I traced my COVID-19 bubble and it’s enormous

Farhad Manjoo
Published : 21 Nov 2020, 11:46 AM
Updated : 21 Nov 2020, 11:46 AM

Experts and officials are unequivocal: Stay home for the holidays. Getting together with family for Thanksgiving without quarantining beforehand is like "bringing a loaded pistol for Grandma's head," Gov. Jared Polis of Colorado warned earlier this month.

Mark Horne, president of the Mississippi State Medical Association, sketched out Grandma's demise in even more horrifying detail. "You're going to say hi at Thanksgiving, 'It's so nice to see you,'" he said in a recent briefing, and then "you're either going to be visiting her by FaceTime in the ICU or planning a small funeral by Christmas."

So there should be no question about my plans. Rather than travelling 300 miles to celebrate Thanksgiving with my sister and my parents — among them my diabetic father, age 71 — my wife, my two kids and I should stay home and binge-watch bad TV.

And yet, for weeks, I've been on the fence. After all that has happened this year, the idea of skipping Thanksgiving has brought me low. I am blessed not to have lost anyone close to me to the coronavirus. For my family, the pandemic's most crushing hardship has been its enforced isolation, especially the cruel way it has cleaved us apart at generational seams, separating my kids from their grandparents.

There are psychological and physical dangers to isolation, but I've been mourning the most basic loss: We are all missing out on a lot of time with one another. As we squander our days apart, alone, glued to screens, kids keep growing up, grandparents keep growing older, babies are born, people die. I worry about life passing us by just as we're trying to save it. If 2020 has taught me anything, it is to resist taking the future for granted and to impose an actuarial frankness on all of our planning. Sure, we could skip Thanksgiving this year — but how many future Thanksgivings will we all have together, anyway?

To find some empirical foothold in a debate mired in uncertainty, I decided to investigate my own potential lethality to the older people in my life. Among other things, I contact-traced myself — an exercise that ended up being nearly as vulgar as it sounds. I went to all of my regular close contacts, then I went to all of their contacts and so on, asking everyone about their potential exposure to the virus.

What I found floored me.

Asking people you barely know for intimate details about their daily lives is not the most cheerful way to ring in the holiday season. Contact tracing — in which health officials track down and urge isolation for people who have recently associated with an infected patient — is an essential tool for interrupting the spread of the coronavirus. But it is a laborious, delicate process, requiring tracers to quickly establish rapport with sick people and to encourage them to provide honest details about their recent activities while still maintaining people's privacy and sense of autonomy.

In an excellent online training course for aspiring contact tracers, Emily Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, outlines a range of common pitfalls on the job. Tracers should not be aggressive in demanding information — but they should avoid passivity, too. They shouldn't talk too quickly or too loudly — but going too slowly or too quietly isn't good either. They shouldn't provide medical advice or opinions — but they shouldn't sound disinterested or bored.

Much of this sounds obvious, but when I sat down a few weeks ago to email people in my network for details about their contacts, I felt paralysed by the task. I'm a journalist who is used to prying into people's lives, but inquiring about people's exposure to the virus crosses a line of familiarity that even reporters rarely breach. What right did I have to ask my son's friend's dad how many people he came into contact with last week? The supervisor at my kids' distance-learning pod is in a relationship. Am I entitled to ask how often he sees his girlfriend? Do they live together? What's her exposure to the virus?

I'm not the only one asking these questions.

"We're having conversations with each other about things that normally we don't," Gurley told me. "The reality is that if someone has been exposed and they have contact with your kid, it becomes a personal issue for you. The reason to ask those questions is because their personal life somehow now is your business, because it influences your risk in a very direct way."

It turned out that I shouldn't have worried about getting too personal. Although some of the people I contacted declined to have their names published, nobody refused to answer my questions, and some people provided so much information you'd think I'd presented them with a court order.

Part of this may have to do with where I live — Northern California, a place of engineers and scientists, where commitment to mask-wearing borders on the beautifully cultish. The technology industry, which dominates the local economy, was early in pushing people to work from home, so a lot of my friends and neighbours have been in isolation for months. My wife and I have seen almost nobody in person indoors. In the spring and summer, my two kids were also isolated at home. After an initial panic, I haven't really worried about getting the virus; we've been very careful.

But when school started this fall, we decided to send our children to a distance-learning pod because things at home were at the breaking point. It's a bizarre setup: Every school day, my son and daughter sit in a classroom on the campus of a local elementary school, and under the supervision of several staff members, they attend classes over Zoom. There are seven other children in the room, and none elsewhere in the school. The empty school is the creepiest, most postapocalyptic setting I'll remember from this awful year.

