What to Know About Social Distancing

Social distancing, as most people probably know by now, is the idea that to slow the spread of the highly contagious coronavirus, you need to maintain a certain distance from people. The Centers for Disease Control and Prevention (CDC) recommends social distancing, staying at least 6 feet apart from others indoors and outdoors, as part of its guidance to stop community spread of COVID-19.

Health Matters spoke to Dr. David Goldberg, an internist and infectious disease specialist at NewYork-Presbyterian Medical Group Westchester and an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, about why social distancing is important in the fight against COVID-19 and how you can incorporate this practice into your daily life — along with frequent handwashing and wearing a mask — to protect yourself from the coronavirus.

Why do we need to practice social distancing?
Most coronaviruses, including the coronavirus that causes COVID-19, are spread chiefly by respiratory droplets produced by coughing or sneezing. These larger droplets fall out of the air rapidly and cannot travel more than 6 feet, so the CDC recommends staying at least 6 feet away from other people at all times, except for those in “pods” or households where everyone has agreed to avoid contact with people outside the pod or household.

The CDC also notes that the virus may be carried by aerosols, which are smaller than droplets and may linger in the air for a longer period. This may be especially significant in closed, poorly ventilated spaces, where aerosols might accumulate. It is therefore preferable to have contact with people outdoors and as far apart as possible or, if this isn’t possible, in large indoor spaces with good ventilation and air filtration.

How can I go outside safely?
When going outside, be sure to wear a face mask and do your best to avoid coming within 6 feet of others. For example, a walk in a large park is fine, but not a walk on a crowded city street. Avoid large social gatherings, and as much as possible avoid close physical contact with strangers if you have to take public transportation to and from work. When visiting family members, don’t let your guard down and keep 6 feet from them to protect yourself and your loved ones.

The duration of exposure is significant. Passing someone as you walk in opposite directions, which involves only a few seconds in close proximity, is much less risky than sitting near someone for several minutes or longer. The CDC recently changed its definition of “close contact” with someone who has COVID-19 from 15 continuous minutes or more within 6 feet of an infectious individual to 15 minutes of cumulative exposure over a 24-hour period. So coming in and out of close contact with an infected individual over an extended period without precautions, such as wearing a mask or handwashing may increase the risk of transmission.

When I go on an essential errand, like to the grocery store or pharmacy, how do I stay safe?
Try to limit your trips to the grocery store or pharmacy as much as possible and always wear a mask. Plan ahead so you can minimize the number of trips you have to make. You can also check with your local grocery store or pharmacy to see if they offer pre-orders with curbside pickup. And go during off-peak times so it’s easier to keep your distance from others. Wash your hands thoroughly when you get home.

It’s recommended that people not shake hands but instead bump elbows. In terms of social distancing, is this a safe or recommended practice?
No. It’s better to stay 6 feet or more away from other people.

Do I need to practice social distancing in my home?
It depends on whether there is any possibility that other members of your household might be infected with COVID-19. If anyone in your home has symptoms suggestive of COVID-19, such as fever, cough, or shortness of breath, that person should be strictly isolated from all others until the results of COVID-19 testing are known.

If there are members of your household who are at risk for COVID-19 infection either because of their occupation or because they do not adhere to the CDC guidelines when outside the home, you should social distance from them in the household. If your living space makes it difficult to keep a 6-foot distance, stay as far apart as you can and continue to practice good hygiene by washing hands frequently, sanitizing surfaces as often as possible, and wearing a mask.

Why aren’t we advised to practice social distancing during a regular flu season?
We have a seasonal flu vaccine, which is now available in pharmacies and health clinics, and we have known treatments for the flu, but we don’t yet have the same tools for COVID-19. Even when we do have a COVID-19 vaccine, we will need to continue social distancing for some time. In addition, the flu is much less lethal than COVID-19. The country continues to experience a rapidly spreading pandemic with COVID-19, and minimizing contact with people is an important tool for stopping it and reducing the chances of a “twindemic,” where people become infected with both the flu and COVID-19.

When will health authorities know that it’s safe to be closer to people again?
Unfortunately, we don’t know. We’ll have to see how this evolves, in the U.S. as well as other countries. What we do know is, right now social distancing, wearing a face mask, and practicing good hygiene with frequent handwashing are some of the best ways to slow the spread of this coronavirus.

David M. Goldberg, M.D. is an internist and infectious disease specialist at NewYork-Presbyterian Medical Group Westchester and an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. He is board-certified in internal medicine and infectious diseases and has a special interest in travel medicine, Lyme disease, and community-acquired infections.