California Officials Say Gathering With Up To Three Households Is Now Allowed. Here’s How To Do It Safely

But many health experts are concerned that loosening guidelines will lead to a winter surge worse than what California saw in the summertime. They say the combination of less stringent rules, holiday travel and winter chill is a recipe for rapid spread.

“I expect that as the cold weather starts and we do move most or all of our activities indoors, we will see an increase in both COVID-19 and influenza infections,” said Dr. Anju Goel, a Bay Area public health physician and leader with the American Medical Women’s Association.

But she says she’s hopeful that people will continue to stay home, wear  face coverings while out and limit who they socialize with.

“Even though we’re moving indoors, we’re still using a lot of other precautions that have now become a regular part of our life and our new normal.”

We asked Goel what to make of the new gathering guidelines.

On the significance of the state allowing social events

We recognize now that we're in this for the long haul and it's really not sustainable to maintain these types of restrictions until we have a vaccine or until we have treatments, which hopefully will be within the next year, but may not be. And we recognize that isolation is very, very detrimental to people's health. So we're humans, we’re social creatures, we need to be around each other to be mentally sound. And there has been a remarkable increase in depression and anxiety since the restrictions started ... So this is really significant that the California Department of Public Health is now allowing gatherings on a limited basis. And the key is to try to do it in a way that minimizes risk. 

On whether gathering is safe

I very much encourage people to associate with other people. Now, it's really up to each individual to decide how much risk they're willing to take. And if your tolerance level is low, then you may decide, even though the state has issued this guidance, you would prefer to continue associating in person only with people that live in your household. And that's fine to do if that's where your comfort level is. But there are lots of ways that we can associate with other people without significantly increasing our risk of COVID. So the key is to do it in a safer way. So there's nothing during this pandemic that we can guarantee is completely safe. There's no behavior that we can guarantee is completely safe. … But what I encourage people to do is to evaluate your own risk level and then try to engage in activities in a reasonable, moderate way with which you feel comfortable. And so that means that you can decide whether you want to associate with anybody outside of your household or not. And if you do want to associate with people outside of your household, you can decide whether that's going to be one other household or two other households or three other households. And then you can decide how frequently you want to do it, for what duration you want to do it, where you want to do it and what kinds of activities you want to engage in, what kinds of precautions you want to take during that engagement. I would just urge people to consider what your own comfort level is and take some moderate precautions to increase your level of safety.

On the two-hours rule

I don't know of any evidence related to that two hour rule, but certainly we know that the shorter the duration, the shorter the amount of time that you are around people, the lesser your risk is. So it certainly makes sense to me that we would encourage people to spend relatively brief amounts of time with others outside of their households.

On keeping it to three households

So we know that the more people that you're exposed to, the higher your risk is. So we're trying to restart the activities that we engaged in as a normal part of life before the pandemic, but doing them in as careful a way as possible … I don't know of any particular science that supports having three households together as opposed to having four households or two households together. I think it's just using the general principle of less exposure and exposure to fewer people is safer.

On keeping your social group consistent

If you're continuing to see the same groups of people over and over, you’re in a sense creating a large extended household. That's not exactly true because all of those people in what you call your small bubble are also having exposure to other people outside of this group or bubble. So for example, many of those people are going to the grocery store. They may be seeing other people. They may be working onsite as opposed to teleworking. So everybody in your group could be having exposure outside the group. But the general philosophy behind that is to have exposure to the same people over and over rather than to have exposure to new people every time you have a social gathering, because that will increase your risk of infection. 

On surfaces and shared items

We do know the coronavirus as well as other organisms, can live on objects for at least a few hours. And we've known that for quite a while. However what hasn't really been proven is that this creates any significant source of infection for other people. So there's certainly a theoretical risk that if you're sharing a bathroom, touching the same item that somebody else is touching and then that item happens to have virus particles on it and then you touch your nose and mouth, that you could become infected. So that's certainly a possibility. But there's no evidence at all that that's a primary mechanism of spread. What actually, though, seems to be the primary mechanism of spread is droplet transmission, so actually being around other people in close proximity and breathing in the same air that other people are breathing. 

On what else people can do to stay safe

What I would also like to encourage people to do, because we are human beings and we have a limited amount of energy and time and motivation to participate in health-promoting activities, is to think beyond COVID. So to take some of those basic precautions that we know are effective, like masking and hand washing and physical distancing, but then instead of spending a lot of effort on all of those other activities that could have a marginal impact, devoting some time and energy to non-COVID related health activities that we know have very significant impacts on health. We have known for decades that exercise affects so many different parts of our physical and mental health. And yet we know that a lot of people don’t exercise regularly … What I would really encourage people to do, instead of focusing almost entirely on COVID-19 precautions, is expanding the way they see their health to prevent health problems and promote wellbeing. If people learn to cook in a more healthy way, if people try to incorporate a little exercise every day, I think they can create some habits that lead to very significant health benefits that can last for their whole lives. … Pandemics come and go, but these types of health problems are chronic. If we can move the needle even a little bit on that, that’s going to make an enormous difference in the overall health of our country.