Is It Safe to Start Visiting Family Again?

Detail from a City of New York campaign to promote physical distancing to arrest the spread of COVID-19.

It’s now been more than a month since BC initiated the first major public health orders that plunged us into our current reality of self-isolation, deserted downtowns and shuttered provincial parks.

In recent days, provincial medical officer of health Bonnie Henry has begun to raise the possibility of a return to normalcy; rolling back restrictions as early as May and getting children back to class before the end of the school year.

This has led to the natural question of whether it’s safe to start looping other family members into your household “quarantine circle.” You’ve been self-isolating for at least two weeks without the slightest whiff of a cough or fever, so why can’t you go back to visiting grandma with the confidence that you don’t have COVID-19?

We did our best to answer that question below.

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If we break quarantine now, it could undo weeks of lifesaving work

As we’ve previously covered in The Capital, Vancouver Island and BC are currently some of the best places on earth through which to live out the COVID-19 pandemic. This is because of social distancing, not in spite of it. To put it bluntly, hundreds if not thousands of people did not die as expected because we took extraordinary measures to shut down civic life and stop visiting relatives.

At this point there’s no reason to believe that the risk has passed; COVID-19 could still do immense damage to BC if it isn’t kept in check. Take the example of Singapore; after doing nearly everything right to successfully contain the disease in the first weeks of the outbreak, the city-state was just starting to relax restrictions when it was suddenly blindsided by a record spike in new cases.

So when we start talking about loosening restrictions, we’re not necessarily dealing with a virus that is any less deadly than it was in mid-March.

Expanding your quarantine circle also expands your likelihood of getting COVID-19

During the First World War, trenches were built in zig-zag patterns in order to limit the damage that could be wrought by a trench raider or a shellburst. In the next war, bomb shelters were built across Europe with carefully demarcated rooms to ensure that if one of those rooms was struck by a direct hit, the damage could at least be stopped from affecting the whole shelter.

A similar principle underlies all of our current physical distancing efforts. We know people are still catching COVID-19, but by keeping them in small, separated units we can limit the virus’ spread to levels that won’t spiral out of control.

Not a straight line in sight ( Source)

There are clearly some gaps in our collective efforts to limit the spread of COVID-19. Consider: If absolutely everyone in BC was perfectly keeping their distance from everyone else, it would conceivably have only taken 14 days until the province was registering no new cases of COVID-19. Instead, even after more than 30 days of most of the province self-isolating, cases continue to rise, deaths continue to be registered and care homes continue to be hit with new outbreak.

People are getting infected at the grocery store. They are getting infected while out for a walk. They are having teenaged children flout social distancing and then carry the virus into their homes. Victoria city council candidate Stephen Andrew appears to have caught the virus despite “fanatical” measures to avoid it (he has diminished lung capacity from a prior battle with cancer).

Despite your best precautions, contracting COVID-19 is still a bit of a numbers game. As a result, the more people you have in your circle playing those odds, the higher the likelihood that one of them gets unlucky.

Even after two weeks of quarantine, you could still be a carrier

In fighting COVID-19, Canada is working from the model that the virus’ incubation period is between 5 and 14 days. This is why arriving travellers are required to self-isolate for 14 days; the idea is that if they were asymptomatic carriers of COVID-19, after two weeks they’d be over the disease.

But the infection math can change if you’re in a household with multiple people. It’s entirely possible that you entered quarantine coronavirus-free, and only caught it from someone else in your household on Day 13. Thus, you could still be carrying coronavirus at least 27 days after you first went into isolation. This is all further complicated by the fact that most COVID-19 infections happening invisibly. As we’ve previously covered, the vast majority of COVID-19 cases show no symptoms whatsoever.

At this point in our understanding of the virus, there’s a non-zero chance that recovered COVID-19 cases can be reinfected. Even if you’ve tested negative for COVID-19, you might have it anyway; the tests are only about 70% accurate. All of this is to say that there is no zero-risk way to bring new people into your quarantine orbit.

Quarantines are a delicately run thing

Be honest; you haven’t been following health recommendations to the letter, have you? There was that day you didn’t give your hands the full surgical scrub after returning from a walk? On your most recent trip to the grocery store maybe you passed a few shoppers well within two meters? We told you not to touch your mask under any circumstances, but you probably adjusted it just that once when it was chafing your nose a little too aggressively?

From a psychological standpoint, loosening self-isolation can be like treating yourself to a cigarette after two smoke-free weeks; that one cigarette can rapidly turns into many more.

Imagine that you decide to widen your quarantine circle to include a sibling. What do you say if one of your other siblings wants in? Maybe you decide to loop in your children’s maternal grandparents, and the paternal grandparents start asking why they can’t join.

We’re not saying it’s impossible to safely bring a new member into your quarantine orbit without overly compromising your physical distancing plans, but keep in mind that doing so could have knock-on effects well beyond what you intend.

There is light at the end of the tunnel

You may have seen plenty of dire predictions around social media forecasting quarantine measures to remain in place for months to come. Most notably, the Harvard scientists who warned that physical distancing measures could remain in place until 2022. Two years on lockdown is such an obviously unsustainable situation that it’s reasonable to think that you might as well just take the risks of breaking quarantine now rather than in six months.

However, there is reason to believe that COVID-19 could disappear just as quickly as it arrived. Below and at this link is a particularly illuminating graph by British computer scientist Mark Handley. It takes the COVID-19 curves from more than two dozen countries, and then arranges them so that all their peaks line up. What it shows is that after a region’s COVID-19 cases have peaked, within 30 days there’s a clear trendline showing that the disease is on its way out.

( Source)

There is still much trauma and tragedy for COVID-19 to inflict on British Columbia, but when Bonnie Henry starts speaking about a tentative return to safe normal life by the summer, she has the data on her side. What could change that data, however, is giving COVID-19 a premature opportunity to spread beyond its current containment.