Winter’s coming. Now what?

Coronavirus and person wearing maskThe stress of living with the coronavirus in our midst for the last six months has been alleviated in part by the opportunity for social interactions with friends and neighbors outdoors where the risks of virus transmission are greatly diminished. But the reality for those of us living in Vermont is that with the onset of winter these encounters are less feasible.

In the past, family travel, holiday parties and indoor social activities helped us cope with the tedium of winter. Sadly, these are no longer encouraged or advised even as social interactions at work and in the classroom continue to be disrupted.

At the same time that we are being driven indoors, case numbers in the United States have exploded. Last week, and for the first time this year, over 120,000 new cases of Covid-19 were reported on a single day in the United States; Vermont has also recently experienced a surge in new cases.

Increasingly, scientists are coming to understand that the principal route of coronavirus transmission is through exhaled droplets and airborne micro-particles. This means that the risks of infection from person-to-person encounters in small indoor settings is enormous. Dr. Anthony Fauci, the nation’s leading infectious disease expert, put it this way: “We’re in for a whole lot of hurt…All the stars are aligned in the wrong place as you go into the fall and winter season, with people congregating at home indoors.”

So now what?
How do we address the need we all have for human contact? Are there strategies we can use that might allow for at least some form of direct social interaction?

One obvious approach is to turn to a strategy that young people and people with school-age kids have been using for a while: the pod or bubble. The idea is to form a small group of people who agree to adhere to a certain set of rules and guidelines as they get together for a shared purpose, whether childcare, socializing, card playing or studying. The concept is based on trust and a shared belief in the factors that increase the risk of contracting the virus and the behaviors that can prevent transmission: wearing a mask, physical distancing, hand and surface hygiene.

The element of trust is critical because it assures everyone in the pod that as a member you will divulge any possible exposures you may have had. It’s also critical because for a pod to function, each member has to understand that their behaviors when outside of the pod have consequences that are then brought back to other members. A visit to a crowded bar by one member, for example, becomes a visit to a crowded bar by all members.

There is a lot of useful information on the internet about forming and maintaining pods (see below). Although these suggestions about pods are principally for adults, it has been parents of school-age children and school systems that have had the most experience in forming and maintaining them.

Things to consider before forming or joining a pod.

  • Pods may reduce the risk of transmission. They do NOT eliminate it. Unfortunately, there will be no risk-free options until effective controls, including a vaccine, are universally in place.
  • Advanced age, existing illnesses such as diabetes, heart disease and cancer, and health factors such as obesity—all are associated with higher risk of death from the virus. Clearly, if any of these apply to you, think long and hard before joining a pod. Visit the CDC website for more information.
  • Are you a threat to others by virtue of your job, recent travel to a high-risk area, volunteer work? How about a recent illness or upper respiratory infection? Do you live with someone who has either been exposed to the virus or been diagnosed with Covid-19?
  • Are you willing to agree to limit close contacts to a few people, say six or fewer, in order to be able to participate in face-to-face small group activities?
  • Are you willing to be open at all times about recent exposures or high-risk behaviors?
  • Are you willing to physically distance, wear a mask, and practice good hand hygiene at all times while interacting with other members of the group?

If you decide to form a group, it’s also important to be clear about its purpose. Will it be purely social, for example, getting together for meals or watching movies, or will it have some other purpose such as recreation or exercise? Different activities are associated with different levels of risk.

Indoor activities with people confined to small space and with inadequate ventilation pose the greatest risk. However, these are exactly the conditions that are likely to exist here in Vermont in the winter. This means that if you are creating a pod that will function indoors, you should, at a minimum, adhere to the following guidelines:

  • Keep the group small. Six or fewer people is probably best.
  • Require that at the outset members first quarantine for at least 7 days and then have a negative PCR test before beginning to meet.
  • Establish and enforce rules that each member must agree to while inside: mask wearing, distancing, hand and surface hygiene.
  • Meet in the largest room in a house and make sure it is easily accessible to group members by passing through a minimal number of other rooms and spaces. All other rooms and spaces should be off limits.
  • Designate one bathroom for use. Guidelines for cleaning and disinfection after use must be established and followed.
  • If meals are being consumed, participants should bring their own food and utensils. Cleaning and washing up should be done when members return home.
  • Require group members to keep a daily log of all encounters they may have with non-group members between pod group activities.
  • Agree to keep alcohol consumption to a minimum at pod events, a behavior known to cause people to let down their guard about physical distancing and mask wearing.

Getting through this next phase of the pandemic will tax us all, but it will surely be easier if we can create small social networks that allow at least some form of face-to-face interaction with our friends and neighbors. Pods are not without risk, though if we proceed carefully, make use of materials that are available on the internet and elsewhere, and learn from the experiences of others, the benefits may well outweigh the risks.

Pod formation resources
Kristi McClamroch Ph.D., MPH
The Essential Step-by-Step Guide to Forming a Pod during a Pandemic

Greater Good Magazine—Science-based insights for a meaningful life
University of California Berkeley
How to Form a Pandemic Pod

A pandemic pod could help you get through winter, experts say.
Here’s how to form one.

The Washington Post
The Dos and Don’ts of ‘Quarantine Pods’ The New York Times

Jim Hyde is associate professor emeritus at the Tufts University School of Medicine. He lives in Charlotte.

If you’ve had experiences setting up and maintaining COVID-free pods and would like to share your stories with others, we’d love to publish them in The Charlotte News. Send your stories to News Editor, Chea Waters Evans, and we’ll take it from there. Thanks.