June 5, 2020

Is there a safe way to hug in an epidemic? Here's what experts say.

Daily Briefing

    After two months or more of physical distancing, many people are beginning to miss the social connections created by hugging—but is there a safe way to hug during an epidemic? The New York Times spoke to virologists, aerosol scientists, and other experts, who outlined the health risks of hugging and how to mitigate them.

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    Health experts warn against close contact

    CDC recommends that Americans stay six feet away from people who don't live in their households to avoid transmitting the new coronavirus to others. As such, experts also recommend against shaking hands, kissing, and giving and receiving hugs. Health experts caution that just one infected person could start an outbreak if they have close contact with others, and note that physical distancing can help to prevent the virus' transmission.

    But as the United States' new coronavirus epidemic continues to grow, some people are becoming eager for human contact, the New York Times reports. Experts note that humans commonly yearn for physical affection, especially during stressful times. Research has shown that human touch can help calm our sympathetic nervous system, which releases stress hormones during stressful times.

    "Humans have brain pathways that are specifically dedicated to detecting affectionate touch," said Johannes Eichstaedt, a computational social scientist and psychology professor at Stanford University. "Affectionate touch is how our biological systems communicate to one another that we are safe, that we are loved, and that we are not alone."

    How risky is a hug?

    In light of that need, the Times spoke with Linsey Marr, an aerosol scientist at Virginia Tech, and other experts to determine the safest way to hug to reduce your chances of transmitting or contracting the new coronavirus.

    According to the Times, Marr used mathematical models from a Hong Kong study to determine a person's risk of exposure to the virus during a short hug, and found that risk was low—even if one of the people involved was infected with the new coronavirus and happened to cough during the hug.

    According to Marr, the viral load required for the new coronavirus to make someone sick ranges from between 200 to 1,000 copies of the virus. While a cough might carry between 5,000 and 10,000 copies of the virus, most of those copies typically land on the ground or other surfaces—even when other people are in close contact. Experts estimate that about 100 to 200 virus copies from a person's cough would be inhaled by or land on a nearby person in such an instance, and only 1% of those particles would be infectious, the Times reports.

    This means that, particularly "[i]f you don't talk or cough while hugging, the risk should be very low," Marr said.

    How to more safely hug

    But that doesn't mean you shouldn't take precautions to further reduce your risk of transmitting or contracting the new coronavirus while hugging, experts say.

    Direct your face away from the other person. Marr said hugging face-to-face carries the highest risk of transmitting the new coronavirus, "because the faces are so close together." She explained, "When the shorter person looks up, their exhaled breath, because of its warmth and buoyancy, travels up into the taller person's breathing zone. If the taller person is looking down, there is opportunity for the huggers' exhaled and inhaled breaths to mingle."

    Instead of hugging with your cheeks together or facing the same direction, people should point their faces away from each other and embrace quickly, Marr explained. And if you're hugging a child, it's safest to allow the child to hug you around the waist to keep potential virus particles away from your faces, according to the Times.

    Hold your breath during a hug. Yuguo Li, an engineering professor at University of Hong Kong, said the highest risk of viral exposure may be at the beginning and end of a hug, when people approach each other and breathe close to each other's faces.

    That's why Julian Tang, a virologist and associate professor at the University of Leicester, recommends people hold their breath during a quick hug to avoid inhaling virus particles. And when you're finished hugging a person, "back away to at least two meter separation before talking again to allow them to catch their breath at a safe distance," he said.

    Skip hugs with casual acquaintances. Li suggested that people should limit whom they hug. Similarly, Marr said, "I would hug close friends, but I would skip more casual hugs." Experts also said people should avoid hugging anyone who has symptoms of Covid-19, the disease caused by the new coronavirus, the Times reports.

    Other precautions to take. Experts also told the Times people should continue to follow standard guidance from CDC, such as washing their hands and changing their clothes after a hug and wearing a face mask. Experts also note that research has shown the risk of transmission is higher in indoor settings, so they should try to hug people outside.

    Remember, low risk doesn't mean no risk

    Still, experts maintain the safest way to show affection to your loved ones during the epidemic is to not hug them at all, because, based on what we know about the new coronavirus now, determining that an activity poses a low risk of contracting the virus doesn't mean it carries no risk at all. People must consider their own personal risk factors, such as whether they have any underlying health problems that increase their risk of developing a severe case of Covid-19 and whether they live with individuals at a heightened righ, when evaluating in which activities, like hugging, they'll choose to take part.

    And since many of the Daily Briefing's readers work as frontline clinical providers or in other health care settings that inherently raise their risk of exposure to the new coronavirus, frontline workers should follow the recommendations of public health authorities and their own organizations for managing that risk (Maxouris/Yan, CNN, 5/10; Parker-Pope, New York Times, 6/4).

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