Coronavirus information changes quickly, so please take note of this story’s publication date. You can find current recommendations and national outbreak data on the CDC website. Or, if you want local coronavirus updates and stats, check out the department of health website for your state or your city. Enjoy reading and stay safe. Let’s flatten that curve.
According to the Centers for Disease Control and Prevention, the coronavirus is thought to be transmitted by “respiratory droplets,” small mucus packages containing viral particles that are formed when people cough or sneeze. Those droplets primarily find their way from a sick person to a healthy one through close contact, i.e., being near someone and crossing paths with their pathogen-filled droplets.
But the coronavirus has only been around for a few months, and we’re still learning how it spreads. Peter Palese, chairman of the Department of Microbiology at the Icahn School of Medicine at Mount Sinai in New York City, says it’s possible that respiratory droplets aren’t the only virus courier. “Fecal-oral transmission may also be a component, since the original SARS virus had this,” he says. “However, the data from China say there is very little gastrointestinal disease seen in COVID-19, so this route is probably of lesser importance.”
Given what we know about the coronavirus so far, it doesn’t take a degree in medicine to wonder if cutting down on close physical contact could be a way to prevent the disease from making its way through a community. In epidemiology, this practice is called “social distancing,” and it is one of several ways that infectious diseases can be prevented or slowed without the use of medicine. Social distancing, per the CDC, entails staying away from large gatherings, avoiding local public transportation (including ride shares), and generally keeping your distance from other people. A 6-foot personal space bubble is the standard recommendation.
Six feet might be farther than you realize; it’s about the length of a full- or queen-sized bed. Many interactions, even with strangers, happen at short distances. Consider scenarios like checking out at the grocery store or going on a date. A standard table for two is about two feet across. Remaining 6 feet away from other people at all times might be challenging in a small town, let alone a large city.
Social distancing isn’t the only strategy the CDC proposes to reduce spread. You may have heard of the other options: “Quarantine” is when a healthy person is sequestered alone because of suspected exposure to an infectious disease. “Isolation” is the exact same type of separation, but for an actively sick person.
All three of these measures can impose a significant burden on someone’s job and personal life. That’s why, for anyone wondering if it’s time to flee to a cabin in the woods, the CDC doesn’t advise dramatically changing your daily habits unless you fall into a defined “risk level” category.
The CDC only recommends social distancing, as a way to prevent COVID-19 transmission, for people in two specific situations. First, it’s recommended for anyone who’s experienced “medium risk” exposure. That happens when an otherwise healthy person comes into close contact with a person who has a confirmed case of COVID-19 (an official diagnosis via an approved test). Close contact, again, means being within 6 feet of someone, e.g., standing behind them in line or sitting next to them on a plane. Second, social distancing is recommended for anyone who has symptoms of the coronavirus and has also had any potential exposure to the disease, no matter how minor.
“Medium risk” becomes “high risk” if someone has been living with a patient who has the disease and hasn’t been taking any protective measures, or if someone has traveled to Hubei province in China, where the disease originated. While medium-risk exposures call for social distancing, high-risk exposures call for more restrictive measures (such as quarantine).
At this point, most people don’t meet the formal criteria for medium risk. While confirmed cases of COVID-19 are on the rise in the United States, they’re still relatively rare. There are two reasons why, according to Kris White, a researcher and colleague of Palese. First, he notes, the coronavirus likely arrived in the US only a few weeks ago. Second, until March 3, the US restricted testing to people who had both respiratory symptoms and a specific reason to suspect they’d been exposed to the coronavirus.
Now that we have a less restrictive testing policy, and improved testing kits, Palese predicts a wider group of people will start being tested. “There is probably a low level of circulating cases undetected, but we honestly don’t know until we do the testing,” says White.
Right now, most people in the US fall into two other risk-level categories. “Low risk” means you’ve been in the same room with someone who has a confirmed case. “No identifiable risk” means you’ve briefly passed by an infected person. Maybe you were in the same subway station at the same time as someone who’s now known to be sick. If you haven’t been near anyone with confirmed COVID-19, then you don’t fall into any of the CDC’s risk-level categories.
Even if you don’t meet the risk-level threshold, the CDC still advises taking basic precautions to protect yourself against respiratory diseases:
- Avoid close contact with sick people.
- Stay home from work if you are sick.
- Clean household and workplace surfaces frequently.
- Wash your hands.
They also recommend that people who have coronavirus symptoms consider wearing face masks in the presence of other people. But, as public health experts have said in recent weeks, you don’t need a mask if you’re healthy. General, precautionary use of face masks is “way overdone,” says Palese. “The widespread wearing of masks has cultural roots; there is no clear-cut scientific benefit for doing it.”
Although, Palese does see one potential benefit to the face-mask frenzy. “I think masks promote a certain amount of social distancing, which may be helpful, since people tend to stay away from someone they see is wearing a mask.”
We’re still learning more about COVID-19, and these recommendations may change if the disease spreads further within the US, or if we learn new information about how it can be transmitted. For now, however, White suggests that people should consider their personal circumstances when deciding how to protect themselves. He feels that someone who’s more susceptible to getting severely ill from the coronavirus, due to their age or a health issue, should consider practicing social distancing in a way that fits their lifestyle — for their own sake.
“They should avoid places where there’s a high chance of being exposed to infected people,” White says, “like large group settings such as parties or concerts.”
Keep in mind that CDC recommendations are meant to give guidance to broad groups of people, including employers, business owners and healthcare professionals, as well as the public. Making personal decisions about your own behavior will require understanding both your personal risk as well as the impact on your life.
Social distancing is one tool that a potentially sick person can use to keep others safe. But for those who are well, there’s no reason to stop living your life. If there’s an urgent need for everyone in your community to curtail daily activities, local or state officials will let you know.