September 29, 2020

How to Form Social Bubbles and Quarantine Pods

As parents face the possibility of a summer devoid of camps, pool parties, barbecues and vacations, many are wondering what they can do to keep their families sane. My kids are increasingly missing their friends and sense of normalcy; it feels like something has to give or we’ll all lose our minds.

One idea that some families are considering — and that infectious disease epidemiologists think might be a smart way to balance mental health needs with physical safety — is to create quarantine “pods” or “bubbles,” in which two or three families agree to socialize with one another but no one else. In a pod, families hang out together, often without regard to social distancing — but outside of the pod, they follow recommended social distancing rules.

The reality is, people need social contact, and some families are struggling without it. So we need to find ways to socialize safely (just as sex education teaches safe sex, even if the safest thing is not to have sex at all). “The ideal thing is that we just stay home forever and never see anybody — but that’s just not sustainable,” said Zoe McLaren, Ph.D., a health policy researcher in the School of Public Policy at the University of Maryland, Baltimore County.

Julia Marcus, Ph.D., an infectious disease epidemiologist at Harvard Medical School, agreed. “We don’t want to prevent disease at the expense of overall health,” she said. So why and how should you start a pod, and what ground rules should you set to keep it as safe as possible?

Certainly, there are ways to be social that don’t involve pods. The ideal option, of course, is to gather over Zoom or FaceTime — no germs involved. If your kids get what they need from virtual meet-ups, those are certainly best.

There’s also the socially distanced play date — when kids get together but remain at least six feet apart, ideally wearing masks. But can you really socially distance a play date? Experts are skeptical, particularly for younger children.

For one thing, it can be tough to keep young kids, whose play is often quite physical, six feet apart. It’s not so much that children can’t estimate distance — many can. But “the much more tricky part is their inhibitory control — their ability to not act impulsively and do things that they want to do,” said Jamie Jirout, Ph.D., an educational psychologist at the University of Virginia’s Curry School of Education and Human Development. Research suggests that inhibitory control doesn’t fully develop until adolescence.

If a 5-year-old really wants to wrestle his friend to the ground, it’s going to be difficult for him to quell that impulse for the sake of an abstract concept like social distancing. And because kids’ working memory is poor (it improves throughout childhood and adolescence), Dr. Jirout said, they may not always remember the six-foot rule. So you will have to constantly supervise the kids and be ready to intervene when they inch too close.

Socially distanced play dates can work well when physical barriers like fences keep kids apart or when kids stay sedentary (such as by playing a distanced game of Battleship). But how safe are these kinds of scenarios? “Spending an hour with a friend in masks sitting on a front porch six feet apart — there’s actually more risk involved in that than you might think,” Dr. McLaren said, because of the possibility of kids exchanging germs via the air they share.

Because of these concerns, carefully-chosen pods may be safer than having distanced play dates with multiple families, particularly when young kids are involved. Plus, if someone in your family gets sick and you’ve been spending time with various families, contact tracing gets much harder.

If you think your family needs a pod, you’ll first want to ponder whom to approach. To minimize your risk for catching and spreading Covid-19, you’ll want to find a family that is being as careful as you are — a family that is mostly staying home, wearing face coverings when they go out in public, and not otherwise socializing in person.

“If the other household is already caring for their neighbor and playing occasionally with their cousins, then there are a number of ways an infections chain could start,” said Stefan Flasche, Ph.D., an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine. The idea is to create a closed loop — each family in the pod does not have contact with people outside the pod.

Ideally, you’ll want to find a family that has a low risk of complications from the coronavirus. Or, for higher-risk families, make sure they understand and are comfortable with the additional risk that the pod would create. If a family has grandparents living in the house or a child or parent with a medical condition that puts them at high risk, take extra precautions and reduce your own potential exposure to the coronavirus to keep them safe. Maybe agree to only go into stores once a week rather than every few days.

Also, the smaller the pod, the better — pods of two families are best, with 5 to 10 people total. “Every additional person you add adds in more risk for everybody else in the group,” Dr. McLaren said. “Keeping the pod size small is really, really key for minimizing your risk.”

It’s also crucial that you choose a family whose judgment you trust. Families are inevitably going to encounter risky situations, and you want to be able to trust that they will make smart decisions, Dr. McLaren said. Likewise, you’ll want to pod with a family that will be transparent and open about what they encounter and experience. If someone sneezes on a member of your pod at the grocery store, you’ll want that pod member to tell you about it so that you can all discuss next steps.

Finally, pick a family that will enrich your family, said Emily Oster, Ph.D., an economist at Brown University. Do the kids like each other? Do you like the other parents? Are there things you can do together that will make the summer more fun? Maybe you could even pod up with a family of a different race or ethnicity so you can grow and learn from each other.

If you’re going to pod up, you might as well choose a family that helps you “become more than the sum of your parts,” Dr. Marcus said, as that will make your quarantine experience more sustainable.

If you decide to try a pod with another family, brace yourself for some awkward conversations. First, the other family might not want to pod with you or has podded with someone else. It’s like high school prom all over again. If they are interested, you’re going to have to discuss your personal and private life with them — what you do every day, how you get groceries, how often you order takeout, Dr. Oster said.

Sit down for a Zoom or FaceTime conversation and set some ground rules — this is just a conversation, and there will be no hard feelings if either family decides not to move forward. Remember that this is a very trying time, and the most important thing is that you remain friends.

Next, talk about what you’re hoping for and share details about your daily life and the precautions your family takes. The goal is to determine whether you and the other family are on the same page with regard to how you approach quarantine and what you are looking for.

Also, keep in mind that even if just one person in their family is at high risk for contracting the coronavirus — maybe the mother is an emergency room doctor and you live in a city where the coronavirus is widespread — that person’s risk will spread over to your family members, too. “The risk in the pod is as high as whichever individual has the highest risk of contracting the virus,” Dr. Marcus said.

Also discuss commitment. Are you expecting that the pod will last all summer? Or would you rather start with a two-week trial period, and then check back in to see how things are going? Dr. McLaren pointed out that it’s possible to pod with one family for a while and then switch to another family; you’ll just need to have a two-week quarantine period between the two to make sure no one has been infected.

If you decide to move forward with a pod, set some firm ground rules. What kinds of activities are OK, and what’s off-limits? What might constitute a “breach” in the pod (such as a trip to the doctor’s or dentist’s office)? “The more communication you have upfront about the various scenarios and how they might play out, the easier it’ll be to navigate those situations as they arise,” Dr. Marcus said. If there is a breach, you can always pause the pod for two weeks while the exposed family quarantines.

Creating a pod isn’t going to be easy. It will probably feel “really weird and hard,” Dr. Oster said, because we’re not used to navigating such uncertainty, and so many strange and rigid rules, with other families. Still, for some families, pods could provide a way to stay sane while we all continue to try to stay safe.