As parents face the possibility of a summer devoid of camps, pool parties, barbecues and vacations, many are wondering what they can do to keep their families sane. My kids are increasingly missing their friends and sense of normalcy; it feels like something has to give or we’ll all lose our minds.
One idea that some families are considering — and that infectious disease epidemiologists think might be a smart way to balance mental health needs with physical safety — is to create quarantine “pods” or “bubbles,” in which two or three families agree to socialize with one another but no one else. In a pod, families hang out together, often without regard to social distancing — but outside of the pod, they follow recommended social distancing rules.
The reality is, people need social contact, and some families are struggling without it. So we need to find ways to socialize safely (just as sex education teaches safe sex, even if the safest thing is not to have sex at all). “The ideal thing is that we just stay home forever and never see anybody — but that’s just not sustainable,” said Zoe McLaren, Ph.D., a health policy researcher in the School of Public Policy at the University of Maryland, Baltimore County.
Julia Marcus, Ph.D., an infectious disease epidemiologist at Harvard Medical School, agreed. “We don’t want to prevent disease at the expense of overall health,” she said. So why and how should you start a pod, and what ground rules should you set to keep it as safe as possible?
When Pods Make Sense
Certainly, there are ways to be social that don’t involve pods. The ideal option, of course, is to gather over Zoom or FaceTime — no germs involved. If your kids get what they need from virtual meet-ups, those are certainly best.
There’s also the socially distanced play date — when kids get together but remain at least six feet apart, ideally wearing masks. But can you really socially distance a play date? Experts are skeptical, particularly for younger children.
For one thing, it can be tough to keep young kids, whose play is often quite physical, six feet apart. It’s not so much that children can’t estimate distance — many can. But “the much more tricky part is their inhibitory control — their ability to not act impulsively and do things that they want to do,” said Jamie Jirout, Ph.D., an educational psychologist at the University of Virginia’s Curry School of Education and Human Development. Research suggests that inhibitory control doesn’t fully develop until adolescence.
If a 5-year-old really wants to wrestle his friend to the ground, it’s going to be difficult for him to quell that impulse for the sake of an abstract concept like social distancing. And because kids’ working memory is poor (it improves throughout childhood and adolescence), Dr. Jirout said, they may not always remember the six-foot rule. So you will have to constantly supervise the kids and be ready to intervene when they inch too close.
Socially distanced play dates can work well when physical barriers like fences keep kids apart or when kids stay sedentary (such as by playing a distanced game of Battleship). But how safe are these kinds of scenarios? “Spending an hour with a friend in masks sitting on a front porch six feet apart — there’s actually more risk involved in that than you might think,” Dr. McLaren said, because of the possibility of kids exchanging germs via the air they share.
Because of these concerns, carefully-chosen pods may be safer than having distanced play dates with multiple families, particularly when young kids are involved. Plus, if someone in your family gets sick and you’ve been spending time with various families, contact tracing gets much harder.
Choosing a Pod
If you think your family needs a pod, you’ll first want to ponder whom to approach. To minimize your risk for catching and spreading Covid-19, you’ll want to find a family that is being as careful as you are — a family that is mostly staying home, wearing face coverings when they go out in public, and not otherwise socializing in person.
“If the other household is already caring for their neighbor and playing occasionally with their cousins, then there are a number of ways an infections chain could start,” said Stefan Flasche, Ph.D., an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine. The idea is to create a closed loop — each family in the pod does not have contact with people outside the pod.
Ideally, you’ll want to find a family that has a low risk of complications from the coronavirus. Or, for higher-risk families, make sure they understand and are comfortable with the additional risk that the pod would create. If a family has grandparents living in the house or a child or parent with a medical condition that puts them at high risk, take extra precautions and reduce your own potential exposure to the coronavirus to keep them safe. Maybe agree to only go into stores once a week rather than every few days.
Also, the smaller the pod, the better — pods of two families are best, with 5 to 10 people total. “Every additional person you add adds in more risk for everybody else in the group,” Dr. McLaren said. “Keeping the pod size small is really, really key for minimizing your risk.”
It’s also crucial that you choose a family whose judgment you trust. Families are inevitably going to encounter risky situations, and you want to be able to trust that they will make smart decisions, Dr. McLaren said. Likewise, you’ll want to pod with a family that will be transparent and open about what they encounter and experience. If someone sneezes on a member of your pod at the grocery store, you’ll want that pod member to tell you about it so that you can all discuss next steps.
Finally, pick a family that will enrich your family, said Emily Oster, Ph.D., an economist at Brown University. Do the kids like each other? Do you like the other parents? Are there things you can do together that will make the summer more fun? Maybe you could even pod up with a family of a different race or ethnicity so you can grow and learn from each other.
If you’re going to pod up, you might as well choose a family that helps you “become more than the sum of your parts,” Dr. Marcus said, as that will make your quarantine experience more sustainable.
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Frequently Asked Questions and Advice
Updated June 5, 2020
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Does asymptomatic transmission of Covid-19 happen?
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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How does blood type influence coronavirus?
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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How many people have lost their jobs due to coronavirus in the U.S.?
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
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Will protests set off a second viral wave of coronavirus?
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
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How do we start exercising again without hurting ourselves after months of lockdown?
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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My state is reopening. Is it safe to go out?
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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What’s the risk of catching coronavirus from a surface?
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
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What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
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How do I take my temperature?
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
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Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
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How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
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Negotiating a Pod
If you decide to try a pod with another family, brace yourself for some awkward conversations. First, the other family might not want to pod with you or has podded with someone else. It’s like high school prom all over again. If they are interested, you’re going to have to discuss your personal and private life with them — what you do every day, how you get groceries, how often you order takeout, Dr. Oster said.
Sit down for a Zoom or FaceTime conversation and set some ground rules — this is just a conversation, and there will be no hard feelings if either family decides not to move forward. Remember that this is a very trying time, and the most important thing is that you remain friends.
Next, talk about what you’re hoping for and share details about your daily life and the precautions your family takes. The goal is to determine whether you and the other family are on the same page with regard to how you approach quarantine and what you are looking for.
Also, keep in mind that even if just one person in their family is at high risk for contracting the coronavirus — maybe the mother is an emergency room doctor and you live in a city where the coronavirus is widespread — that person’s risk will spread over to your family members, too. “The risk in the pod is as high as whichever individual has the highest risk of contracting the virus,” Dr. Marcus said.
Also discuss commitment. Are you expecting that the pod will last all summer? Or would you rather start with a two-week trial period, and then check back in to see how things are going? Dr. McLaren pointed out that it’s possible to pod with one family for a while and then switch to another family; you’ll just need to have a two-week quarantine period between the two to make sure no one has been infected.
If you decide to move forward with a pod, set some firm ground rules. What kinds of activities are OK, and what’s off-limits? What might constitute a “breach” in the pod (such as a trip to the doctor’s or dentist’s office)? “The more communication you have upfront about the various scenarios and how they might play out, the easier it’ll be to navigate those situations as they arise,” Dr. Marcus said. If there is a breach, you can always pause the pod for two weeks while the exposed family quarantines.
Creating a pod isn’t going to be easy. It will probably feel “really weird and hard,” Dr. Oster said, because we’re not used to navigating such uncertainty, and so many strange and rigid rules, with other families. Still, for some families, pods could provide a way to stay sane while we all continue to try to stay safe.
