June 21, 2020
Social isolation is tough. And, we’ve already talked about how expecting abstinence is not a good public health strategy. Are there modifications we can make that can hugely decrease transmission risk and also provide social and physical connection? Enter the concept of the “bubble”, “COVID-teams”, “Pods”, or “Quaranteams.”
Let’s use the term Double Bubble. For one, it’s fun to say and two, in my research for this letter, it seems to be the most popular term (likely because of one). Double Bubble refers to the concept of expanding your isolation team to include another isolation team (ie. household). This has been a strategy that lots of people (and even a number of countries including New Zealand, Canada, and Germany) have used successfully. Let’s talk about how this should work because not doing this the right way can lead to a huge amount of unnecessary risk and could damage friendships instead of strengthening them.
I think if you are considering this there are two articles I would really like for you to read (here and here). The first is from the perspective of an individual Double Bubbling with a couple of his friends. It really goes through the do’s and don’ts and the interpersonal issues. The second one addresses epidemiological and social aspects. Here is a 2 min blurb by a pediatric nurse practitioner discussing this concept on NPR’s Corona Virus Daily back on May 15.
Again, whenever we are talking about harm reduction, we are talking about something that will confer risk. I’ve said it before and will again. Whenever we talk about risk, you need to consider your risk tolerance, your personal situation, your medical issues, and the value of the benefit the action will provide you.
Having offered my usual disclaimer, if you are interested in venturing into Double Bubble territory, read below (but also read the two articles I referenced above):
The people in Group 1 increased their risk by 3x and the people in Group 2 by 50%. I realize I am oversimplifying. Just because someone in your household or double-bubble gets COVID does not mean everyone will get it. But, I think you see my point. You are adding the risk of the other group to the risk of your group. Hence, why trust is so important.
And with that, I hope you have a framework in which to start thinking about Double Bubbles. If I missed something, let me know and I’ll share it in the next letter.
Stay emotionally connected and physically distant,
PS: My alma mater recently reported they have developed a mouse model for COVID. This is BIG TIME for speeding up the development of therapeutics for COVID. I’ll take the credit as I went there in the mid-’90s… you know standing on the shoulders of giants. Just saying.
PPS: Follow up on the false-negative letter. Here are two more articles that I used in answering a follow-up email question. This is a nice layperson article from Stat News that is excellent and here is a British Medical Journal article that is written for the medical community but I think it uses accessible language. Here are the main points from the BMJ article: