Inverse asks

The most common social distancing confusion, explained by medical experts

What to do when "the risk is not zero."

Before 2020, social distancing was just another phrase for avoiding your ex or an overzealous coworker. But this year, as the novel coronavirus spread, social distancing became an essential part of our lexicon and one of the best strategies for staying healthy.

People across the globe are engaging in social distancing by staying six feet apart from anyone outside their "quarantine bubble." But although this public health precaution is now a fixture of daily life for some, confusion remains – especially when it comes to social distancing outside.

Inverse asked readers what confuses them most about the coronavirus pandemic. Over 1,000 people wrote in. Now we're answering those questions with reporting and expert insight.

In an Inverse survey, 1,017 readers responded to the question: "What's the biggest misconception you think people have about social distancing?"

The majority of respondents, at 37 percent, said: "Socially distancing is less important if you're outside."

Meanwhile, 24 percent of respondents answered: "You only need to do it indoors."

These misconceptions reflect a pandemic turning point. As lockdown measures ease and people's public health vigilance wears thin, some large gatherings including weddings, baby showers, and house parties, have resumed. After months of social isolation, people are flocking together. So, is it okay to ease up on social distancing if you're outdoors?

According to Denis Nash, an epidemiologist and executive director of the CUNY Institute for Implementation Science and Population Health, the answer isn't black-or-white.

"Outdoors is generally safer in terms of the onward transmission risk and risk of acquiring Covid-19," Nash tells Inverse.

"But the risk is not zero, so it is important to wear masks within six feet of someone who is not in your household or social bubble."

LaMar Hasbrouck, an internist and a former senior medical officer at the Centers for Disease Control, stresses that risk reduction behaviors are "additive, not substitutive." He emphasizes that different behaviors "add a level of protection" upon one another, including:

  • Social distancing
  • Good ventilation
  • Wearing a mask
  • Avoiding crowds
  • Washing hands
  • Avoiding personal greetings, like handshakes and hugs

Do you need to wear a mask and socially distance outside?

When a person infected with Covid-19 breathes, coughs, sneezes, talks, or sings, they expel respiratory droplets that spray into their immediate vicinity. Some of these potential coronavirus containing droplets fall immediately to the ground, end up on surfaces, or evaporate in the air. Others land on the eyes, noses, or mouths of others, and can subsequently be inhaled.

This viral "splash zone" led to the United States public health "six feet apart" rule, as well as other nations' one to two-meter separation. At this distance, the risk of viral droplets sneaking their way into the body drops precipitously.

Crucially, in indoor settings, especially with stagnant air, tiny viral droplets can stay suspended in the air for an estimated eight to 14 minutes. But outside, with constantly circulating air, droplets tend to evaporate much faster, typically within seconds.

"With outdoor environments, the airborne risk is reduced given the wind currents and open-air, allowing quicker dilution," Hasbrouck says. "This risk can be reduced indoors with good air circulation systems and HEPA filters."

These droplet dynamics mean the risk of catching or spreading Covid-19 outdoors is lower risk than it is inside. However, people should be vigilant in both settings, Hasbrouck says. Neither setting is zero-risk.

When faced with a prospective activity or gathering, the CDC suggests asking yourself these four questions:

  1. How many people will you interact with?
  2. Can you keep six feet of space between you and others?
  3. Will you be outdoors or indoors?
  4. What’s the length of time that you will be interacting with people?

"Durations greater than 15 to 20 minutes are considered significant," Hasbrouck says. "Walking by someone, or brief interactions and transactions are less risky."

Hasbrouck also advises investigating whether people are likely to be wearing masks, and the type of activities or behaviors at the event. Will there be personal exchanges or well-spaced tables? Will there be buffet style food or meals served by staff wearing protective garments? A question seemingly small as "will there be board games?" can make a big difference.

"If there is enough space for people to stay six feet apart, I say bring your mask and go for it," Nash says. "I would not want to be in an outdoor situation for long periods where I couldn't easily keep my distance from others, even with a mask."

But importantly, social distancing and mask-wearing may be dropped as an event progresses or people are drinking.

"It is easy to forget what you are trying to do once you get deeper into social interactions, or if there is alcohol or drugs involved," Nash cautions. "That is something to be careful of."

The Centers for Disease Control offers a framework to think through risk.Centers for Disease Control

There's no magic formula for Covid-19 risk calculation. Instead, there are factors of health vulnerabilities and risk tolerance to consider, and preventative strategies you can take to mitigate those risks.

"Risk can be dramatically reduced by practicing the three W's: wear a mask, wash hands often, and watch your distance and duration at the event," Hasbrouck says.

Ultimately, though scientists have progressed in developing treatments and vaccines, the pandemic is far from over. That may feel disheartening, but mastering the rules of social distancing can help people navigate this time and still have a social life.

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