For several months, we’ve been answering questions about social distancing, self-quarantining, mask wearing, and all the other things you can do to avoid contracting COVID-19 or infecting others. But as states gradually loosen broad restrictions on public accommodations, allowing businesses and workplaces to reopen after implementing mandated safety precautions, we find ourselves grappling with questions that hit much closer to home: We can now get a haircut, eat a meal at a restaurant, and go back to work in our labs. But when can the kids see grandma or have a play date? When can I start hanging out with the friends I used to hang out with in those pre-coronavirus days? And what about that person I’d just started dating at the beginning of the year but haven’t seen in the flesh in four months? For many of us, Zoom’s just not cutting it anymore — if it ever really did.
Public policy may be helpful in making hair salons and restaurants safer, but it hasn’t offered much guidance about how to balance personal and public health concerns with our need for in-person contact with other humans. Is there a safe way for us to begin interacting socially with other people again?
New Zealand’s social bubble strategy might offer a roadmap.
A “social bubble”— sometimes called a “quarantine pod” — is an exclusive social network. Members of the bubble agree to socialize and/or have physical contact with each other, and only each other, generally without taking any special precautions. Outside of the bubble, members agree to follow recommended precautions such as social distancing and masking, along with any other rules upon which all members have agreed. If any individual displays symptoms of the virus or tests positive, the entire bubble will self-quarantine, thereby containing the spread of the illness and preventing it from being transmitted beyond that small group.
During its initial lockdown in response to the pandemic, New Zealand defined a “bubble” as consisting of a single household. But as transmission of the virus began slowing, the government permitted citizens to expand and merge their bubbles, particularly when doing so would help individuals meet specific needs for care and support.
So, how do you begin the process of a bubble expansion/merger?
Start by identifying individuals who might become part of your bubble. In some cases, it will be obvious — a romantic partner, close friends, or members of your extended family. If children are involved, you may want to approach another family with kids of the same age to provide opportunities for play, socialization, and shared homeschooling and childcare (more on that coming soon). Above all, potential “bubble-mates” should be people you trust to maintain exclusivity and follow the ground rules set by the group.
The smaller the bubble, the safer it will be. Most experts recommend a maximum of 10 individuals, but smaller is better. You should also consider geography and transportation, says Dr. Shawn Ferullo, MIT Medical’s director of student health. “Having bubble-mates within walking or cycling distance is ideal,” he says. “Not only is it easier to meet up safely, it also restricts potential community spread of the virus should any member of the bubble become infected. Otherwise, I would try to be as careful as possible with travel. A personal vehicle will be safer than any form of public transportation.”
Talk about risk; decide on the rules; agree not to cheat. No matter who your potential bubble-mates are, any such alliances must start with brutally honest and potentially awkward conversations that involve delicate negotiations and some willingness to compromise — a process one writer described as “high school prom all over again.” Begin with an honest discussion about each individual’s risk of contracting the virus and each individual’s risk of serious complications if they do become ill. If one person’s job or daily activities put them at particularly high risk, you may end up deciding against merging your bubbles. Assuming you agree to move forward, you’ll need to agree on ground rules besides exclusivity. Clarity around the rules are even more important if some members are at higher risk of complications from the COVID-19 illness due to age or underlying medical conditions.
Start by clearly describing your daily routines and the precautions you take. This is where compromises may come in. For example, you may be comfortable doing yoga in the park without a mask, feeling that you can maintain sufficient social distance during that activity. But if a would-be bubble-mate is uncomfortable with this, you might agree to begin wearing a mask while you exercise. If individuals in your potential bubble agree to change some of their current practices, you may all want to spend two weeks following the rules separately before a merger.
Define what constitutes a breach. Agree on the activities that are allowed, and define what constitutes a breach. As states increasingly loosen restrictions, this becomes even more important. Are you comfortable with your bubble-mates dining inside a restaurant, only on the patio, or just getting take-out? How about going to church or visiting the dentist? Communicate about these things upfront, and keep on communicating. If a breach occurs, those individual(s) can simply withdraw from the bubble and self-quarantine for two weeks before joining the group again.
Be creative in dealing with unique circumstances. As authors of a monograph on New Zealand’s bubble experiment noted, situations in which multiple housemates live together but have quite different social networks present unique challenges. The authors describe one group of four roommates who decided that each would expand their individual bubble to an exclusive relationship with one other person who was a close friend or partner. Households like this one, who felt they had navigated unique situations successfully, emphasized the importance of extensive and transparent conversations and group consensus.
Joint-custody situations, in which children divide their time between two households, present similar bubble-building challenges. Even with careful negotiation, these cases may result in larger-than-recommended bubbles.
Technically speaking, bubble size should not matter as long as the boundaries are secure, but with each additional person comes an increased risk of even inadvertent breaches. Regardless of the arrangement your group comes up with, remember that the goal is to create a completely closed loop.