During the coronavirus pandemic, social bubbles have provided a chance for necessary social interaction while still staying safe. However, experts warn that these bubbles can "leak" easily, putting people at risk.
"COVID bubbles require a lot of super clear communication with those that you're going to enter into a bubble agreement with," said Jodie Guest, Ph.D., vice chair of the department of epidemiology in the Rollins School of Public Health at Emory University in Atlanta. "It really takes a lot of preemptive conversation to decide that you're all on the exact same page. ...The biggest leaks are usually from people who think they're being careful but are in multiple bubbles."
Guest and Dr. David Dowdy, an epidemiologist and associate professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, spoke to TODAY Health about the causes behind a leaky bubble, what you should do if someone in your bubble is diagnosed with COVID-19 and how you can seal a bubble to prevent further exposure.
What causes "leaky" bubbles?
Guest said that the most common cause of leaky bubbles is people not being open with each other about how many contacts they are having.
"One thing to remember is if you invite one person into your COVID bubble, but they are in three other COVID bubbles, your bubble now contains them and all the people in their other bubbles," she said. "...I think it's hard to remember that every person you have contact with, you now have had contact with all of their contacts."
Dowdy said that while COVID-19 bubbles can be safe, it can be helpful to think of them as "nets instead of solid walls," meaning that they may be better than socializing freely but still aren't impenetrable.
"Everyone is having interactions of some sort outside that bubble, whether it's going to the store, and while it's unlikely transmissions are going to happen in every activity, it's not just one person having these little interactions," he said. "...Each person is having those relatively low-risk encounters on a daily basis, and that number gets multiplied by the number of people who are in the bubble, so it becomes essentially impossible to maintain bubbles above a certain size."
Another issue, Guest said, is that people may not think about their daily activities as contacts, even though they provide the opportunity for exposure to the coronavirus.
"You hear a lot of people say, 'Well, I'm really not doing anything outside of my home,' but then they're getting their hair done, they're going into restaurants and things like that. But they're not doing it often, and so it's easy to think, 'I'm not doing very much,' because you're not, compared to your former life. But you're still doing things that are risky, and you're going to bring that risk home," she said. "We really have to be very, very careful, when we say, 'I'm not doing anything.' What does that actually mean?"
Dowdy said that the size of a bubble has a lot to do with how safe it is: The more people in a bubble, the harder it is to keep track of everyone's interactions.
"It's not like there's a magic number that 'below this level, it's safe,'" Dowdy said. "It's really more like the smaller you keep the bubble, the safer you are. As you expand the bubble, the risk is not additional, it's not as simple as a bubble of 10 is twice as risky as a bubble of five. It's more exponential, so the larger the bubble gets the riskier it gets — and that risk goes up quite rapidly as you get larger."
What should you do if someone in your bubble contracts COVID-19?
In case a bubble does become unsafe and one person is diagnosed with the coronavirus, Dowdy and Guest both said that all members of the bubble should consider themselves exposed and isolate for two weeks.
"My family and I have a COVID bubble with another family ... But if they were to have an exposure to COVID-19, they would tell us, and then we would say, 'Well, we can't see each other for 14 days to be safe,'" Guest said, stressing that honest communication is the most important factor in a bubble's success.
If you are exposed, Guest said that a 14-day quarantine is the safest option, but at a minimum, people should quarantine for at least 7 days and produce a negative test.
"That's the minimum that you need to consider doing," she said.
How can you seal a bubble?
When it comes to sealing a bubble, the keys are minimizing interactions and being as honest as possible about your contacts, exposures and any expectations you have for others in the bubble.
"You want to make sure that you're forming (a bubble) with those who you can trust to be doing the same thing as you," said Dowdy.
Guest said that "clear communication" can help establish guidelines about acceptable risks and activities, and noted that as cases continue to rise, it might be necessary to tighten those restrictions.
"You might need to readjust what your contract has been with your COVID-bubble friends about what's acceptable, with numbers going up so much," Guest said. "Be more specific about what's acceptable and not acceptable, because there's so much community spread across the entire United States."