The pod has instituted many safety measures. The kids wear masks at all times, and there are temperature checks and a daily questionnaire about recent exposures. But the Centers for Disease Control and Prevention's definition of a "close contact" for the coronavirus does not take into account these precautions and instead is based primarily on proximity and duration; you're at risk of catching the virus if you're within 6 feet of an infectious person for at least 15 minutes during a 24-hour period, whether or not you're wearing a mask.

Through the pod, then, our kids are now a primary vector for contagion — putting not just my wife and me at risk but also our parents, if we choose to see them. The map of my bubble makes this plain; if not for our children, my wife and I would be an island unto ourselves. But the thing about kids is, they're never alone; as Gurley pointed out, your friends and co-workers may live by themselves, but if you have kids, there's a good chance they associate with other kids, and you can be sure those kids are around other adults, creating an invisible chain between you and people you don't know.

A lot of people, it turns out. Rebecca Green, the mom of one first grader in the pod, is a doctor who has daily contact with two colleagues and about 10 in-person patients a week. Green's younger son, the first grader's brother, attends a preschool with 10 other children and two teachers. Through this single connection, then, my kids are linked to at least two dozen other people, including a rotating cast of patients. Green told me that she thinks about this level of exposure often, and she outlined several mitigating factors. Her practice has "strict COVID rules around illness, and anyone with even a cold has to have a negative COVID test to return to work," she told me. The preschool is also exceedingly careful. "Someone had a cold three months ago, and everyone had to have a negative COVID test to return to preschool," she said.

Still, for months, I've been linked to two dozen strangers, just a few ill-timed coughs away from COVID, and all the while I'd been none the wiser. As I was analysing the far-flung corners of my bubble, I was often reminded of the double-dipping bit from "Seinfeld." The dip looks untouched, pristine. But how many people are double-dipping their chips in your dip?

So that sealed the deal, then, right — we're staying home for Thanksgiving?

Well, not so fast. Mapping the far reaches of my coronavirus bubble revealed far more contacts than I'd expected, but there was something unexpectedly reassuring about candidly discussing COVID risks with Green and other parents. I discovered that my network is robust in ways that I hadn't anticipated. All of my indirect contacts are taking the virus seriously; none of them spun conspiracy theories about the pandemic, or suggested it was no big deal, or told me to bug off and mind my own business. None of them was beyond risk, but I was also satisfied that they seemed to be doing the best they could to avoid getting sick.

I asked Gurley if I was crazy to even consider visiting my family for the holidays. She told me I wasn't. In a pandemic, everyone is at some level of risk; what's important is understanding your risk and deciding whether seeing your loved ones is worth it. "I think we have to acknowledge the reality of people's lives," she said. "In my family, for example, we have a family member who has been diagnosed with stage 4 cancer and may not live very long — so of course that person is at high risk, but at the same time, would we pass up the chance to see them in a way that we felt was safe?"

I wouldn't be going to Thanksgiving to see a family member dying of cancer. Mine is a more mundane desire: to see my folks in person in a year we've spent mostly apart and to accommodate their intense desire to spend time with our kids before the kids get too old for all that. This may not be enough to satisfy others' scrutiny; on social media, among lefties like myself who proudly believe in science and ostentatiously defer to expertise, I've noticed quite a bit of travel-shaming. The CDC says the safest way to spend Thanksgiving is to stay home. After discovering how huge my bubble is, shouldn't I just go with that advice?

But I can't do it. Even after mapping my bubble, the question of whether or not to go still feels, in the end, like a gut call, ruled more by emotion than empirical data.

So, after thinking long and hard about this, and after extended conversations with my eager parents, my wife and I decided that we would travel for Thanksgiving. This might come as a surprise, given what I found in mapping my bubble, but the exercise prompted us to add several important safety measures to substantially reduce the risks.

We're pulling our kids out of the learning pod for a week before we leave. We're looking into getting tested before we go, and will all probably quarantine for a couple of weeks after we return.

Early on Thanksgiving morning, the four of us will get in the car and drive, not fly, to my parents' house. Over five hours in the car, we will likely stop to use the restroom once or twice, but will not come into close contact with others (as defined by the CDC). We will meet my parents in their backyard.

I can't promise that they won't hug our children, but our plan is to have the outdoor meal socially distanced. Our celebration will involve a total of seven people — fewer than the 10-person limit that many states have imposed on gatherings. Afterward, we plan to stay overnight in the area, not in their home, and to drive back the next afternoon.

There are risks to this plan, as there are risks to many activities during the pandemic, and I understand the torrent of criticism I'll get for this decision. But I think our outdoors, distanced celebration balances safety and our obligations to family; it is also in line with what even some epidemiologists say they're doing this year.

It's all so much work — the worrying, the double-checking, the uncertainty, the constant spectre of death. But for family, it's worth it.

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