How to set up a quarantine bubble

And knowing when to cash out your risk savings.

Welcome to Not a Doctor, the only newsletter about health and science that references Fleetwood Mac (nope, not that song).

As you may have noticed, I took a little break for two months; more on that below. But I’m so excited to jump back into talking about what science means for you — how you can keep yourself and others as safe, healthy, and happy as possible right now.

Today, we’re talking about quarantine bubbles and risk assessment — woo hoo! Super sexy, I know!

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Sometimes doing the work means taking a break

Over the summer, I realized I needed to do some life work — the sad and difficult work of grieving the loss of dear ones, but also the happy, soul-filling work of enjoying sunny afternoons with my kiddo and long walks with family. (And I put the finishing touches on my anthology about premature birth, which will be published on Nov. 10 — only two weeks from tomorrow! Ahhhh!)

I’m glad I didn’t pressure myself to write when it wasn’t working. We all need to take breaks and go easy on ourselves whenever we have the opportunity to do so.

I also took a little break from this newsletter because I wasn’t sure what I could say about the pandemic anymore. It seemed as though the people who needed information were finding it, while others were taking necessary breaks from constant updates. (Which we all need to do!!)

My little family adhered pretty strictly to safety precautions over the summer, though, even as case counts in our region declined. I started to wonder if I was being paranoid. Had I read too many studies to be able to relax? Was I punishing myself and my family by staying locked down, or hurting loved ones who needed me?

But every time I sat down to reevaluate, the math never made sense. I carefully weighed hugging the family members who live a few hours away — but could this act of love infect them or me?

Friends offered to meet for lunch at a recently reopened restaurant — but could we simply take a walk outside, at a distance, wearing masks, instead? Either way, we would be catching up, but only one would give me a panic attack about potential exposure later.

I could go ice skating at an indoor rink, or I could go running outside. I could go to the store myself or order groceries for pickup.

What compromises was I willing to make, and which ones would be worth it?

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Setting up a risk account

I see personal risk like a bank account. I don’t mind “spending” a little risk for what really matters. But if I can get by without it, I’d rather save that risk up for when I need it. So, I met with my parents and siblings, but I took every precaution in the book: always outside, wearing masks, trying to keep a six-foot distance. To me, that was comfortable math; for you, the calculation might look a little different.

As we head into winter, when many of us spend more time indoors, this kind of risk calculation may come in handy. Dining indoors, for instance, is one of the highest-risk activities you can do, so you should weigh those risks carefully. Maybe you absolutely adore eating at restaurants, and life isn’t living without it. In that case, take every precaution you can (wear a mask when you aren’t actively eating; find a restaurant with good ventilation and spacing; tip your server at least 40%) and go for it. But the trade-off might be no more indoor visits with your elderly parents. (And if you are the elderly parents, I recommend takeout only!)

This is the kind of math that only you can calculate, however, because everyone’s needs and risk tolerance and vulnerabilities are different.

For my little family, we’ve prioritized social interaction and care for our son by forming a quarantine bubble (or “quaran-team,” if you will) with three other families. The kids interact nearly every day, doing virtual school and playing with each other, and the adults socialize once a week or so.

We are essentially using up our entire risk allowance with this bubble. We see each other indoors, with no masks on. That means outside of the bubble, we are as cautious as you can get. We have to trust each other to keep us all safe, and we communicate constantly about potential risks each person may bring into the bubble.

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Quaran-teamwork makes the quaran-dream work

If you’re interested in forming a quarantine bubble, here’s what has worked for us.

1. Regular communication

First, you should lay out all of the precautions you take, and areas of potential concern. We went through every single detail of our days: do you go to the grocery store in person? What about the pharmacy? Do you eat indoors or outdoors at restaurants? How often do you see the doctor or dentist? Do you go to work in person, and if so, how many people are there and wearing masks? Are your kids in school or daycare?

Everyone in the group needs to agree on what is okay and what they’re not comfortable with, and then they need to abide by these rules.

If anything changes — if you agreed not to eat indoors, but then you really wanted to celebrate your anniversary at your favorite spot — you email everyone to see if they’re okay with the activity. (Ideally, you do this in advance, but real life doesn’t always work that way.) If they’re not, then you seal yourself out of the bubble for two weeks and monitor for symptoms.

2. Don’t pop the bubble

Some people have been reducing the number of people they see regularly without officially forming bubbles. This reduces your risk; the fewer people you come close to, the fewer opportunities you have to contract the virus. But don’t think that simply limiting your contacts will keep you safe. The people you’re visiting need to be taking the same precautions as you if you want to keep the risks pretty low.

If my bubble includes you, but your bubble includes three other families, and those three families all have bubbles with nine other families… that’s a pretty damn big “bubble,” and eventually it may pop.

It could create a chain of transmission that eventually lands the virus in your household, which is exactly what happened to a friend of mine this week. They did everything right, except for having dinner with another family without discussing their potential risks first. And now nearly all of them are Covid-positive.

Photo: Hernán Piñera

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Chains of transmission

Again, everyone’s risk assessment is different, and until we’re able to offer everyone paid leave and health insurance and personal protective equipment, there is no judgment if you’re not able to adhere to every single precaution.

But for me, it’s helpful to think of these chains of transmission when I’m thinking about risks to myself and others. Any time I can cut a link in the chain, I’m reducing the odds of sickening my family, your family, and the strangers down the line. Every choice to take precautions is a decision to sever a chain.

That’s right, Fleetwood Mac — you CAN break the chain!

I can’t cut every link and end this pandemic right now — I wish I could! But I have to remember that the chains I do cut may mean the world to someone. We can’t save everyone, but we can try to do as much as we can.

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As always, please leave a comment or reply to this email if there’s something I’ve overlooked or something you’d like clarification on. You can also follow me on Twitter and Instagram, if you’re so inclined.

Once again, I’m trying out new things with how often I post; right now, I’m planning to do one or two longer posts a week. If there’s something you’d like for me to dive into, please let me know!

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