Daily Sitka Sentinel

Lonely? DHSS Says ‘Expand Your Bubble’

By SHANNON HAUGLAND

Sentinel Staff Writer

Under Phase II of the governor’s plans to “reopen responsibly” in Alaska, gatherings of up to 50 are allowed at social and religious gatherings as long as non-household members stay at least six feet apart, the state Department of Health and Social Services says.

Sitkans gather in groups to cheer on the Sitka High School Class of 2020 as they parade on Lake Street. The state gave some guidance on "expanding your bubble" during this time of social distancing. (Sentinel Photo by James Poulson)

But what about having dinner with one other household at your home, watching your friend’s children or allowing your children to play with their cousins or the children of your closest friend? What level of social interaction is currently considered safe?

The state gave some guidance on those questions Friday, when Alaska Chief Medical Officer Dr. Anne Zink said the answer to “expanding your bubble” may vary from household to household and will depend on the risk factors of everyone involved.

State mandates say people are expected to keep at least 6 feet away from all non-household members.

“However, in some cases, if a stronger support network is needed, Alaskans may begin to expand their social circle to include just a few others,” Zink said in an advisory to the public.

Zink provided her advice in the DHSS online blog “Play Every Day.”

As Alaskans begin to socialize more, Zink said it may be helpful to consider a concept called an “expanded social bubble,” already in use in New Zealand and some Canadian provinces. 

“The idea behind this concept is that a household may choose to expand slightly to link with one other individual, couple or household if it is deemed mutually beneficial and agreeable to everyone involved,” Zink said. “This is something that other countries and communities are trying out, as a way of providing added social support while continuing to limit most social interactions.”

Once linked, the individuals within an expanded social bubble can visit each other’s homes, share meals, care for one another, help with home projects or go on recreational outings together. Children within that enlarged bubble may play with each other in close proximity, indoors or outdoors.

Outside that “bubble,” all household members still must keep a six-foot distance from non-household members. Once a household has expanded its bubble to include others, the members within that bubble need to remain consistent.

“You should not choose to include two new members one week, and then substitute one of those members for someone else the following week,” Zink said.

“Consistency is key,” she said. “Expanding your bubble, even to include just one or two others, is not something to be done lightly. Alaskans have done a tremendous job since late March preventing the spread of COVID-19 by limiting their social interactions. That needs to continue, but we recognize that if people have more social support, limiting other social interactions will be easier to maintain as COVID-19 continues to be of concern in our communities.”

The state recommends “keeping bubbles as tight as possible” if it includes those at particular risk from COVID, such as those age 65 and up, and those with ongoing health conditions.

“The larger the group, the more socialization can occur, but with that comes added risk,” DHSS said. “If one person in the group becomes sick, that person will need to be isolated from the remainder of the household and everyone else who is not ill will need to remain quarantined, assuming close contacts occurred with the sick individual.”

Attachments with the department’s release are available online.

Sitka Public Health Nurse Denise Ewing said the concept of expanding a bubble can work in certain circumstances, but not others.

“It’s a great way for (younger) kids to play and play safer and not completely miss out on the stimulus they need for their developing brains,” she said. “I can see it working in that way and being great.’

But Ewing said it becomes more difficult the older the kids are.

“It would be harder for older teens to stay within the confines their families have arranged,” she said. “I’m not saying it’s impossible. I’m saying it’s more difficult; it’s harder with larger families and large family units. The more people, the larger the bubble, the more difficult it is, and you’re more prone to popping that bubble.”

The dynamic can change with the entry of one person, she added.

“Bringing in one person every other week would make it more difficult to track,” she said. 

She noted that the bubble gets much bigger if someone in either family is working in an office, or has contact with groups outside the bubble.

But Ewing said she can see “great value” when the bubble can be expanded safely, in creating more meaningful relationships between families.

“It’s a great building exercise, to deepen relationships outside your family unit,” she said. “It’s not going to be perfect but it can help if done correctly. ... This is a compromise - a mindful compromise.”

DHSS has provided two worksheets on which people can list those in the “current bubble” and a new family to add, followed by guidelines. The second page is a “contact sheet,” to fill in with “who did I interact with,” followed by date, time and location.

They are available at: http://dhss.alaska.gov/dph/Epi/id/SiteAssets/Pages/HumanCoV/whoisinyourbubble.pdf

Ewing commented, “Doing the worksheet with family and friends is very helpful for that general awareness.”