San Antonio Express-News (Sunday)
Done right, making room in your bubble for others can bring joy while managing risk
certainly doesn’t help. Loneliness and social isolation increase the risk for depression and anxiety, and can also lead to increases in the risk for serious physical diseases such as coronary heart disease, stroke and premature death.
Quaranteams, therefore, are not simply a convenient idea because they let people see their friends and family. Isolation poses serious health risks that social bubbles can help alleviate while improving social well-being and quality of life.
Why quaranteams work
Social relationships enhance well-being and mental health, but they also act as a vehicle for infection transmission. As people emerge from lockdowns, this is the conundrum: How do we increase social interaction while limiting the risk of spread?
A recent study used social network theory — how information spreads among groups of people — and infectious disease models to see if quaranteams would work in this pandemic.
The researchers built computer models of social interactions to measure how the virus spread — a model of typical behavior; of typical behavior but with only half the number of interactions; and of three different social distancing approaches that also had half the number of interactions as normal.
The first social distancing scenario grouped people by characteristics; people would only see people of a similar age, for example. The second scenario grouped people by local communities and limited intercommunity interaction. The last scenario limited interactions to small social groups of mixed characteristics from various locations, i.e., quarantine bubbles. These bubbles could have people of all ages and from various neighborhoods, but they would only interact with each other.
All of the social distancing measures reduced the severity of the pandemic and were also better than simply reducing interactions at random, but the quaranteam approach was the most effective at flattening the curve. Compared to no social distancing, quarantine bubbles would delay the peak of infections by 37 percent, decrease the height of the peak by 60 percent and result in 30 percent fewer infected individuals overall.
Other countries are starting to incorporate quaranteams in their prevention guidelines now that infection rates are low and contact tracing programs are in place. England is the latest country to announce quaranteam guidance with their support bubble policy.
New Zealand implemented a quarantine bubble strategy in early May and it seems to have worked. Additionally, a recent survey of 2,500 adults in England and New Zealand found a high degree of support for the policies and high degree of motivation to comply.
Building a quarantine bubble
To make an effective quaranteam, here’s what you need to do.
First, everyone must agree to follow the rules and be honest and open about their actions. Individual behavior can put the whole team at risk, and the foundation of a quaranteam is trust. Teams should talk in advance about what to do if someone breaks the rules or is exposed to an infected person. If someone starts to show symptoms, everyone should agree to self-isolate for 14 days.
Second, everyone must decide how much risk is acceptable and establish rules that reflect this decision. For example, some people might feel OK about having a close family member visit, but others may not. Our family has agreed that we only visit with friends outside, not inside, and that everyone must wear masks at all times.
Finally, people need to follow the rules, comply with physical distancing outside the quaranteam and be forthcoming if they may have been exposed.
Additionally, communication should be ongoing. The realities of the pandemic are changing at a rapid pace, and what may be OK one day might be too risky for some the next.
Risks of joining a quaranteam
Any increase in social contact is inherently more risky right now. There are two important ideas in particular that a person should consider when thinking how much risk to take.
The first is asymptomatic spread. Current data suggest that between 20 and 45 percent of people infected with COVID-19 are asymptomatic or pre-symptomatic and able to transmit the virus to others. The best way to know if someone is infected is to get tested, so some people might consider requiring testing before agreeing to join a quaranteam.
The second thing to consider is that consequences of getting sick are not the same for everyone. If you or someone you live with has a health condition, such as asthma, diabetes, heart disease or a compromised immune system, the assessment of risk and reward from a quaranteam should change. The consequences of a high-risk person developing COVID-19 are much more serious.
If individuals are informed and sincere in their quaranteam efforts and follow the guidance for social distancing, mask-wearing and hand-washing, quaranteams can offer a robust and structured middle ground approach to managing risk while experiencing the joy and benefits of friends and family.
about
Melissa Hawkins is a professor of public health in the Director of Public Health Scholars Program at American University. This article is from The Conversation, a nonprofit that distributes scholarly findings in accessible form.