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September 4, 2020

Weekly line: How to (politely) stand your ground on social distancing

Daily Briefing

    Public health officials are urging Americans to continue social distancing, especially during the upcoming Labor Day weekend, to help get the country's coronavirus epidemic under control. Here's how you can sidestep invitations from friend and family who aren't perfectly distancing—without alienating them.

    Advisory Board's take: 3 ways you can limit the effects of social isolation

    Small gatherings among families, friends emerge as sources driving new coronavirus cases

    Understandably, it may be tempting to view social distancing recommendations and advice to self-isolate as a warning only against hanging out in large groups or crowded spaces. After all, quarantine fatigue is real, but we know that the reopenings of bars, restaurants, and other businesses in Sun Belt states largely drove spikes in new coronavirus cases during the summer.

    However, maintaining recommended social distancing and self-isolating measures also includes avoiding small, close gatherings with families and friends who don't live in your household—which, according to contact tracing research, have emerged as a new source of coronavirus infections in several states, USA Today’s Jorge Ortiz writes.

    "People don't think of [small gatherings] in the same way" that they think about "a bunch of people on the beach or in the bars, but these small events add up to a lot," Peter Chin-Hong, a professor of medicine at the University of California-San Francisco (UCSF) who specializes in infectious diseases, told Ortiz. Chin-Hong said several of his patients with coronavirus infections told him that they likely contracted the virus while attending barbecues.

    And the trend isn't limited to states, such as California, which have endured significant outbreaks. For example, Maryland Gov. Larry Hogan (R) in late July said contact tracing had revealed that at least 44% of new coronavirus cases in the state at that time were tied to people who reported attending family gatherings, while 23% were tied to people who reported attending house parties.

    In Washington, contact tracers linked at least 29 coronavirus cases to a party held in early June, which also lead to potential exposure at 31 employers. "We're finding that the social events and gatherings, these parties where people aren't wearing masks, are our primary source of infection," Erika Lautenbach, director of Washington's Whatcom County Health Department, said at the time.

    In Washington, D.C., officials found that a backyard fundraiser with about 24 guests was linked to new cases of coronavirus infection among a few attendees. In addition, Matt Lambert—an ED physician in Washington, D.C.—told Ortiz that he treated infected patients who said they contracted the coronavirus at a small dinner party with just eight attendees.

    And in some anecdotal evidence, when physicians Miles and Brytney Cobia held a gathering with close family members at a lake house in Alabama, eight out of the 11 people who attended the gathering ended up testing positive for the coronavirus.

    "Small gatherings are a concern because there's so many of them," George Rutherford, who also works at USCF and serves as the principal investigator for California's contact tracing program, told Ortiz. In fact, Rutherford added, "[t]hey may account for a much greater proportion of the cases than we think right now."

    Officials urge Americans to continue social distancing—especially over Labor Day weekend

    In light of the coronavirus' spread among small groups, public health officials are urging people to continue social distancing and limit their close contact to only those who live in their household—especially over the upcoming Labor Day weekend.

    On Monday, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that whether America is able to avoid spikes in new coronavirus cases tied to Labor Day weekend—like those the country saw after the Memorial Day and July 4th holidays—will determine whether the country gets a "running start" at containing the virus' spread for the rest of this year.

    Similarly, HHS Assistant Secretary for Health Brett Giroir on Tuesday said it's particularly important that Americans take precautions to prevent spikes in coronavirus transmission stemming from gatherings over the Labor Day weekend if the country hopes to avoid an onslaught of new cases that could emerge as the United States enters the fall and winter months.

    "Labor Day is coming up, and we need to stress personal responsibility. … We have to go into the fall with decreasing cases like we're doing now," Giroir said. He added, "If we get through this weekend, as … Fauci said [Monday] … and we do what we're supposed to do, we're going to be in really good shape going into the fall."

