Despite the fact that COVID-19 case numbers are at an all-time high and “safer at home” still remains absolutely true, a lot of people who have been rigorous and careful for the past four months are starting to think about wading back into socializing. They are beginning to consider meeting a few unmasked friends at the beach, or kissing someone, or letting their children have a playdate. (For the record, I am not one of these people—I am still as at-home and antisocial as I was on March 10!)
Getting Along is a column about taking care of yourself, setting boundaries, and having difficult conversations, for people who struggle with all three.
Several articles I’ve read about summer activities in the age of coronavirus, like this one from Vox, include quotes like, “The level of risk here is strongly tied to how careful you and your friend (and whoever else you and they live with or see regularly) are being” and “if everyone has been extremely careful” and “be sure to have self-isolated for two weeks beforehand or be very careful about your social distancing.”But what exactly does “careful” mean in a world where a large part of the population is denying the well-established value of masks, and where plenty of other people simply wear their masks incorrectly? (They have to cover your nose, y’all!!) Or when even the most self-aware people might be so used to their new COVID-reality routines that they simply don’t register the risks inherent in their daily activities anymore?The thing is, I think most people genuinely believe they are being pretty careful… which may be why we continue to see instances where people with a cough or symptoms that get worse over the course of a house party or even diagnosed cases are infecting loads of other people.So, not to be all, “I don’t care if you drink, as long as you do it in my house,” but… if you have a strong desire to socialize with people outside of your household and want to break the 6-foot barrier, skip masks, and/or meet indoors, you should absolutely do so as responsibly as possible—which includes being very clear about how everyone involved defines “careful,” and being really honest with yourself and the people you’re planning to meet up with about what you’ve been up to for the previous two weeks.
If you want to organize an intimate and thus riskier hangout, you, the host, have an additional responsibility to do the work to make sure it’s safe for everyone involved. That means doing due diligence to see how “careful” everyone has really been, and adjusting the plan to a lower-risk socially distant outdoor gathering if necessary (or simply postponing for the foreseeable future). If you’re hanging out one on one with someone, you both owe each other a frank conversation.To help folks think about this, and essentially create an interpersonal “screener” that people could use when planning to socialize in a higher-risk way, I spoke to several experts about what sorts of questions people should be asking. Here’s what they said.
“I think that the first thing we kind of have to do is give ourselves permission and say, ‘It's OK to ask these questions,’” bioethicist Kelly Hills told VICE. But most of us aren’t in the habit of grilling our pals or our in-laws about their health and hygiene practices, so talking about this stuff might feel fairly taboo. (Hello, fellow Midwesterners who are currently sweating just thinking about this!) That said, this is our new normal, and a pandemic is a great reason to update our definition of good manners; being willing to be a little “nosy” or uncomfortable will save lives.Perhaps you feel like there’s no reason to go through all this effort—because of course your friend or your mom or the doctor you’ve been talking to on Tinder is too smart and too caring to do anything you consider an obvious non-starter. But Hills said that a lot of us assume our friends are like us—that “what I think is risky is what they think is risky, and what they think is common sense is what I think is common sense. It just doesn’t work like that,” she said. Syra Madad, Senior Director of System-wide Special Pathogens Program at New York City Health + Hospitals, agreed. “Sometimes common sense is not very common,” she told VICE.
First, know that having a conversation like this isn’t overkill.
You also shouldn’t assume you’ve been careful enough for people to want to see you. “Human beings are not always amazing at assessing their risk,” Julia Marcus, infectious disease epidemiologist and assistant professor at Harvard Medical School and Harvard Pilgrim Health Care Institute, told VICE. “We certainly see that with HIV—that one of the greatest barriers in HIV prevention is that people just don't believe themselves to be at risk.”So if you’re thinking of taking part in a hangout that would involve close contact (currently defined as less than 6 feet for more than 15 minutes), being indoors, and/or not wearing masks—that is, factors that are known to increase the risk of transmission—you might say something this:
- “I’d love to see you, but I’d also want to talk in more detail at some point about the safety measures we’ve each been following and the risks we (and our housemates/other people we’ve seen) have been taking before we start making plans. Basically, I just want to make sure we’re on the same page so we both feel super comfortable with getting together. Would you be cool to talk more about this [later/tomorrow/this weekend]?”
