As the grim reality of a foreseeably empty social calendar sets in, many people are creating social bubbles, or “podding,” as a way to strike a balance between following guidelines for reducing the spread of COVID-19 with the very real need for human interaction and social support. A social bubble or pod is when two families or a small group of individuals agree to socialize together during the pandemic. “I think it’s great that people are recognizing the need to limit their social groups, not only because of the ease with which COVID-19 spreads but also because people can often carry the virus and not have symptoms and unknowingly transmit it to others,” says Avraham Cooper, MD, a pulmonologist and intensive care physician at the Ohio State University Wexner Medical Center in Columbus. “Creating a social bubble is probably the safe way to try to spend time with people who aren’t in your immediate family right now. It’s safer than the alternative — that is, continuing to socialize in different small groups of people or a wider group,” he says. A social bubble or pod can definitely work, but it relies on all the participants being upfront about how much they’re following guidelines and if they’re adhering to those rules long term, says Sharon Nachman, MD, director of the division of pediatric infectious diseases at Stony Brook Medicine in Stony Brook, New York. “Right now, the best way we have to keep people from getting sick with COVID-19 is prevention through social distancing, masking, and keeping their contacts to a very limited number of people,” says Dr. Nachman. RELATED: Life After Lockdown: COVID-19 Safety Tips for Offices, Restaurants, and Hair Salons “I think the desire to spend time with people outside your immediate family is very understandable. Being social is an important part of being a human being,” says Dr. Cooper. “None of us have ever lived through a time like this when we’ve had to stay away from other people in this way.” Social isolation, a necessary measure to slow the spread of COVID-19, has had a negative impact on mental health. According to an online household pulse survey conducted by the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC), 40 percent of Americans reported symptoms of anxiety or major depressive disorder the week of July 16 to July 21. As a comparison, 11 percent had those symptoms from January to June 2019. Physical health can also suffer due to loneliness: A landmark study published over 20 years ago found that the lack of social connection can impact health negatively more than having obesity, smoking, or high blood pressure. “The key is balancing that desire to maintain those social ties with coronavirus safety,” says Cooper. RELATED: COVID-19: Protecting Our Mental Health While We Ride Out the Pandemic
How Many People Should Be in the Bubble?
There aren’t any formal guidelines as far as size or best practices for creating a bubble or pod, says Cooper. The Hawai’i State Department of Health suggests keeping your bubble small; every additional person adds risk. “It’s essentially a numbers game in terms of risk that depends on the number of people in the pod and how adherent the members are to following guidelines when they are out in the world as well as when they are socializing within the bubble,” says Cooper. It’s also a good idea to keep your bubble small because of the logistics of when you all get together — in larger groups it’s harder to maintain social distance, he adds.
What Do People Need to Do Before It’s Safe to Be in a Social Bubble Together?
Once people decide to form a social bubble, they shouldn’t jump right into socializing, says Cooper. “If people haven’t been quarantining themselves and they just decide that all of a sudden they’re going to come together and form a pod, that actually really doesn’t necessarily offer much protection,” he says. To be as safe as possible, it’s important for everyone in the bubble to quarantine for two weeks, have a COVID-19 test, or both before socializing begins, Cooper explains, “so that everyone can feel confident that they’re not going to unknowingly transmit the virus to other people.” RELATED: Your COVID-19 Testing Guide: Nasal-Swab Tests, Antibody Tests, Saliva Tests, and More
How Do You Create Rules That Everyone Will Follow?
“It’s important that everyone agree on the ground rules for the pod to work,” says Nachman. Discuss what sorts of precautions you’re taking in your day-to-day life and what you’re willing to do, she says. Does everyone agree to wear a mask every time they leave their house? Is it okay to visit restaurants, go grocery shopping, or go to the gym? “It requires trust and everyone being honest about what you can do and what you won’t do,” she says. It’s important to have honest discussions with everyone and set very clear expectations, agrees Cooper. “Being in a pod with other people is making a commitment, and you want to be sure than everyone can follow through,” he says. Be aware that fatigue with the restrictions can set in, says Nachman. “You can’t backslide or become more relaxed about masking and social distancing and still think you’re still being safe,” she says. RELATED: Women Are Overwhelmed and Exhausted From Coronavirus Life Adjustments
Is It Possible to Form a Bubble if People Are Working Outside the Home?
