In the Time of Coronavirus: Corona and Boundaries

Even before COVID-19 arrived, many of us were already diligent about washing our hands and avoiding contact with someone sneezing or coughing to avoid becoming ill. Many have always understood the importance of washing our hands before meals and coughing or sneezing into a tissue.  So, what is different now?  Researchers have discovered that many individuals can carry the novel coronavirus without showing any of the typical symptoms of COVID-19: fever, dry cough, and shortness of breath. But these asymptomatic or only mildly ill individuals can still shed virus and infect others. What this means is that it is not enough to avoid individuals who are coughing and sneezing but that, in fact, we need to keep our physical distance also from those individuals who do not appear sick.  The idea of social or physical distancing is now being recommended by the CDC to control the virus as we are being advised to practice behaviors that involve remaining out of congregate settings, avoiding mass gatherings, and maintaining distance whenever possible to limit the ability of the virus to spread.

There is wide variation in interpreting what it means to maintain social or physical distance. Some, especially early on, have downplayed the risk of COVID 19 and have continued gathering in social venues and maintaining close contact while thinking that the guidelines may be overly cautious or expressions of panic, hysteria, anxiety, or even political affiliation.  It is important that everyone fully understands that maintaining social or physical distance is an appropriate response to a pandemic given the very real danger of the virus. Thankfully, led by the scientific and biomedical professionals in our own community, we are increasingly beginning to understand more clearly that when faced with a very real threat of a viral pandemic situation, caution, vigilance, and care to socially distance ourselves from one another are not only recommended but urgently required.

What exactly does social distancing mean?  Many are recommending that people stay at home as much as possible, go out only for critical needs like groceries and medicines, or to exercise and enjoy the outdoors only in wide open spaces. Some are considering skipping the grocery store altogether to order their supplies on line or for pick up.  Other recommendations include avoiding social gatherings of more than 10 people, no handshakes, regular hand washing, and, when encountering someone outside of your immediate household, trying to remain at least 6 feet apart.

While understanding that physical and social distancing is critical to slow the spread of the COVID-19 virus, the mental health consequences of the recommended practices include risk for feelings of vulnerability, helplessness, and loneliness. As others recommend in this series of essays, you can still stay healthy and physically distant while remaining socially connected and decreasing feelings of loneliness, helplessness, and vulnerability.  Staying connected with friends and family via social media and regular video chats can help along with phone calls to more vulnerable individuals such as the elderly relatives, single friends, and neighbors. 

Mental health professionals often advise their patients to understand what they have control over and then to exercise that control to avoid feeling helpless and depressed.  The current situation is challenging in that maintaining social distance involves behavioral change of everyone. If you go to the grocery store and someone there is not respecting physical distance, your choices are limited to avoiding the grocery store altogether or doing what you can while there.  For example, it may require setting limits or at least gentle reminders of the need for greater physical distance.  If someone is standing too close to you (i.e., less than 6 feet away) in the check-out line, it may be appropriate to remind a person of the importance of physical distancing.  Like with any clear boundary or limit setting, it is important to be polite, be mindful of tone and nonverbal body language, remain calm, and keep statements short and objective. For example, it may be appropriate to say,  would feel more comfortable with more physical space between us in this check-out line. It is hard to set clear boundaries if you are uncertain of the importance of social or physical distance.  So, in many ways, it will be helpful for all of us to have our eyes wide open about the real dangers of COVID-19 so that we can practice social or physical distancing in our everyday routines. In this way, we are supporting healthful behavior that is not only taking care of oneself but also taking care of one another.