“We're in an age where, you know, the departments of health are suggesting people do online orgies and [use] glory holes… and when those are the pieces of advice being given by public health [officials], I think people should feel like they have full permission to ask the questions that they need to to feel safe,” Hills said.
The experts I spoke to were in agreement on a few “do not meet up with a person who has recently done X” red flags (more on those later), but said that ultimately, deciding whether or not to meet up comes down to your own comfort level with certain activities. The point of this conversation isn’t to convince the other person or people to see things your way or vice versa; it’s to figure out if you all feel comfortable with the level of risk involved in getting together.So, before you have this conversation, think about what things they could tell you that would absolutely not be OK with you. Once you know that, you can better tailor your end of the conversation.
Decide what your dealbreakers are before having this discussion.
Marcus said that thinking about the benefits of a particular activity or seeing a certain person is an important aspect of deciding to take a risk—because that’ll help you determine whether this risk is worth the reward, and whether there are any ways to tweak your plans a bit to make them a bit safer. Ultimately, you should feel confident that the juice is worth the squeeze—and be sure that there aren’t other, lower-risk ways to get nearly the exact same juice.
Also consider why exactly you’re doing this at all.
If you can’t stand the thought of having to try to convince your sibling to host their kid’s birthday party outdoors instead of inside, or to get everyone to change their plans for your sake, it’s also very much OK to not go and do this particular thing! You can always say something like, “I’m so sorry but I feel concerned about protecting everyone still and don’t want to create more risk. I’m going to opt out of this one, but I miss everyone and want to find a way to safely get together in the near future!”
In most instances, it’ll be impossible to know for sure that you and the person you’re planning to see are absolutely, positively COVID-free. If your goal with this conversation is total certainty and zero risk, that might be a sign you’re not actually ready to hang IRL. And feeling good about the answers to all of these questions isn’t a reason to go wild; it’s still wise to be as cautious as possible in all aspects of your life.
Finally, remember that no questionnaire is going to be foolproof.
Based on my interviews with Madad, Hills, Marcus, and Zoë McLaren, an associate Professor at the School of Public Policy, University of Maryland Baltimore County,I put together a list of questions to use to guide your “Are we good to remove masks and get close?” conversation. You should feel free to ask these qs in your own voice; there’s no need to put on a lab coat, get out a clipboard, or read them verbatim, as long as you ultimately get the answers you’re looking for. (By the way, if you’re aiming to form a pod, you’ll probably need to build on these and go deeper.)
An (incomplete) list of questions to ask
Try to approach this as an open, non-judgmental conversation between everyone involved, and not a one-way interrogation. It’s also OK if someone isn’t comfortable agreeing to meet up immediately at the end of the chat; it’s totally reasonable to say, “Hm, I don’t actually know much about the risk associated with X so I might need to read more about that after we talk if that’s cool.”The questions are all jumping off points; you should also follow up to learn more about the specifics, and to ask what precautions were in place, so you can figure out how risky the activity was and if you’re comfortable with it. You also may need to expand this to ask about other people who live in any of the households involved—because every additional person introduces more unknowns and more risk. Even if you trust your friend, you might not trust their roommate nearly as much. And while most of these questions are framed around past behavior, it’s also worthwhile to discuss what they have planned for the next few days, or however much time will pass before you actually get together with them.For most of the questions, there are too many variables in a given situation for us to say unilaterally what the “right” answer is—again, this is about deciding what you feel OK about. That said, Madad recommended taking seriously some factors that increase risk considerably:First, talk about the spaces where recent activities happened—anything indoors, or with big crowds where it’s hard to keep much distance is a higher risk. Places without much ventilation (like open windows or high ceilings) should also give you pause. Second, the type of activity matters. Being indoors with people who are singing, coughing, yelling, or breathing heavily (like, say, on a treadmill at the gym) is also high-risk.
