Of the many things we miss from our pre-pandemic lives, hugging may top the list. We asked scientists who study airborne viruses to teach us the safest way to hug.
A Canadian woman was so desperate to hug her mother during quarantine that she created a “hug glove” using a clear tarp with sleeves so the women could hug through the plastic. A video of two young cousins in Kentucky hugging and weeping after weeks apart in quarantine was shared thousands of times.
“We did not expect for them to react the way they did,” said Amber Collins, who recorded the reunion of her 8-year-old son, Huckston, with his cousin Rosalind Arnett, age 10. “They were so overjoyed they didn’t know how to express themselves, except to cry. This hug shows how powerful the human touch truly is.”
Not only do we miss hugs, we need them. Physical affection reduces stress by calming our sympathetic nervous system, which during times of worry releases damaging stress hormones into our bodies. In one series of studies, just holding hands with a loved one reduced the distress of an electric shock.
“Humans have brain pathways that are specifically dedicated to detecting affectionate touch,” says Johannes Eichstaedt, a computational social scientist and psychology professor at Stanford University. “Affectionate touch is how our biological systems communicate to one another that we are safe, that we are loved, and that we are not alone.”
To learn the safest way to hug during a viral outbreak, I asked Linsey Marr, an aerosol scientist at Virginia Tech and one of the world’s leading experts on airborne disease transmission, about the risk of viral exposure during a hug. Based on mathematical models from a Hong Kong study that shows how respiratory viruses travel during close contact, Dr. Marr calculated that the risk of exposure during a brief hug can be surprisingly low — even if you hugged a person who didn’t know they were infected and happened to cough.
Here’s why. We don’t know the exact dose required for the new coronavirus to make you sick, but estimates range from 200 to 1,000 copies of the virus. An average cough might carry anywhere from 5,000 to 10,000 viruses, but most of the splatter lands on the ground or nearby surfaces. When people are in close contact, typically only about 2 percent of the liquid in the cough — or about 100 to 200 viruses — would be inhaled by or splashed on a person nearby. But only 1 percent of those stray particles — just one or two viruses — actually will be infectious.
“We don’t know how many infectious viruses it takes to make you sick — probably more than one,” said Dr. Marr. “If you don’t talk or cough while hugging, the risk should be very low.”
There’s tremendous variability in how much virus a person sheds, so the safest thing is to avoid hugs. But if you need a hug, take precautions. Wear a mask. Hug outdoors. Try to avoid touching the other person’s body or clothes with your face and your mask. Don’t hug someone who is coughing or has other symptoms.
And remember that some hugs are riskier than others. Point your faces in opposite directions — the position of your face matters most. Don’t talk or cough while you’re hugging. And do it quickly. Approach each other and briefly embrace. When you are done, don’t linger. Back away quickly so you don’t breathe into each other’s faces. Wash your hands afterward.
And try not to cry. Tears and runny noses increase risk for coming into contact with more fluids that contain the virus.
While some of the precautions may sound like a lot of effort for a simple hug, people need options given that the pandemic will be with us for a while, said Julia Marcus, an infectious disease epidemiologist and assistant professor at Harvard Medical School.
“There’s a real challenge right now for older people who worry that they won’t be able to touch or connect with family for the rest of their lives,” said Dr. Marcus. “Keeping hugs brief is particularly important because the risk of transmission increases with more prolonged contact.”
Here are the Dos and Don’ts of hugging, based on the advice of Dr. Marr and other experts.
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DON’T hug face-to-face
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“This position is higher risk because the faces are so close together,” said Dr. Marr. “When the shorter person looks up, their exhaled breath, because of its warmth and buoyancy, travels up into the taller person’s breathing zone. If the taller person is looking down, there is opportunity for the huggers’ exhaled and inhaled breaths to mingle.”
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DON’T hug cheeks together, facing the same direction
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This position, with both huggers looking in the same direction, also is higher risk because each person’s exhaled breath is in the other person’s breathing zone.
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DO hug facing opposite directions
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For a safe, full-body hug, turn your faces in opposite directions, which prevents you from directly breathing each other’s exhaled particles. Wear a mask.
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DO let children hug you around the knees or waist
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Hugging at knee or waist level lowers risk for direct exposure to droplets and aerosols because faces are far apart. There is potential for the child’s face and mask to contaminate the adult’s clothing. So you might consider changing clothes, and wash your hands after a visit that includes hugs. The adult also should look away so as not to breathe down on the child.
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DO kiss your grandchild on the back of the head
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In this scenario, the grandparent is minimally exposed to the child’s exhaled breath. The child could be exposed to the taller person’s breath, so kiss through a mask.
