I recently saw an article on CNN where a number of medical experts were asked questions about how and when to visit friends and family during the COVID-19 pandemic. I’m just an old country doctor, but I decided to take the same questions and answer them from my point of view:

1) What should people be thinking about as they consider visiting family or friends they have not seen during the pandemic? How can people safely grow their “social circles” during this reopening phase?

We know that COVID-19 is highly contagious and can be spread even by those who are asymptomatic. A number of strategies, however, can allow people to begin to reconnect without raising risks significantly.

Certain factors should be weighed before visiting family and friends. Even as we attempt to reopen, the factors that led to the lockdowns still exist. There’s no treatment or vaccine yet, and the virus is no less contagious than it was.

First, the easy decision: If you’re sick or the person you’d like to visit is sick, visits are a hard no. If you absolutely must visit, meet outside, wear masks, and stay more than six feet apart.

Your inner circle should consist of very few people, perhaps just your immediate family. You know how likely they are to have contact with COVID patients during work or socially. The more people in your circle, the harder it is to know who’s been exposed during their daily activities. If your nuclear family includes elderly folks or those with serious health conditions, use extra care around them.

Brand new contacts are a bit of a crap shoot. Since a person may be contagious for a good two weeks or more, you’re in contact (by proxy) with all the people with whom they’ve interacted.

Find out whether a new contact is COVID-savvy or if they make a show of not wearing masks or social distancing. Do they share your level of concern about exposure? Have they been in crowds or confined spaces where the risk is elevated? Is your area currently in the midst of a peak in the number of COVID cases?

2)How are you connecting with family and friends at this point, and how has that changed over the course of the pandemic?

Lots of texting and virtual visits using Facetime, Zoom, etc. during lockdowns. These comprise almost all our contacts. When restrictions in Florida were relaxed, we met a very few people in person for short visits while outdoors and keeping more than six feet apart. One son came for an outdoor visit. One daughter has visited as well but the only physical contact we had was with her golden retriever puppy named Phil.

3)What steps do you think people should take if they are going to see people they don’t live with? How does your view change based on people’s ages?

Visits should be outside if at all possible, where the viral load is less concentrated. Some disagree, but I feel ok not wearing a mask in these outdoor visits if everybody is more than six feet apart or in motion, like a bike ride or trail hike. Make sure that any gathering is small and relatively short in duration; postpone those big family birthday/holiday parties for now.

As someone who is well into his geezerhood, I appreciate it when people wear masks if we’re in a small room together. One of our sons is a kidney transplant recipient, so we’re especially careful around him. IF you’re going to visit someone else’s home, don’t be shy about asking where you can wash hands or, at least, carry hand sanitizer with you (and, of course, wash often in your own home).

4)What cues should people look for throughout the summer to loosen or tighten how strict they are with social get-togethers? What factors would make you change your behavior?

I make sure to keep track of the number of cases and the latest CDC recommendations. Citizens should avoid any group activities if the area is experiencing spikes in cases. Gatherings that include small children that don’t understand social distancing should be especially careful.

Remember that every part of the country will have first and second waves, and they will likely occur at different times. This may be controversial, but if cases drop way down, restrictions should relax and businesses should reopen. You should realize, however, well that there will be a rise in cases as a result.

(Aside: People forget that health officials give advice purely in the hopes of “flattening the curve”, and leave concerns about a collapsing economy to the politicians and bureaucrats. The wisest medical advice in an epidemic scenario is rarely the soundest financial advice.)

5)When will you feel safe visiting family and close friends without social distancing or masks?

It’s uncertain as to whether we will ever return to the “good old days” of 2019. Once there is a viable treatment that is widely available or a proven safe vaccine, perhaps we’ll see things get close to the way they were; I will act accordingly. Expect socially responsible folks to have (as I have always recommended) a supply of masks and an early trigger to renew social distancing.

One issue that I don’t see discussed and is, to me, a concern is that we have experienced epidemic outbreaks several times in the last decade: MERS, Ebola, Zika, Chikungunya, SARS-CoV2 and others. I believe health officials will be quick to institute lockdowns in future outbreaks, and that may bode poorly for returning to our previous prosperity.

6)What’s your advice if family members or friends see the risks differently?

If you’re confronted with a stranger who won’t take measures to prevent infection, just move away. With friends and family, everyone has a different opinion. The important thing is to reach areas of agreement on what measures people can accept that will decrease the spread of the infection. We’re all in this together.

Don’t be afraid to lead by example. When others see you’re serious about measures that lower the risk of COVID-19, they may be more likely to take things seriously as well.

One last thing: I hear people being shamed for wearing commercial face masks instead of cloth face mask coverings. Yes, medical workers should be given priority, but I’ve written for many years about the importance of having face masks and other epidemic/pandemic supplies in disaster medical storage. If you have them, wear them.

Joe Alton MD

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