Precautions also matter; properly worn masks and rigorous hand washing make a big difference. The time spent doing an activity also comes into play; for example, discovering that your pal (or their roommate) took a five-hour flight home from Florida, surrounded by a lot of coughers, a couple days ago, that would be… concerning. And learning that the person was actually in Florida for a wedding with 100 guests? Probably worth waiting a few weeks before you try to make this hangout work.Intro questions and considerations
- What city and state are you in? You don’t need to ask that of your pals since you presumably know the answer, but the experts I spoke to said that where you live and the local numbers really matter. If you or anyone you’ll be seeing lives in a place where indoor dining is happening or cases are increasing (or has recently traveled to one), it simply might not be the right time to get together. “The local prevalence of COVID is going to give you some kind of baseline level of risk as a kind of interacting with other people,” McLaren said. “If you're living in the South right now, they're having a huge surge in cases; even people who are being very careful have a really high risk of coming into contact with somebody who's contagious.” While you’re thinking locally, also look into what getting a test looks like in your county right now; could you easily get one in a couple days if you needed to?
- What does everyone do for a living/how do they spend their time? Again, this isn’t something you need to ask out loud, but it’s something to think about. If your sibling delivers groceries for Instacart or their roommate volunteers in a nursing home, you and your parents should probably not go to their place for a dinner party right now.
- “Do you or anyone you live with/see regularly have conditions that mean that getting COVID would absolutely fuck your shit up?” Even if your friend isn’t terribly concerned about their asthma or the fact that they are seeing their elderly parents next week, you’re absolutely allowed to bow out of seeing them because you’d rather not kill them.
- “What precautions have you been taking when you go out/interact with other people?” Hills suggested asking open-ended questions as much as possible, and gave this as an alternative to “Are you wearing a mask?” which is fairly narrow (it doesn’t account for things like face shields), and has, unfortunately, become divisive.
- “What made you decide to do things X way?” or something else that communicates “What’s your source?” in a friendly, non-judgmental way. Hills said it’s wise to ask people where they are getting their information, and to hear how they decided something was or wasn’t a risk so you can decide if you feel OK with it.
- “What’s your apartment building (and, if applicable, workplace) like in terms of crossing paths with other people as you go in and out?” Basically, do they have to pass through a lobby where there are a bunch of unmasked and possibly chatty neighbors? Do they have a long, slooooow elevator ride up to their place?
- “In the past two weeks have you been in contact with other people outside of [name of any housemates you know of]? Who/what/when/where/how long/what precautions were in place?”
- “When you’ve gone out in the past two weeks, how did you get around (e.g., walking, car, bike, Uber, public transit, etc.)?”
- “How have you gotten food/groceries in the past two weeks? What precautions are you taking?”
- “How are you doing laundry these days?”
The high-risk red flag questionsThese are the questions where, if the answer is yes, you’re going to need to seriously rethink your plans for having close contact, being unmasked, being indoors together, etc.
- “Have you eaten food from any cafes, bars, or restaurants in the past two weeks?” You mainly need to know if they’ve eaten at restaurants indoors (which is super, super high-risk). The above phrasing is a slightly more open-ended way to ask the question, just in case they forgot that they sat at the bar and ate onion rings while they waited for their to-go drinks last week.
- “Have you gone to any bars in the past two weeks?”
- “Have you gone to anyone’s home in the past two weeks? Who/what/when/where/precautions?” House parties, dinner parties, baby showers, birthday parties… all fairly high-risk.
- “Have you had anyone in your home in the past two weeks? Who/what/when/precautions?”
- “What does working out look like for you right now?” If they’ve been going to a gym or doing indoor workouts with other people, that’s pretty risky.