“Once you decide to leave your house in the time of COVID-19, you’re taking on some amount of risk,” says Nachman. That doesn’t mean that pods are only for people who are working exclusively from home. “If a person’s workplace is following guidelines in regard to masking, social distancing when possible, and hand-washing, that person can still be part of a bubble,” says Nachman. “I think it can be done provided that person is wearing a mask consistently and being super careful.” Including people who work outside the home or even high-risk people like healthcare workers is a choice that each bubble needs to make for itself, agrees Cooper. “There’s no scientific data on who to include or not include in a social bubble, which makes it hard to give a firm answer,” he says. The bubble strategy tries to eliminate uncertainty by creating a small group of people who have quarantined themselves ahead of time or tested themselves and found they are negative for COVID-19. “They’re coming together and spending time together, and they’re essentially trusting that this other group or family is not bringing COVID-19 into that bubble. I think the more contact people in the bubble have in their jobs or daily life outside the social bubble, the harder it is for that certainty to be there,” says Cooper. If someone works in healthcare or is an essential worker who is in close contact with other people, they can still be in a bubble, but it’s a higher-risk bubble, according to the Hawai’i State Department of Health. All the same precautions on hand-washing, social distancing, and masking should be adhered to, and these bubbles should stay small. RELATED: Are You an Essential Worker or Do You Live With One? Here’s How to Minimize Your Coronavirus Risk
Can I Do a Bubble Once My Kids Go Back to School?
Whether a family can do a bubble once kids return to school depends on how much risk people in the bubble are willing to take on and if their schools are requiring face coverings and social distancing, says Nachman. “A social bubble that includes children attending school can still work provided the school is enforcing mask wearing and social distancing. In that case, you’re cutting back on the potential to pass infection,” she says. The CDC recommends cloth face coverings or clear face coverings for all teachers and students except in specific instances where it may not be feasible. Social distancing, washing hands, and regular cleaning and disinfecting are also recommended in an effort to prevent the spread of COVID-19 in schools. Cooper has more reservations about creating social bubbles that include children attending school. “I think if kids are going to school, it’s not a bubble anymore, at least not in the way that people are intending it to be,” he says. RELATED: Is It Safe to Send Our Children Back to School?
Can Older People or People With Health Conditions Be in a Social Bubble?
If some people in the bubble are older or have health conditions that put them at a higher risk for a severe case of COVID-19, that needs to be considered when creating the group’s ground rules, says Cooper. “From a minimizing risk perspective, it would make sense for everyone in that bubble to take more precautions while socializing within the bubble,” he says. It may also be possible for a small group of individuals who are all at a higher risk to form a social bubble. Says Nachman, “It can be done if the appropriate precautions are taken. Everyone would need to quarantine ahead of time and adhere to the guidelines carefully as long as they are part of the bubble.”
Do People Still Need to Social Distance and Wear a Mask Within the Bubble?
Whether to continue social distancing and wearing face coverings while socializing within the bubble is a decision that each group needs to make after weighing the risks, says Cooper. “I still think that social distancing and wearing a mask is a good idea when you’re around people who aren’t in your immediate family, especially when indoors — you just don’t know with certainty what people are bringing in,” he says. Nachman agrees that it’s something that everyone in the bubble needs to agree on. “After everyone has isolated for the two-week initial period, provided they’re not inviting anyone else into their circle, they can consider socializing within the bubble without a mask,” she says. “If you decide to take off the masks within the bubble, you have to be super careful. Everyone in the group needs to adhere to social distancing and masking guidelines at all times when you’re outside your social bubble,” says Nachman. RELATED: Do You Really Need to Wear a Mask This Summer?
Do Children Need to Wear Masks While Socializing in the Bubble?
“We’re still missing the data that would give us more of a clear answer as to whether children need to wear masks,” says Nachman. There was a well-designed and delivered study out of South Korea that looked at how likely kids of all ages were to transmit the infection within their families, but it still had gaps in it, she says. “The study only tested symptomatic adults and children. In that study, younger kids under age 10 weren’t good spreaders, even within the family, but the children over age 10 were as likely to spread the virus as adults in the family,” says Nachman. “In order to have a complete picture about the risk of kids getting and passing COVID-19, a study would need to include asymptomatic infection. There hasn’t been a study that tests 100 percent of everyone in the house all the time,” she says. It’s clear that we are seeing more adults with symptoms than we are children from the same household, but that doesn’t translate to knowing that kids are not infected, says Nachman. “We just don’t have the data on how often kids are asymptomatically infected or how often those children are then spreading the virus. It’s a great question that we just don’t have the answer to yet,” she says. RELATED: Kids and COVID-19: What We Know Now
