SALT LAKE CITY — Most mornings, Ron Barbosa enters his mother’s bedroom, passing several “Get Well Soon” balloons and a vase of flowers to gently insist that 86-year-old Carole push off her fuzzy gray blanket and get out of bed.
She’s never thrilled with the idea, preferring to stay where she is, resting and clutching a framed picture of her white-haired husband with his arm around her, kissing the top of her head.
“I miss you, Frank,” she’ll say to the picture. “Love you, Whiskers.”
But there will be no more kisses.
Frank Barbosa, 88, her high-school sweetheart, died Wednesday — another victim of COVID-19.
Carole is slowly clawing her way back from COVID-19 — the global pandemic that became intensely personal when it sent both Carole and Frank to the hospital, as well as one of their daughters. The virus also sickened 15 other members of the large, close-knit Dallas-area family, which consists of Carole and Frank’s six adult children, more than two dozen grandchildren and 20-plus greats.
“When you have such a big, giant loving family, we’re always together,” says Ron Barbosa.
And therein lies the danger.
As the Fourth of July holiday approaches, public health officials face surging COVID-19 cases, particularly in the West and the South, plus stressed, stir-crazy families who desperately want to preserve traditions.
Yet, it’s very likely that during family picnics and parties, people will forget, or even ignore recommendations about physical distancing and mask wearing, leading to more potential COVID-19 spikes.
Is there any way to gather safely? And how does a family get everyone to comply?
Ron Barbosa’s message is simple: “When you mix households, beware. Learn from us. Keep that 6-foot distance, don’t try to do that kiss on the cheek, even the elbow bump — that’s too close. When you’re a big family, it’s like a wildfire.”
The rising risks
In just two weeks, Sacramento has gone from having the lowest per-capita COVID-19 rate among big U.S. cities to a California hot spot — with breakouts traced back to large family birthday parties, Memorial Day picnics and bar patronage, said Dr. Peter Beilenson, director of the Sacramento County Department of Health Services.
In the past 10 days, the city counted nearly 1,000 new cases — compared to 2,000 total the previous 18 weeks, said Beilenson. (Black Lives Matter protests resulted in four cases thus far, he said, and a new paper in the National Bureau of Economic Research found no evidence that protests in 315 of the nation’s biggest cities resulted in COVID-19 spikes.)
In Utah, 60% of the state’s cases came from a household contact, while another 20% came from a social interaction with a friend or family member in Salt Lake County, which has the state’s highest concentration of cases, said Nicholas Rupp, Salt Lake County Health spokesman.
And it’s not just a U.S. problem.
In India, a family pushed ahead with a wedding despite the groom feeling ill. He died days later and more than 100 of the 350-plus guests tested positive for COVID-19.
Trying to slow the spread, Sacramento shuttered bars on Monday, but there’s no way to close family gatherings.
“We’ve implored people in the last couple of days,” Beilenson said, “the way to be patriotic this Fourth of July is to literally stay home.”
That message is now echoing across the country, but staying home doesn’t mean having dozens of family members over from different households.
For the Barbosas, COVID-19 probably spread during a family round of golf, followed by a surprise indoor family birthday party without masks — both events attended by one younger relative with a slight cough he blamed on dusty work conditions.
The family has been criticized as careless, but they never considered their own flesh and blood a threat.
“I think that’s one of the more challenging pieces of this whole pandemic,” said Brandon Marshall, an associate professor of epidemiology at the Brown University School of Public Health. “The fact that we want to spend time together with our family and our loved ones, to support each other, but in fact, those situations are where we see a fair amount of COVID-19 transmission.”
How to decide
Permanently avoiding extended family is not the answer, because research shows “when people are in crisis, it’s our resources that help us come out of that crisis, and families are a part of that,” says J. Mitchell Vaterlaus, a professor of human development and family science at Montana State University.
But never before has the choice to gather with family been so complicated.
Now, a barbecue requires each household to weigh potential risks and benefits, keeping in mind that one person’s choices can have dramatic communal consequences, says Valerie Reyna, a professor of human development at Cornell who studies risky decision-making.
To help with decisions, consider these points:
First: “When things seem familiar, they seem less risky,” says Reyna.
Because of their familiarity, family gatherings don’t strike us as inherently dangerous. It’s similar to how we recoil when a stranger sneezes in a grocery store, says Marshall, but don’t really notice when it’s a relative at home.
This may be why family members don’t wear masks around each other — they don’t want to imply that they perceive familial interaction as risky.
Yet family members tend to talk closer and for longer, which is why the whole Barbosa family now sits outside on grandma’s lawn, wearing masks. Even in the hot, sticky Texas summer.
“The mask is a show of love,” Barbosa says. “The mask just says ‘I love you.’ It has to be that way. You just gotta do it.”
Second: “Feelings often mess up our ability to make logical calculations about risk,” says Marc Schulz, a professor of psychology at Bryn Mawr College in Montgomery County, Pennsylvania.
Humans are poor estimators of risk, he says, pointing to people who fear airline travel, yet jump in their car without a second thought — even though driving is significantly more dangerous than flying.
Throw in emotions and things get complicated. This explains why people eager to see loved ones may be more willing to take on higher levels of risk, he says.
To accurately gauge a situation’s riskiness, try reimagining it. If the party were for a stranger, would your perceived level of risk and behavior change? Are there ways to make the situation safer?
Third: Past victories are not a guarantee of future success.
Like a teenager trying a bicycle stunt — one great landing doesn’t mean all subsequent attempts will be injury free. COVID-19 has shown itself to be a complicated disease, and just because it hasn’t hit home yet doesn’t mean it won’t.
“When more people do things like meet with family members who they haven’t been isolating with and it works OK, it convinces people that there must be some safety to it,” Schulz said.
Just because no one got sick after a maskless Memorial Day picnic doesn’t mean that a Fourth of July gathering is risk-free. In fact, it may even be the opposite, as many parts of the country are seeing record-level case counts.
If you gather, here are some tips from the CDC and Deseret News’ interviews with experts:
- Keep it outside. Viral droplets dissipate much faster outside than inside.
- Keep the guest list small — even if everyone is family.
- Invite elderly, at-risk, ill or out-of-state relatives to attend via technology.
- Have a conversation BEFORE invited family arrives. Listen and be kind when establishing safety rules.
- Wear a mask. Even outside. Masks should cover the nose and mouth, except when eating.
- Encourage family members to bring their own food and drinks. Alternatively, have one person serve food, avoiding multiple hands touching serving utensils.
- Maintain physical distance of 6 feet from others, standing or sitting.
- Provide hand sanitizer and encourage its use.
- Use paper towels in the bathroom and keep the fan on, if possible.
- Talk with kids about the rules and their role in keeping others safe. Frequently wipe down objects they play with and sanitize their hands.