow certain guidelines: Do it outdoors; wear a mask; point your faces in opposite directions; avoid contact between your face and the other person's body; keep it brief and wash your hands afterward.

Shannon Albers, a 35-year-old resident of Sacramento, says she started hugging people again after reading a story about how to do it safely in The New York Times.

"After 89 days I finally got to hug my mom, and she started crying," Albers recalls. "We were standing on the driveway, and I said, 'Do you want a hug?' She immediately tightened her mask and started coming down the driveway, and I said, 'Wait, Mom. There's rules.'"

Chronically ill and elderly people may not want to risk it, says UC-Berkeley's Reingold. "But if you are out drinking beers with somebody in a crowded room, I'm not sure the hug makes a difference, frankly."

This KHN story first published on California Healthline, a service of the California Health Care Foundation.