Social distancing monogamy

Yup, it’s a thing. We’ve been home for days and days. It’s becoming increasingly clear that we’ll need to continue social distancing for some time to come. Many of us are sick of the people living in our households. There’s such a thing as togetherness, but come on! Many others are sick of having no one in their household. More than 1 in 4 Americans live by themselves. True, living alone is a very effective social distancing strategy. But in these times when we crave human companionship, being alone all of the time can take a mental toll.

Steps to social distancing monogamy

At my urging, a good friend moved to New York City in February. It took only six weeks for the city to completely shut down after the move. That wasn’t the plan.

After the restaurants and bars closed on March 15th, there was no way, no how that I was going to leave my house unless it was a dire emergency. I certainly wasn’t going to visit any of my friends.

Did I mention that I hate the phone? I’m reconsidering that. Just like I reconsidered my decision to see absolutely no one. Bad epidemiologist! Not so fast. I did a cost benefit analysis of how aggressive I am in my protective behaviors—and the impact of total isolation on my mental health, because I live alone. I know that the decontamination chamber I’ve set up in my hallway keeps me safe once I’m home. After a rigorous evaluation, my friend passed muster, too. Against all of the rules, we decided to have weekly meet-ups. I spend each week looking forward to our evening together, watching silly movies and eating food prepared by two people very unaccustomed to cooking.

I was the first to confess to my friends what I was doing. And they confessed right back. The process is always the same. Pick one or two people—absolutely no more than that. Conduct a detailed and honest analysis of protective behaviors. If you’re not comfortable with their behaviors or they’re not comfortable with yours, don’t see each other. Period. It’s not personal. I had a friend turn me down. She’s still my friend and always will be. The final step in the process is to commit to quarantine if either of you gets sick.

There is one HUGE exception to practicing social distancing monogamy. It can’t be done with people over the age of 60 or with those with pre-existing health conditions. This sucks, because older people are much more likely to live alone than younger people. Make sure that you call or text, email or FaceBook, people you know who live alone. They need you now more than ever. Unless they tell you that they don’t. Again, don’t take it personally.

Does social distancing matter?

This coronavirus is the sneakiest virus I’ve ever seen. Most people with Covid-19 start infecting others two to three days before they have any symptoms. People continue to be contagious the entire time they have symptoms. Don’t forget about the people who never get any symptoms. They spread the virus, too. Recent estimates suggest that up to 50% of people who have Covid-19 are asymptomatic. The vast majority of coronavirus spread happens when people don’t know that they’re infected.

Enter social distancing, an infectious disease control strategy created in the Middle Ages in response to the Black Plague. It still works. This is why. Without social distancing, each Covid-19 case will spread the disease to two to three other people. Let’s call it 2.5 people. (I know, half a person. Bear with me.) Those newly infected 2.5 people will each spread the disease to 2.5 more people and so on. At the end of one month, this single Covid-19 case will be responsible for 244 new infections. That’s what we mean by exponential growth. With social distancing, it may be possible to cut the number of new infections in half: 1.25 new infections for each Covid-19 case. At the end of the same month, that leads to….only four new infections. Yes, social distancing matters.

Be a superhero. Wear a mask. (Also, stay home.)

Public health authorities have recently recommended that everyone should wear cloth masks, if they go outside. Masks are to social distancing as frosting is to cake. Masks are not the main form of protection. If you leave your house, social distancing of six feet is the most important part of the coronavirus prevention equation. We’ve recently learned that even six feet may not be far enough away. The masks are a tiny add-on of protection, mostly so that people who don’t know they’re infected don’t pass it on. The best bet is to just stay home.

If you have to go out, don’t use medical masks. Those are for the healthcare workers who can’t stay six feet away from their patients. The CDC has shared mask making patterns with the public. Two of the patterns are ‘no-sew’ projects involving old T-shirts and coffee filters.

The other thing that will make you a superhero to those you love? It turns out that people with Covid-19 tend to share it with their family members and close friends. Go ahead. Put that coffee filter on your face and know that you could be saving the life of someone you love.

Be smart. Be safe. Be well.

Maureen Miller, PhD is a Columbia University trained infectious disease epidemiologist and medical anthropologist who consults with both the public and private sector.