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5 common questions about social distancing, answered

Can you go for a walk? Should you order takeout?

Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

Well, we’ve made it through one week of aggressive social distancing. We could have many more to go, as Vox’s Brian Resnick has written.

With that in mind, I decided to concentrate on the reader questions that I seemed to be getting multiple versions of. These are the questions a lot of you have as we adjust to our new reality.

First up: What exactly are the dos and don’ts of social distancing?

Questions from Lisa D.:

If we have no symptoms, is there any harm to walking outside with a friend as long as we keep 6 feet apart? How about 3 feet?

And Deirdra M.

If one has no reason to think they’ve had any contact with carriers, is it safe to see one or two people in your home (or theirs)?

These two questions seemed of a piece: When we say social distancing, exactly how much distance are we supposed to be keeping?

First, we should remember that the novel coronavirus is very contagious (an infected person will infect 2 to 2.5 others on average, versus about 1.3 others with the flu), and there is evidence that people who have only mild symptoms or no symptoms at all are helping spread the disease. That makes it more difficult to contain and is partly why we are taking such aggressive social isolation tactics: We cannot always be sure who has the virus, and we don’t want to risk it being passed along unwittingly to a more vulnerable person.

That’s why the first, second, and third rules of social distancing are obviously: Keep your distance!

Vox’s Rebecca Jennings spoke with an expert about some of the alternative ways to connect with people besides in-person interactions. I know it sounds extreme, but social distancing is really about physical distancing, and it works best when everybody practices it, with as few exceptions as possible.

That said, it’s natural to seek human contact. We’re social creatures. And the prospects of weeks upon weeks without seeing other people just isn’t palatable for many of us.

If you do need to get out, it’s okay to take a walk. It’s okay to say hi to your neighbors if you see them on your walk. Just keep a full 6 feet away from other people as much as you can.

The same rules apply for small get-togethers. Think hard about whether it’s really necessary. Don’t mingle if you’re not feeling well. If you are going to see other people in person, follow the official guidance (no gatherings of more than 10 people) and pay attention to your local health department: Cities and states have started instituting shelter-in-place protocols that discourage even small gatherings with people outside your family.

And no matter what, practice good hygiene: Wash your hands before you go out, while you’re out, and when you get home.

Here’s a related question I got several variations of, via Randy M:

I am getting Amazon food boxes and local pizza both delivered to my porch. I never see the delivery people Are the boxes safe? Are dry goods safe in the box? Is delivered pizza safe?

The topline guidance here is the same: Be thoughtful and consider the well-being of your fellow humans. The delivery people who are out and about to bring you your Amazon order or that pepperoni pizza are, by definition, not able to practice the kind of social distancing that experts are encouraging.

But I also understand the impulse to support local businesses especially in a time of crisis. As Recode’s Rani Molla reported recently, most US cities were already seeing a steep drop in dinner reservations before cities started to mandate restaurant closures. There will be a deep economic toll to social distancing, and the occasional delivery or takeout order is a small way each of us can alleviate it. Experts don’t think you are at any particular risk by getting takeout or home delivery.

But take what precautions you can. Maybe wait until you can get one big Amazon order. Take advantage of the new settings some food delivery apps have rolled out to accommodate social distancing, which, for example, allow you to ask that your food be left on your doorstep or in your apartment lobby. That’s better protection for you and your delivery person.

These are the golden rules of safe and ethical food delivery, according to The Verge:

  • Practice social distancing
  • Throw out the packaging
  • Wash your hands
  • Tip well
  • Support local businesses and order directly from the restaurant if you can

One last question I know a lot of you have, as you eye the various surfaces of your home with distrust (or is that just me?). Via Andrea L.:

How long does the virus survive on surfaces and potentially pose a risk to individuals?

Let me first say that we are learning new information about the novel coronavirus all the time. So our knowledge today could be obsolete by next week.

But for now, this is what we know from the preliminary research about how long the virus sticks to common surfaces, according to the Harvard Medical School:

  • 2 to 3 days on plastic and stainless steel surfaces
  • Up to 24 hours on cardboard
  • 4 hours on copper
  • Up to 3 hours in the air as droplets

We don’t know, however, how certain conditions (temperature, exposure to sunlight, etc.) affect that duration.

In general, it’s a good rule to clean surfaces you touch a lot through the course of the day, first with soap and water, then with disinfectant. And as always: Wash your hands, wash your hands, wash your hands.

Let’s end with a couple of science questions. First, from Elizabeth:

Is there any information on if you gain immunity if you catch it and get better? Or can you catch it twice?

This is one of the most important unanswered questions we have about the coronavirus, as Vox’s Brian Resnick covered today.

The usual rules of the disease road say that if you get an infection, your body will build up immunity to it and you’re much less likely to get the same infection a second time. That will probably be broadly true for the novel coronavirus too, experts say.

But some number of people could come down with the virus again, and we just don’t know yet what that reinfection rate will be. Already, there are some anecdotal stories of people who came down with symptoms, seemed to recover, and then tested positive for Covid-19 again. Our bodies have not had any experience fighting off the novel coronavirus, and for some people, the antibodies they built up in their first infection may start to fade away after a time.

In short, there isn’t a great answer to this question yet. But we shouldn’t assume that a person who’s already caught the virus is totally immune from a second infection. The risk may be lower, even much lower, but we can’t say it is zero.

Today’s last question, from Tom M.:

Are there any reliable statistics on the age distribution of diagnosed cases, perhaps along with some categorization of degree of seriousness by age (including death), and the existence of existing health problems prior to contraction?

A couple of days ago, the CDC actually put out the first such statistics for the outbreak in the United States. This table is a handy answer to this question:


As you can see, the risk of hospitalization, intensive care, and death increase steadily as the patients get older. But being younger doesn’t mean you can’t get a serious case of Covid-19: These early returns indicate upward of 20 percent of people under age 55 are being hospitalized and a small but real number of them have ended up in the ICU. Fewer than 1 percent have died, but it does happen.

This tracks with the age breakdowns we’ve seen in other parts of the world and projections from public health experts who have tried to anticipate what the outbreak will ultimately look like in the United States.

We know people with heart disease, lung disease, and diabetes are at higher risk of getting very sick from Covid-19, according to the CDC. People who have compromised immune systems may also have a higher chance of developing more severe symptoms.

I know with some of these questions, the answer sounds like a shrug. We still have a lot to learn about the Covid-19 coronavirus. That’s why caution should be the motto for all of us for the time being.

This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.

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