A week or so into May, Alison Willis called her parents with a bold idea: What if they came over for dinner on Mother’s Day?
Don’t answer right away, she told them on the phone. Just think about it. Later, when they’d agreed to the visit, the family negotiated terms: Her parents, ages 69 and 70, would wear N95 masks except while eating. Everyone would stay 6 feet apart. They’d order in dinner, so everyone’s food came in separate containers.
No, GG couldn’t hug her 6- and 9-year-old granddaughters.
“My dad said no, that’s crossing a line,” Willis said.
Her father would know — he’s Warner Greene, a virologist and senior investigator at the Gladstone Institutes who’s studied HIV for decades and recently shifted to the coronavirus that’s infected 5 million people globally.
The Mother’s Day dinner, at the Willis home in San Mateo, was a little awkward, but it was wonderful just to be in the same space again, father and daughter said. “There was lots of joking,” Greene said. “It wasn’t completely normal, but it was good.”
As the Bay Area gradually reopens the economy and slips out of its collective isolation, these kinds of encounters are expected to become more common, not just for Willis and Greene but for families all over the region. Public health officials talk of how people may safely return to work and to school in the near future, but many residents want to know: When can I see my loved ones again?
There is no official answer yet. Formally, public health authorities say that current shelter-in-place orders don’t allow people to spend time with others outside their household. On Friday, Santa Cruz County announced four new clusters of cases associated with family gatherings, including Mother’s Day celebrations.
Gov. Gavin Newsom, when asked at a news briefing Friday when people could socialize again, reiterated that the state is still experiencing widespread disease and people need to keep sheltering in place.
“I have a very personal struggle with this right now,” said Dr. Erica Pan, the health officer for Alameda County. “My parents live in San Francisco, and they usually spend a lot of time with our kids. And it’s really hard for everyone. But right now we want people’s bubbles to be their household unit. We still want to minimize the number of people that we are in contact with.”
Authorities have noted repeatedly that older people and those with health problems that put them at risk may be discouraged from venturing far outside their homes for many more months — perhaps not until there is a vaccine or robust treatment for COVID-19.
But experts say they also recognize that many people, regardless of age and health status, may not be able to abstain from seeing friends and family for the duration of this pandemic. Eventually, people are going to need to make difficult risk assessments for themselves and others as they re-engage — beyond Zoom and FaceTime — in those relationships.
“It’s an unknown calculus,” Greene said. “You desperately want the social interaction with your family. It’s particularly important after what we’ve gone through. But the personal risk — can you imagine how bad the family would feel if we had that interaction and then someone got infected? I certainly don’t have the answer to this one.”
Many public health experts are taking a “harm reduction” approach to talking about connecting with friends and family again. The idea is that social activities are always going to be risky as long as the coronavirus is circulating. But abstinence isn’t an option for many people when it comes to seeing loved ones, so they need to find ways to do that with the least amount of risk.
Other elements of reopening society, from resuming retail and restaurants, to safely conducting outdoor activities, have been closely monitored by public health officials. They’ve issued detailed guidelines and directives. But evaluating the risks around socializing may lie largely on individuals and families, experts said.
“There are certain things that are just not wise to do under any circumstances now — not wearing a mask, not washing hands. The obvious things,” said John Swartzberg, an infectious disease expert with UC Berkeley. “It’s the nibbling at the edges where people will have different opinions. I’m coming to think we should be tolerant of how people act at those edges. Where the risk is very small, it’s open for reasonable people to make reasonable judgments.”
Swartzberg said that he and his wife decided they weren’t willing to stop seeing their son and daughter-in-law and grandchildren, who live only 10 minutes away in the East Bay. “So we meet them outside, at least once a week,” he said. “And the 10-year-old draws a line where 6 feet is, and we stay outside the line.”
Any movement toward reconnecting with family and friends should start with a conversation, said Jei Africa, behavioral health director for Marin County. Start by asking if the other people are open to meeting in person at all — as Willis did with her parents. Make it clear that “no” is an acceptable answer, Africa said.
Next, families should agree on boundaries: Will everyone wear face coverings the entire time? Will the gathering happen inside or outside? Should everyone bring their own food? Is any physical contact allowed?
The answer should depend on science, and what is known about how the virus spreads — outside is better than inside, for example, and yes, people should wear face coverings when they can. But it’s also up to individuals’ risk tolerance. A grandparent may decide that a quick hug around the knees from a small grandchild is acceptable, but not a kiss on the cheek, for example.
“Do not assume that people want to hug you or kiss you or shake your hand,” Africa said. “And do not be hurt by people asking to change their usual routines and behaviors. We’re really social beings. And sometimes it’s not the holding hands or hugging. It’s the proximity, just being next to to somebody, that matters.”
Getting that message across to children may be especially complicated. Greene said the first time he saw his granddaughters was at the end of a driveway, when everyone was wearing masks, and the 6-year-old had a tough time understanding why she couldn’t get close to her grandparents.
A Stanford emergency physician has even written a children’s book on the topic, called “I Love You When You’re Close and When You’re Far Away.” He wrote it with his 2-year-old daughter in mind.
If families are considering an in-person meeting, Africa suggested explaining to young children, “Just for now, we can be in the same space but keep a distance. I know it will be hard, but it means we keep each other healthy.”
It’s not just close family members who are talking about reconnecting, but friends too. Infectious disease experts say that can get into dicier territory, because boundaries may be less clearly defined. And the more people begin to socialize, the more likely they are to get lazy about social distancing, experts worry.
But especially for people who don’t have family nearby, or who have been isolating alone, expanding that quarantine bubble will happen eventually. Some families are talking about blending households, if only so their children have playmates again.
Often, they’re finding that requires careful, complicated negotiations.
The families need to agree on hygiene protocols around handwashing and physical contact and mask-wearing. They need to disclose who is in their bubble already, and whether they have other family or friends beyond the household. And perhaps most important: They need to agree to not see other families.
Willis has talked with a family down the street about coming together. Their children are friends, and for the past two months they have been relegated to seeing each other only through windows or from behind masks.
“The girls just yearn to be together,” Willis said. “So we’ve discussed, would they be the family to expand the bubble, to double up? But you have to tread that conversation carefully. Who else are you going to see? Is your bubble going to expand in the other direction with more people? Do I put my parents at risk if I include my neighbors in our bubble?
“It all starts to get a little blurrier as it gets bigger,” she said.
Some people aren’t yet ready to move beyond their household contacts, which is certainly preferable, most public health officials say. Shannon Bennett, chief of science for the California Academy of Sciences, said she and her mother agreed in early March that her mom should remain in Vancouver, British Columbia, during the outbreak, and they have no immediate plans to reunite.
She has family members in the Bay Area, but they are older relatives who don’t yet feel safe interacting with people outside their home, Bennett said. So for a while longer it’s just the three of them: Bennett, her husband, and her 15-year-old daughter.
“We miss them all, my mom and them, but it’s better — you’re investing in the long term,” Bennett said. “Let’s keep them alive a long, long time and not put them at risk, just because we would love to share hugs.”
But the Bennetts did extend their family bubble a little over the weekend, she said. They adopted a puppy.
Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com Twitter: erinallday
https://www.sfchronicle.com/bayarea/article/Love-in-the-time-of-coronavirus-How-families-and-15291411.php
2020-05-24 18:40:36Z
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