Illinois’ extended stay-at-home order comes with slight relaxations — like the opening of garden centers and golf courses in some parts of the state.
So it’s no surprise that some families are thinking about relaxing their own quarantine rules and even welcoming new members to their self-isolated units.
But Dr. Tina Tan, a specialist in pediatric infectious disease at Northwestern University’s Feinberg School of Medicine, thinks that would be a mistake.
“It’s definitely not safe,” Tan said, noting that, without comprehensive testing, new roommates could infect others without knowing it.
Still, she knows that another month of staying at home means families could be considering new living arrangements. These may include welcoming in an elderly parent, taking in a grandchild or bringing home a child who’s been living with the other custodial parent.
Others may want to take in a lonely friend or, like Dan Libenson, merge whole family units. Libenson did this last month with close family friends on his block in Hyde Park. But before merging the groups, he followed some strict rules and considered the factors in both houses carefully.
“I think that what really makes it possible is that we have this family we are so extremely close with,” he said. “And we are blessed to have six children between the two families who are extremely responsible and extremely understanding of what’s going on and, for whatever reason, are good at following these particular rules.”
It also helps that all four parents work from home, two are scientists and one went to medical school.
And Libenson notes, both families have deep confidence that the others are maintaining strict safety rules. “You really have to trust the other people before you would do it.”
All these unique factors — responsible kids, scientific backgrounds, parents working from home and deep trust — make Northwestern Medicine’s Dr. Tan doubt the process could work for many families. Even if most people are observing social distancing, she said, all you need is one person to break the rules, “as we saw with those people having the party last weekend. … So the best thing is that you just don’t bring [other people] into the household.”
University of Chicago infectious disease specialist Emily Landon is more open to the idea of adding to a quarantined household, but she also wants people to carefully consider the risk.
“Any time you expand the group, there is going to be a little bit more risk,” she said. “But that may be a tolerable risk or manageable for some families and really nice to help a family move forward and make sure everyone is taken care of.”
She said people can start assessing the risk by thinking about who they are bringing together. For instance, introducing an elderly relative to a home where one or more people work outside the home could be too dangerous.
“In that case, maybe it’s just safer for people to bring stuff to grandma [where she lives] and wear a mask and see her periodically that way,” Landon said.
Still, for those who decide blending is the best path, there are some basic rules medical professionals suggest to make it a little safer.
“If you were going to do this and be as safe as possible, you’d want negative [COVID-19] tests on everybody involved,” said Dr. Stephen Gluckman, professor of medicine at the Hospital of the University of Pennsylvania.
This could be tough in a state with still limited testing for the asymptomatic with no known exposures.
“In that case, you can minimize that risk by having the other person be in pretty strict quarantine for two weeks at home before they come to be with you,” said Landon with UChicago Medicine.
In other scenarios, Gluckman said, he has seen medical professionals self-isolate in different parts of the same home.
“So you could do that 14 days and then combine up if there is no ongoing exposure to the outside,” he said.
But even after that two-week quarantine phase, Landon said everyone should remain vigilant during the “wash-in” period for about two more weeks.
“You’d want to be extra careful about cleaning surfaces, washing hands, and you could even wear a fabric mask at home,” she said.
And strict standards that consider the whole household are critical.
“You sort of have to follow the risk level of the highest risk person in the household,” Landon said. “So bringing a grandmother into a quarantine family may mean everyone has to curtail their actions a little bit more.”
Maintaining strict rules in one household is hard enough, but Libenson said the key to keeping it up in both households is a serious commitment to honesty and faithfulness.
“It’s like a relationship and we are exclusive,” he said. “And if somebody did something that put other people in danger, it would be a level of betrayal that would be so unacceptable that it would be almost inconceivable.”
Libenson said he knows their 10-person quarantine unit is highly unusual and it could confuse people.
“So when we’re out in public we are really careful to not walk all together,” he said. “We don’t want to set a bad example for people on the street who don’t know we have this kind of relationship.”
Libenson said it also helps that the six combined children are close friends, which helps them stick to the rules of exclusivity. This is something other parents struggle with as kids beg to go out and play with friends. Tan, with Northwestern Medicine, said she gets questions about it all the time.
“And it’s like, ’No they can’t do that!’’” Tan said. “You can basically do playdates over the internet, so you can FaceTime with someone else, but you cannot have them go out and ride their bikes together or play together. You just can’t do that.”
Landon at UChicago Medicine said restricting children protects everyone.
“Unfortunately children are the most likely of all of us to be asymptomatic and still be contagious,” she said. “So that kid that looks perfectly normal playing on the swings may actually have COVID. In fact, when I hear about people having no idea where they got their COVID, the first question I ask is ‘Have your kids been playing with other kids?’”
Despite the continued necessity for social distancing, Gluckman said there are still fun ways to connect with friends, even if they can’t move in.
“We meet with our friends but stay six feet apart or more,” he said. “We set out lawn chairs and bring our own refreshments. … It’s not ideal, but it’s actually not bad. At six feet you don’t have to yell at each other, and you get a chance to socialize. Not only can you do it, I would encourage it for one’s psyche if nothing else.”
As these psychological effects of quasi-quarantine continue to take their toll, Gluckman said people are going to continue weighing their living options and the risk involved.
“There’s no 100% [safe method],” Gluckman said. “But if grandma is really alone locked up for six weeks, then I think it’s a reasonable thing to consider.”
Monica Eng is a reporter for Curious City. You can follow her @MonicaEng.