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How to Hug During a Pandemic - The New York Times

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A Canadian woman was so desperate to hug her mother during quarantine that she created a “hug glove” using a clear tarp with sleeves so the women could hug through the plastic. A video of two young cousins in Kentucky hugging and weeping after weeks apart in quarantine was shared thousands of times.

“We did not expect for them to react the way they did,” said Amber Collins, who recorded the reunion of her 8-year-old son, Huckston, with his cousin Rosalind Arnett, age 10. “They were so overjoyed they didn’t know how to express themselves, except to cry. This hug shows how powerful the human touch truly is.”

Not only do we miss hugs, we need them. Physical affection reduces stress by calming our sympathetic nervous system, which during times of worry releases damaging stress hormones into our bodies. In one series of studies, just holding hands with a loved one reduced the distress of an electric shock.

“Humans have brain pathways that are specifically dedicated to detecting affectionate touch,” says Johannes Eichstaedt, a computational social scientist and psychology professor at Stanford University. “Affectionate touch is how our biological systems communicate to one another that we are safe, that we are loved, and that we are not alone.”

To learn the safest way to hug during a viral outbreak, I asked Linsey Marr, an aerosol scientist at Virginia Tech and one of the world’s leading experts on airborne disease transmission, about the risk of viral exposure during a hug. Based on mathematical models from a Hong Kong study that shows how respiratory viruses travel during close contact, Dr. Marr calculated that the risk of exposure during a brief hug can be surprisingly low — even if you hugged a person who didn’t know they were infected and happened to cough.

Here’s why. We don’t know the exact dose required for the new coronavirus to make you sick, but estimates range from 200 to 1,000 copies of the virus. An average cough might carry anywhere from 5,000 to 10,000 viruses, but most of the splatter lands on the ground or nearby surfaces. When people are in close contact, typically only about 2 percent of the liquid in the cough — or about 100 to 200 viruses — would be inhaled by or splashed on a person nearby. But only 1 percent of those stray particles — just one or two viruses — actually will be infectious.

“We don’t know how many infectious viruses it takes to make you sick — probably more than one,” said Dr. Marr. “If you don’t talk or cough while hugging, the risk should be very low.”

There’s tremendous variability in how much virus a person sheds, so the safest thing is to avoid hugs. But if you need a hug, take precautions. Wear a mask. Hug outdoors. Try to avoid touching the other person’s body or clothes with your face and your mask. Don’t hug someone who is coughing or has other symptoms.

And remember that some hugs are riskier than others. Point your faces in opposite directions — the position of your face matters most. Don’t talk or cough while you’re hugging. And do it quickly. Approach each other and briefly embrace. When you are done, don’t linger. Back away quickly so you don’t breathe into each other’s faces. Wash your hands afterward.

And try not to cry. Tears and runny noses increase risk for coming into contact with more fluids that contain the virus.

While some of the precautions may sound like a lot of effort for a simple hug, people need options given that the pandemic will be with us for a while, said Julia Marcus, an infectious disease epidemiologist and assistant professor at Harvard Medical School.

“There’s a real challenge right now for older people who worry that they won’t be able to touch or connect with family for the rest of their lives,” said Dr. Marcus. “Keeping hugs brief is particularly important because the risk of transmission increases with more prolonged contact.”

Here are the Dos and Don’ts of hugging, based on the advice of Dr. Marr and other experts.

“This position is higher risk because the faces are so close together,” said Dr. Marr. “When the shorter person looks up, their exhaled breath, because of its warmth and buoyancy, travels up into the taller person’s breathing zone. If the taller person is looking down, there is opportunity for the huggers’ exhaled and inhaled breaths to mingle.”

This position, with both huggers looking in the same direction, also is higher risk because each person’s exhaled breath is in the other person’s breathing zone.

For a safe, full-body hug, turn your faces in opposite directions, which prevents you from directly breathing each other’s exhaled particles. Wear a mask.

Hugging at knee or waist level lowers risk for direct exposure to droplets and aerosols because faces are far apart. There is potential for the child’s face and mask to contaminate the adult’s clothing. So you might consider changing clothes, and wash your hands after a visit that includes hugs. The adult also should look away so as not to breathe down on the child.

The Coronavirus Outbreak

  • Frequently Asked Questions and Advice

    Updated June 2, 2020

    • Will protests set off a second viral wave of coronavirus?

      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

    • How do we start exercising again without hurting ourselves after months of lockdown?

      Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • How many people have lost their jobs due to coronavirus in the U.S.?

      More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

In this scenario, the grandparent is minimally exposed to the child’s exhaled breath. The child could be exposed to the taller person’s breath, so kiss through a mask.

Julian Tang, a virologist and associate professor at the University of Leicester in England who studies how respiratory viruses travel through the air, said he would add one more precaution to a pandemic hug: Hold your breath.

"Most hugs last less than 10 seconds, so people should be able to manage this,” Dr. Tang said. “Then back away to at least two meter separation before talking again to allow them to catch their breath at a safe distance. Holding your breath stops you exhaling any virus into their breathing zone, if you are unknowingly infected — and stops you inhaling any virus from them, if they are unknowingly infected.”

Yuguo Li, a University of Hong Kong engineering professor and senior author on the paper that Dr. Marr cited to make the calculations, said that hugs probably pose less risk than a longer face-to-face conversation. “The exposure time is short, unlike conversation, which can be as long as we like,” he said. “But no cheek kissing.”

Dr. Li said the risk of viral exposure may be highest at the start of the hug, when two people approach each other and could breathe on each other, and at the end, when they pull apart. Wearing a mask is important, as is hand washing, because there’s a low risk of picking up the virus from another person’s hands, skin or clothes.

Dr. Marr noted that because the risk of a quick hug with precautions is very low but not zero, people should choose their hugs wisely.

“I would hug close friends, but I would skip more casual hugs,” Dr. Marr said. “I would take the Marie Kondo approach — the hug has to spark joy.”

Illustrations by Eleni Kalorkoti

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