    How to stand your social distancing ground (without miffing your family and friends)

    So to be good stewards of public health, we need to continue social distancing. But how do we keep turning down invitations from friends and family who aren't being as careful—without alienating them?

    1. Set and communicate your boundaries

    The first thing people need to do is determine in which types of activities they're comfortable participating, Gary Brown, a marriage and family therapist in California, told the Washington Post's Jenna Jonaitis. Brown said, "You have the right to set your own level of tolerance for risk."

    And Lyndsay Volpe-Bertram, section chief of psychology at Spectrum Health, told Jonaitis that people should assess their comfort levels based on their own feelings—and no one else's. She suggested that people ask themselves: "If I left everybody else's opinion out of it, what would I feel most comfortable with?"

    Once a person identifies their boundaries, they should communicate those limits to family and friends. Volpe-Bertram acknowledged that doing so can feel uncomfortable, and she suggested that people practice what they'll say before having conversations with others about their boundaries, Jonaitis writes.

    Further, it's important to remember that, often, family and friends will respect our decisions. Carla Marie Manly, a clinical psychologist in California, told Jonaitis, "Our true friends respect our boundaries, even if they disagree with them."

    However, it may take friends and family some time to understand and honor our boundaries, she said. "Give the person one, two, three times to catch up to you to get the message," Manly said—and if after that, it still seems like they're not getting it, explain that respecting your boundaries is important to continuing your relationship.

    It's also important to ask others about their boundaries, Manly told Jonaitis, as doing so could help both parties feel closer and better respect each other's limits.

    2. Practice saying no

    Even if you communicate your boundaries, your friends and family still may invite you to take part in activities you're not comfortable with—and some might even try to make you feel guilty for not attending, Volpe-Bertram told Jonaitis.

    Because of that pressure, it's important that people practice and get comfortable with saying no. "The more we can work on our assertiveness skills and feel comfortable stating what we think and what our limits are, the easier it's going to be," Volpe-Bertram said.

    To get to that point, people should "[r]ealize [they] have a right to [their] own opinion," particularly when it comes to their own health and safety, Brown told Jonaitis. "It's more than [it] simply being okay for you to disagree. It's a basic right, and you don't really have any need to apologize for it," he said.

    It also may be helpful to acknowledge and validate others' feelings when turning down an invitation, Volpe-Bertram said. For instance, she suggested saying, "I know you really miss us, and we miss you too. This is really hard."

    The Los Angeles Times' Jessica Roy adds that it's important to keep a polite and positive tone when having these conversations—and it may be helpful to keep them short. "Put a smile on your face when you make the call and keep it simple: 'Thank you for the invitation, I'm so sorry but I can't make it.' You don't need to explain why or start adding qualifiers or caveats. That's where you run the risk of veering into judgmental territory," she writes.

    And remember: holding firm to your own boundaries doesn't mean you have to convince others to abide by the same standards. As Elaine Swann, an etiquette and lifestyle expert and founder of the Swann School of Protocol in California, told Roy, "Our goal is not to try to correct anyone or chastise them or even educate them. … We should not take on the task of trying to correct or fix other people."

    3. Explore new ways to connect with others

    The coronavirus pandemic has spurred a multitude of new ways for people to stay connected without seeing each other in person, and people should embrace those tools and explore new ones to continue bonding with others, Jonaitis writes.

    For example, Jonaitis suggests that, "[o]utside of chats and shared activities via video," people can make plans and talk about things they'd like to do together once they feel comfortable. Volpe-Bertram explained, "Talking about [plans] can get those positive emotions flowing and … foster that sense of connection."

    And Roy notes that, even if you don't feel comfortable attending events in person, you can still send gifts to recognize the occasions. "Just because you can't go to an event doesn't mean you can't be appreciative toward the host. If it's a milestone birthday or a wedding, send a card and a gift. If it's a more casual get-together, have flowers delivered or send the hosts some money ahead of time with a note: 'So sorry I can't be there. Dessert's on me!" she suggests.

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