No, you can’t expand your quarantine circle just yet

Pennsylvania Gov. Tom Wolf recently extended the stay-at-home order in Philadelphia and surrounding counties until June 4. But not everyone is staying at home. Data shows people are increasingly traveling further from home. And as the weather warms up, popular city spots like Lemon Hill are getting flooded with people spreading out their picnic blankets — often inviting friends to join.

Here’s the deal: People are going against local guidelines and scheduling social hangouts. Sometimes everyone’s maintaining six feet of distance from one another, and other times they’re not. Either way, you shouldn’t follow suit. If you live in one of the areas where stay-at-home orders remain in place, now is not the time to expand your quarantine circle, warn experts.

“In Philadelphia, we’re still seeing significant numbers of patients in our hospitals, and we’re still so far from normalcy,” says Dr. Eric Sachinwalla, medical director of Infection Prevention Control for Einstein Medical Center Philadelphia. “The more people you interact with at this point, the more your chances are of being around someone who’s sick and spreading the virus without knowing it yet.”

A person with the coronavirus can be contagious before starting to feel symptoms. This could be your friend, your brother, the guy next to you at the supermarket — virtually anyone. It’s also been shown that people can get infected but never have any symptoms at all, and still transmit the virus. Many people who do feel symptoms have mild ones, particularly in the early stages. So your friend could be a little sniffly and sneezy, but assume it’s just allergies. All of this together makes it too risky to hang out with others right now.

“The problem is that we don’t have testing for everyone, and we’re still in the most dangerous part of this epidemic,” says Mike Levy, associate professor of epidemiology at the University of Pennsylvania. “There’s just no way to calculate your risk right now between households.”

Let’s say you contract the virus and are fortunate not to have an awful experience. The unfortunate news: You may pass it along to someone who isn’t as lucky.

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If you’re in a place with a stay-at-home order, you’re not supposed to be interacting with people outside of your household except for essential purposes.

“Local and state officials are making decisions based off of what the local epidemiological data is telling them,” says Dr. Craig Shapiro, pediatric infectious diseases specialist at Nemours/Alfred I. duPont Hospital for Children. “This is a public health problem. By not following those orders, you’re not just affecting you or your household, but you’re impacting your whole community, which includes those people who are at higher risk to develop serious complications.”

According to the CDC, the coronavirus spreads mainly among people who are in close contact (within about six feet) for a prolonged period of time. But the problem is, that six feet of distance isn’t risk-free, and experts say that right now the region is still seeing too many new daily infection cases to test it.

“The six feet idea is largely around the concept of droplet transmission — when someone coughs, sneezes, or talks, the droplets from their mouth or nose can infect another person in close proximity,” says Dr. Patricia Henwood, associate professor of emergency medicine at Thomas Jefferson University’s Sidney Kimmel Medical College, and leader of the Emergency Medicine COVID-19 Task Force at Jefferson Health. “But we don’t have a ton of data on ‘six feet’ for every scenario and how the virus moves through the air, so that’s just a minimum recommendation, along with masks and handwashing.”

Henwood notes that until infection numbers decrease to a level where officials can do widespread contact tracing, hanging out with people you don’t need to be seeing should be kept to a minimum. Contact tracing is the process used to track who an infected person has recently interacted with to determine who else might be at risk of contracting the virus.

“The case number is too high right now, but normally we’d track back all the people someone [who’s infected] has been in contact with, including those they’ve hung out with while socially distancing,” says Henwood. “Then all those people would need to quarantine — that goes for anyone part of the socially distanced hangout, too.”

For now, the six-feet-apart rule is meant for when you’re exercising outside or are in a situation where you have to be near other people. Outside of that, you should err on the side of caution.

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Is this going to last forever? No.

“This pandemic will forever change our world view. But the stay-at-home part? That will be temporary,” Henwood wrote in a recent Inquirer opinion piece. “Patience with resuming normal activities and expanding social circles will continue to save lives.”

But as we practice patience, that doesn’t mean we can’t look forward. Now’s the perfect time to start thinking about how you can plan ahead. When restrictions do start to ease, there will be plenty of in-between steps before we return to social normalcy.

At the start, experts say taking note of exactly who you’re interacting with is going to be crucial. This may require you to go through what’s essentially a prescreening process.

Is this friend you want to see an essential worker? Are they going to the grocery store every week? Where else have they been in the past few weeks? Are they hanging out with other friends? How many? Are they caretakers for their grandparents or anyone who might be at high risk?

“It might feel a little uncomfortable asking these questions, but it’s likely to be the new norm for awhile,” says Shapiro. “Hopefully you can trust your close friends and family because without knowing where people have been, you’re always going to increase your risk.”

Expanding your social circle will likely be a slow process. Levy says to think of your household as if it’s an island. How can you build as few bridges — pathways for the coronavirus to travel along — out from the island as possible? Can you join forces with just one other household, and both commit to only seeing each other?

“Maybe you team up so that you can rotate having one parent watch the kids while the other parents work — this kind of situation is going to be less risky than sending your kids off to summer camp,” says Levy. “If you open up your island to multiple families, who are also seeing other families, that’s going to create this big network, and it’s just like with Facebook — things can spread really quickly through those networks.”

You can also start to think about where you’ll feel comfortable hosting small gatherings when restrictions start to ease. Outdoor settings, like a backyard, are going to be your best bet. And if you are breaking the rules right now, you should be bearing that in mind already.

“If you’re going for a walk and able to maintain separation, that’s probably safer than being in a confined space for long periods of time,” says Sachinwalla. “But really, at this point, we should be continuing tele-interactions and following the guidelines being put out.”