Passing by a coughing stranger on a sidewalk during a global pandemic or having coffee with a work friend — for most people, one of those two scenarios will sound considerably safer than the other.
We know the work friend, they know us. They don't appear unwell, and neither do we. Even if it may be risky to sit close together and remove our masks, it doesn't really feel threatening — unlike the coughing stranger.
But it's precisely those interactions between people who know each other that may be contributing to a sharp rise in COVID-19 cases.
"The real threat we often overlook and don't realize is there," says Tegan Cruwys, a clinical psychologist and researcher at the Australian National University, "is our closest networks — our family, our friends, our valued communities."
How we're wired to think about risk
Feeling the threat of contagion may not be as palpable when we're with the people we know and like. That's not just because we prefer to spend time with them than strangers, but also because we are wired to assume our friends are less threatening.
As social creatures, when we identify with people and see them as being part of our community — "one of us" — Cruwys says, we have a sense that they are trustworthy and will act in our best interests.
That means we are less likely to perceive them as contagious, and we will be more tolerant of any symptoms they may have. As a result, we're more likely to take risks around them — sit close together, share food, or hug them.
But just because we think like that doesn't necessarily mean the people closest to us are less risky when it comes to disease transmission, says Cruwys: "Contagious diseases don't respect those group boundaries."
On Saturday (24.10.2020), Germany recorded 14,500 new infections — the highest number recorded in a single day since the start of the pandemic.
Lothar Wieler, president of the Robert Koch Institute, Germany's federal disease control body, says the new outbreaks don't appear to be occurring in public spaces, such as at workplaces or on public transport. Instead, the main source of infection, he says, are private gatherings.
"It's mostly coming together in private — at parties and [church] services and weddings," Wieler told DW. "We shouldn't have too many of these events," he said.
Not only do parties and weddings attract larger crowds, but crowds of people who have a shared social identity — who know each other and want to spend time together.
Research suggests that it is in these more intimate settings, or so-called "psychological crowds," that our perception of potential health risks is lowered — meaning we tend to accept riskier behavior from others and engage in it ourselves.
When we perceive people to belong to the same social group as us, explains Daniella Hult-Khazaie, a social psychology researcher at the University of Keele in the UK, "we want to be closer to them both physically and psychologically."
"We have a mutual sense of respect and trust. And that's what makes us less vigilant in risky situations because we perceive these people to be safe people," Hult-Khazaie told DW. That is in contrast to "physical" crowds, such as at the supermarket and or on public transport.
It's when we're in physical groups that we tend to "overestimate" health risks, says Cruwys.
"We're quite ready to see strangers as a being a threat and a risk," Cruwys says, adding that although the public health messaging around COVID-19 has focused on encouraging people to avoid others in public spaces, people more often need help with questions such as, 'How do I safely celebrate my son's birthday without putting anyone at risk?'"
Do we cut off friends, extended family, colleagues until this is over?
This pandemic has reminded us how human interaction helps viruses to spread. It might seem logical to limit social contact between people altogether in order to eliminate new infections.
But Melissa Hawkins, an epidemiologist and professor of public health at The American University, says limiting all social contact would worsen another serious health issue of the pandemic — loneliness and social isolation.
"It's not just the risk of infection that we need to consider but our mental health and ways to protect that as well," Hawkins told DW.
Negative mental health impacts of the pandemic are evident. One survey of UK adults during April reported one in four respondents as saying they had had feelings of loneliness in the "previous two weeks," up from one in ten people prior to the lockdown.
Another survey said 13.6% of adult respondents in the US reported symptoms of serious psychological distress — an increase from 3.9% in 2018.
Other research suggests that people who feel less socially connected have a higher risk of early death than those who smoke, drink, or those who are obese.
"We need to think of ways to protect ourselves from the virus and the risk of infection while also protecting ourselves from mental health conditions that are on the rise as well," Hawkins said.
Balancing risk with need for social connectivity
When considering how to best balance the risk of infection with the social and emotional needs of life, Hawkins says we should use a concept of "harm reduction."
Instead of telling people to simply stay home and avoid all social contact, harm reduction is based on the idea that it isn't always possible to eliminate risk, and instead advocates lower-risk choices that are sustainable for people.
During the pandemic, that could take the form of a "quaranteam" or a "risk bubble" — two ideas that have been recommended in the UK and New Zealand — whereby a small group of people agree to reduce their social circles to include just a trusted few.
A recent study, published in Nature, compared several social distancing models and found a "closed group" concept the most effective way to limit viral spread.
This is also where technology comes in. "Staying connected is critical for our wellbeing," says Cruwys. "But that does not necessarily need to be face-to-face or without taking precautions, like physical distancing, in order to be good for our health."