Coronavirus in Context: Staying Safe with a Social "Bubble"

[MUSIC PLAYING] You're watching Coronavirus in Context. I'm Dr. John Whyte, Chief Medical Officer at WebMD. We're starting to see an increase in the number of cases in some states. So what do we do about this. How do we protect ourselves and others?

Joining me today is one of the foremost authorities on COVID, an expert in infectious disease, Dr. William Schaffner from Vanderbilt University. Dr. Schaffner, thanks for joining us again. It's great to see you.

Good to be with you, John. It's always a pleasure.

Let's start off with this concept of a COVID bubble that some people are talking about as a strategy to keep yourself and your family members and friends safe while kind of slowly expanding on the number of people that you can interact with. What do we mean by a bubble, and do you recommend it?

Well, John, it's actually a very clever idea. You know, people are trying to take the national guidelines and adj-- adjust them to their own personal lives. And now we're opening up. But you want to be careful, you want to open up carefully, right?

And so you would like to get out with your family and interact with friends. And so the question is, how do you do that safely. And that's the notion of the bubble. Let's say we have a family with two children, and they want to get together with another family with two children.

So the trick would be to have a conversation with that family to make sure that they're on the same careful wavelength that you are. And then if they have been and you've been careful, well, then, you can get together. The children can play with-- play with each other, the grown ups can have dinner, et cetera.

And you can be assured that everyone inside that bubble is on the same wavelength as far as wearing masks, social distancing, and being careful. So it reduces the risk very considerably of having the COVID virus be part of your bubble.

You've kind of established ground rules. Is that right based on kind of your appetite in a sense for risk? Everyone's kind of at a different place for how they assess risk. Would that be a good characterization of it?

Yeah. It would, John. You know, I don't like to use four letter words like safe, because we can't assure complete safety. The moment we walk out the front door, we assume a little bit of risk.

But we want to control that risk. And by having a conversation with that other couple, making sure that you're on the same wavelength, well, then you reduce the risk that either you will introduce COVID or they will introduce COVID to your little bubble. And you can get together and interact rather safely.

How big can the bubble be? Is it--

Ah, well, you know, the larger it gets, the more chances for risk. So the conversations really have to be pretty clear. At least in our neck of the woods, the recommendation continues to be that we not gather together in groups larger than 10. And so there is admonishment, don't go into those large groups.

So if you do that, a bunch of fellows getting together for a poker party or something like that, or whatever, uh, that's good as long as, once again, you can be reasonably assured that you're all together.

And you have to have those discussions, specific discussions about whether, you know, folks want to go to the gym. You know, they're going to choose to go in the morning, or when there's not a lot of people, or, you know, you're only going to associate with people that won't go to the gym, or will only eat Al Fresco. I mean, is-- is that accurate as well? You really want to discuss with the other people in your bubble what you all agree to, and then, you know, be honest when folks don't adhere, you know, to those guidelines that you're all establishing?

Well, John, as my mother told me, conversations are very important. And so having clear and honest conversations, saying Frank or Susie, you know, we're all trying to be on the same page. So let's go through some of these details and make a little list of those things.

When do you go to the supermarket? Are you going to the gym? Are you going to work? Et cetera, et cetera, to make sure that you're comfortable and they're comfortable with how things are going to work out.

Well, our mothers always do give us good advice. I wanted to ask you quickly a couple of things that are in the news. We're seeing in some states increase in cases in young people. That's not surprising. They're probably not doing all of those issues of physical distancing and mask wearing, um, as we would like. Does that concern, you either for that young people themselves or the fact that they may infect people that are at greater risk?

Well, actually both. Because, you know, young people, although they're profoundly less affected by COVID than older persons, they're not totally without risk. And there are hospitalizations and deaths among young people who are perfectly healthy. So this can be a very nasty virus.

And then, of course, although their infection is very mild, may have no symptoms at all, they can be contagious. And they can actually infect people who are at greater risk of severe disease. So that concerns me a lot, actually.

What's your latest take on the data regarding antibodies and some recent research that has come out, um, that has talked about that they're probably not protective because they don't last long? You know, again, there's always challenges with what type of antibodies have been measured, how do you test it. But what's our current thinking on the role of antibodies, the presence of them, in terms of protecting someone from reinfection?

Well, I think our thinking is still in its infancy. We're learning a lot more about this. If we take lessons from the human cor-- coronaviruses, The ones that produce common colds, for example, we do get protection after we've had an infection with one of those human strains. But the protection, the antibodies, wane, and they start to wane after about a year, and you can become susceptible and get reinfected.

And the very early data regarding COVID is beginning to resemble those data. So we need to wait and see. This has implications for vaccines. Because vaccines may only be able to provide protection for a relatively short period of time, so it may be, in the future, everything going well. We may be rolling up our sleeves every fall. Flu in one arm, COVID vaccine in the other.

Isn't that a little unusual, other than the influenza example? Most vaccines that we have developed have conferred a longer time of immunity. Um, is that right? If not lifelong immunity, certainly in many years.

Oh, yeah. For sure. Now remember, we're supposed to get, uh, reimmunized against tetanus, and now diphtheria and pertussis all combined in one vaccine, every 10 years. So we have some precedent. And, of course, you know, we've developed the vaccines that are so good, which were the easy vaccines to develop, right? Now we're into, uh, the advanced course, we might say. Things are going to get a little bit more nuanced.

Well, Dr. Schaffner, I want to thank you for taking time to provide insight into how we can stay safe, uh, how we can keep our family members safe, our friends, and our community. Thanks for all that you're doing, uh, to help protect us.

My pleasure. And stay safe yourself, John.