- “What’s the riskiest thing you’re doing these days/in the past two weeks?” “You can follow the rules 99 times out of 100, but if that one thing you’re doing is really risky, then you can get infected,” McLaren said. “So you kind of want to think about, ‘What's the riskiest personal thing this person is doing?’ as one measure of thinking about a potential risk.”
Symptoms, COVID tests, and more major risk factorsA huge disclaimer: asking about symptoms alone isn’t enough—because we now know that a huge amount of COVID-19 cases are asymptomatic, and that people can spread the virus before they start showing symptoms. That said, if your pal (or, say, their roommate) has had a bunch of symptoms, that’s… important information to have!With that in mind, below are some questions inspired by the American Medical Association’s screener for physicians who are deciding whether to see people in person for non-COVID care that you could ask your loved ones as well.
- “Have you or anyone in your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit?”
- “Have you or anyone in your household been tested for COVID-19?”
- “Have you or anyone in your household visited or received treatment in a hospital, nursing home, long-term care, or other health care facility in the past 30 days?”
- “Have you or anyone in your household traveled in the U.S. in the past 21 days?”
- “Have you or anyone in your household traveled on a cruise ship in the last 21 days?”
- “Are you or anyone in your household a health care provider or emergency responder?”
- “Have you or anyone in your household cared for an individual who is in quarantine or is a presumptive positive or has tested positive for COVID-19?”
- “Do you have any reason to believe you or anyone in your household has been exposed to or acquired COVID-19?”
- To the best of your knowledge, have you been in close proximity to any individual who tested positive for COVID-19?
If the answer to any of these questions is “yes” or “hmmmm” or anything but an enthusiastic "nope," that’s a big reason to not go forward with your plan to meet up.
It would be a bummer to have this conversation, decide to meet up, and then have to cancel at the last minute because one of you started feeling under the weather or decided to spontaneously meet up with a different unmasked friend the day before. But it would be far worse if that went unmentioned and obliterated all trust in the relationship, or had tragic consequences. So you and your friends should commit to being totally honest during these conversations, along with vowing to not shame or have hard feelings if one of you doesn’t like the answer, or if things ultimately don’t work out.“We have to give ourselves permission to say, ‘Hey, that's cool that that works for you. It doesn't work for me. So let's have a Zoom coffee date instead,’” Hills said. “You might have to cancel at the last minute, and that's traditionally considered such awful manners. We need to change that to be like, ‘You know what, if you're not feeling good, and you need to cancel five minutes before you're supposed to be somewhere—fantastic, that's amazing. Thank you so much for being courteous to everyone around you, please take care of yourself.’”“You want to create a very open environment [where] we understand that mistakes can happen. But if it does, it's not a big deal, just let us know. And then we can kind of distance for two weeks while you quarantine, and then pick up where we left off,” McLaren said.“Transparency should 100 percent be rewarded right now, even if that transparency is telling you something you didn’t want to hear,” Hills said.
Be sure to build an escape hatch into your plans.
We’re constantly learning more about coronavirus transmission, symptoms, and effective precautions, so it’s really important to stay on top of the news, and to tweak your conversation to reflect the present reality and known science. “We want to be constantly vigilant about situations where things are more risky than we might think,” McLaren said. “It's not like you just make the rules one time; the pandemic is an ongoing adaptation. As you learn more about what isn't safe, you might want to think about adjusting. And people's risk tolerance and their essential needs can change as well.”On the other hand, some things haven’t changed. “We've been saying the same thing since March, right since this started: ‘every single person plays a role in this pandemic,'” Madad said. "The actions that you take will ultimately have an effect on the trajectory of this outbreak. So if you decide to go to a restaurant indoors with 30 other people, if you decide to hold a party with 50 other people… now you're enabling new chains of transmission, and the new chains of transmission will then go out and infect other people.”“Everybody wants to go back to a sense of normalcy,” she continued. “And if you want to do that, you need to work together, and abide by the social measures that have been talked about by public health officials like myself.”Rachel Wilkerson Miller is the author of The Art of Showing Up: How to Be There for Yourself and Your People. Follow her on Twitter.