Julian Tang, a virologist and associate professor at the University of Leicester in England who studies how respiratory viruses travel through the air, said he would add one more precaution to a pandemic hug: Hold your breath.
“Most hugs last less than 10 seconds, so people should be able to manage this,” Dr. Tang said. “Then back away to at least two meter separation before talking again to allow them to catch their breath at a safe distance. Holding your breath stops you exhaling any virus into their breathing zone, if you are unknowingly infected — and stops you inhaling any virus from them, if they are unknowingly infected.”
Yuguo Li, a University of Hong Kong engineering professor and senior author on the paper that Dr. Marr cited to make the calculations, said that hugs probably pose less risk than a longer face-to-face conversation. “The exposure time is short, unlike conversation, which can be as long as we like,” he said. “But no cheek kissing.”
Dr. Li said the risk of viral exposure may be highest at the start of the hug, when two people approach each other and could breathe on each other, and at the end, when they pull apart. Wearing a mask is important, as is hand washing, because there’s a low risk of picking up the virus from another person’s hands, skin or clothes.
Dr. Marr noted that because the risk of a quick hug with precautions is very low but not zero, people should choose their hugs wisely.
“I would hug close friends, but I would skip more casual hugs,” Dr. Marr said. “I would take the Marie Kondo approach — the hug has to spark joy.”
This has been a golden age for brain research. We now have amazing brain scans that show which networks in the brain ramp up during different activities. But this emphasis on the brain has subtly fed the illusion that thinking happens only from the neck up. It’s fed the illusion that the advanced parts of our thinking are the “rational” parts up top that try to control the more “primitive” parts down below.
So it’s interesting how many scientists are now focusing on the thinking that happens not in your brain but in your gut. You have neurons spread through your innards, and there’s increasing attention on the vagus nerve, which emerges from the brain stem and wanders across the heart, lungs, kidney and gut.
The vagus nerve is one of the pathways through which the body and brain talk to each other in an unconscious conversation. Much of this conversation is about how we are relating to others. Human thinking is not primarily about individual calculation, but about social engagement and cooperation.
One of the leaders in this field is Stephen W. Porges of Indiana University. When you enter a new situation, Porges argues, your body reacts. Your heart rate may go up. Your blood pressure may change. Signals go up to the brain, which records the “autonomic state” you are in.
Maybe you walk into a social situation that feels welcoming. Green light. Your brain and body get prepared for a friendly conversation. But maybe the person in front of you feels threatening. Yellow light. You go into fight-or-flight mode. Your body instantly changes. Your ear, for example, adjusts to hear high and low frequencies — a scream or a growl — rather than midrange frequencies, human speech. Or maybe the threat feels like a matter of life and death. Red light. Your brain and body begin to shut down.
According to Porges’s “Polyvagal Theory,” the concept of safety is fundamental to our mental state. People who have experienced trauma have bodies that are highly reactive to perceived threat. They don’t like public places with loud noises. They live in fight-or-flight mode, stressed and anxious. Or, if they feel trapped and constrained, they go numb. Their voice and tone go flat. Physical reactions shape our way of seeing and being.
“You might think that in everyday life, the things you see and hear influence what you feel, but it’s mostly the other way around: What you feel alters your sight and hearing,” Barrett writes in “How Emotions Are Made.”
When we’re really young we know few emotion concepts. Young children say, “Mommy, I hate you!” when they mean “I don’t like this” because they haven’t learned their culture’s concepts for hatred vs. badness. But as we get older we learn more emotional granularity. The emotionally wise person can create distinct experiences of disappointment, anger, spite, resentment, grouchiness and aggravation, whereas for a less emotionally wise person those are all synonyms for “I feel bad.”
A wise person may know the foreign words that express emotions we can’t name in English: tocka (Russian, roughly, for spiritual anguish) or litost (Czech, roughly, for misery combined with the hunger for revenge). People with high emotional granularity respond flexibly to life, have better mental health outcomes and drink less.
If bodily reactions can drive people apart they can also heal. Martha G. Welch of Columbia University points to the importance of loving physical touch, especially in the first 1,000 minutes of life, to lay down markers of emotional stability.
Under the old brain-only paradigm, Welch argues, we told people to self-regulate their emotions through conscious self-talk. But real emotional help comes through co-regulation. When a mother and a child physically hold each other, their bodily autonomic states harmonize, connecting on a metabolic level. Together they move from separate distress to mutual calm.
Welch has created something called the Welch Emotional Connection Screen, which measures the emotional connection between mothers and pre-term babies. By encouraging this kind of deep visceral connection through 18 months, her therapy can mitigate the effects of autism.
