So what am I supposed to do now? Social distancing for families

We’re basically three days into the Great American Pandemic Shutdown. I feel like the initial shock is wearing off and I’m more calm than I was. I’m getting used to the idea, at least, that everything is canceled. Call it stages of grief or something. With the first wave of distress past, now we start to grapple with the actual effects of losing our routines and security.

And oh boy, the kids are home indefinitely.

A friend of mine is looking at her family and wondering what to do. Or more to the point, what she should NOT do, in terms of social distancing. Officials are warning parents, don’t treat this like a snow day. (Sorry, my California friends, this is a cultural reference you might not understand.) We didn’t close school so gangs of kids could go share saliva at Chuck E Cheese. My friend wonders, what does “social distancing” look like for me and my family? Should we dine out? Go to movies? Get haircuts? Are playdates allowed?

Good questions. If she is a responsible citizen and a good parent, what are the answers?

Shades of gray, my friends.

Here’s a short answer: as of today, March 14, 2020, public health officials in the US have not asked all citizens to self-quarantine. Rather, only people with known exposures, travel history, or symptoms (e.g., fever, cough) should sequester themselves at home for 14 days.

Which does not mean everybody else gets to do as they please.

One part of the longer answer is personal risk. If you are 70 years old and recently had an organ transplant, your personal risk of a bad outcome is much higher than a healthy 18-year-old. This should influence how much you avoid contact with other people. For most people, middling in age and average in health, it’s not necessarily a quantitative question. How afraid are you? What do you have at stake in terms of caring for elderly parents, or a job you must do? How far are you personally willing to go to avoid exposure to the SARS-CoV-2 coronavirus? These factors, and your personal risk tolerance, will influence how you behave.

The other part is about collective risk (or responsibility). The emphasis right now is on large gatherings of people, because that yields the greatest public health benefit for the community. Multiple smaller gatherings don’t necessarily add up to the same risk as one large one. To illustrate, imagine 50 people, one of whom is carrying the coronavirus. If all 50 get together, then 49 people are exposed. If those same people have ten separate gatherings of 5 people each, only 4 people get exposed to the one carrier. It’s like the old adage, one bad apple spoils the barrel. So keep the barrel small.

Put all of that together, and for now, choose moderation. If you and your family are not in a high-risk category, if you have not been exposed, if you don’t have symptoms, then go about your life while generally choosing to keep to yourselves. (Easier to do now that most public venues are closed.) Maybe choose two friends for your kids to hang out with, but don’t arrange a birthday party. If you go out to eat or to a gym, be diligent about hygiene. Wash your hands. Wipe surfaces. Keep six feet away from other people. Avoid physical contact. Don’t touch your face.

Keep in mind all of this can change suddenly. Right now the incidence of coronavirus in your U.S. community is probably not very high. But it’s growing. Without social distancing efforts, one scientific paper estimates the doubling time is about 6 days. With exponential growth we could abruptly enter a phase of the pandemic when stricter personal isolation is necessary, of the kind deployed in Wuhan and now in northern Italy. Listen to public health officials and if the need arises, we will all stay home.

Get the scientific backstory on SARS-CoV-2 and emerging infections. Read my concise ebook “The Coming Pandemic” for free. If you like it, please share with others and leave a review on amazon.

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