When you step back and see the brain and body thinking together, the old distinction between reason and emotion doesn’t seem to make sense. Your very perception of the world is shaped by the predictions your brain is making about your physical autonomic states.
You also see how important it is to teach emotional granularity, something our culture pays almost no attention to.
You also see that we’re not separate brains, coolly observing each other. We’re physical viscera, deeply interacting with each other. The important communication is happening at a much deeper level.
A portrait of life in the shelters for the children detained after crossing the U.S.-Mexico border.
.. Adan Galicia Lopez, 3, was separated from his mother for four months.
.. Do not misbehave. Do not sit on the floor. Do not share your food. Do not use nicknames. Also, it is best not to cry. Doing so might hurt your case.
Lights out by 9 p.m. and lights on at dawn, after which make your bed according to the step-by-step instructions posted on the wall. Wash and mop the bathroom, scrubbing the sinks and toilets. Then it is time to form a line for the walk to breakfast.
.. one of more than 100 government-contracted detention facilities for migrant children around the country that are a rough blend of boarding school, day care center and medium security lockup.
.. The facility’s list of no-no’s also included this: Do not touch another child, even if that child is your hermanito or hermanita — your little brother or sister.
Leticia had hoped to give her little brother a reassuring hug. But “they told me I couldn’t touch him,” she recalled.
.. But more than 2,800 children — some of them separated from their parents, some of them classified at the border as “unaccompanied minors” — remain in these facilities
.. these facilities are united by a collective sense of aching uncertainty — scores of children gathered under a roof who have no idea when they will see their parents again.
.. She would quickly write these notes after she had finished her math worksheets, she said, so as not to violate yet another rule: No writing in your dorm room. No mail.
.. She kept the letters safe in a folder for the day when she and her mother would be reunited, though that still hasn’t happened. “I have a stack of them,” she said.
.. it chose one of the harshest deterrents ever employed by a modern president: the separation of migrant children from their parents.
.. earning “big brother” status for being good role models for younger children. They were rewarded the privilege of playing video games.
.. You couldn’t touch others. You couldn’t run. You had to wake up at 6:30 on weekdays, with the staff making banging noises until you got out of bed.
.. Diego said that he was not afraid, because he always behaved. He knew to watch for a staff member “who was not a good guy.” He had seen what happened to Adonias, a small boy from Guatemala who had fits and threw things around.
“They applied injections because he was very agitated,” Diego said. “He would destroy things.”
A person he described as “the doctor” injected Adonias in the middle of a class, Diego said. “He would fall asleep.”
.. But because of the rules, the two boys did not hug.
.. Yoselyn Bulux, 15, is a rail-thin girl from Totonicapán, Guatemala, with long dark hair and no clear memory of how she summoned the strength to climb the wall at the border.
.. “If you do something bad, they report you,” Yoselyn recalled. “And you have to stay longer.”
.. Also on Saturday, Yoselyn met with a counselor, whom she liked. They talked about her hope to be with her mother soon.
.. then the woman serving as her escort handed Yoselyn over to her father, who was so overcome at the sight of his daughter that he could not speak.
.. They were taken to the shelter, given new clothes and separated: Victor to the boys’ area, Leidy to the girls’.
.. But at least he had a trabajadora de caso — a caseworker — named Linda who helped him navigate his new world. “She did everything she could to find my mother,” Victor said. “She called every state.”
.. The walls that separate the sleeping quarters do not reach the high ceilings, which means that sounds travel in the yawning spaces within the 250,000-square-foot building. One boy will make a loud animal noise, after which another will emit an animal-like response.
“Someone will start mooing,” the employee said. “They just think it’s funny. They just do it long enough so everyone can hear, and then we all start laughing.”
.. staff is overworked and a little stressed out by the 12-hour shifts and the considerable responsibilities.
.. During the day, the staff is required to maintain a ratio of one worker for every eight children. The ratio sets the tempo and culture at Casa Padre, the employee said. “It’s a big deal if we’re out of ratio.”
.. If one boy in a classroom needs to use the restroom, then a staff member has to find seven others who also want to go to the bathroom. “They’ll all stand in a line and then we’ll walk to the restroom,”
.. Some of the boys at Casa Padre were separated from their parents at the border, but most were caught crossing without a parent or guardian. All seem to keep themselves entertained with soccer or movies or video games.
.. “If they get sad, it’s like a quiet thing,” the employee said. “You’ll see them sit on the floor and just kind of wrap their arms around themselves.”
.. Some time in the evening is set aside for prayer. Boys can be found praying in a classroom, in a game room, in a bedroom. Some kneel.
