The NHL has a bubble. Should you?

Pucks down, hockey is back, and we have a bubble strategy to thank.

Before the Bruins and other teams in the National Hockey League (NHL) hit the ice, they pledged to “bubble” with teammates. In a press release, the NHL called the two Canadian sites where each of the 52 members of the 24 teams promised to sequester, “secure zones” instead of bubbles.

Whatever it’s called, the concept of bubbling seems to be working. The NHL has not seen a positive COVID-19 test in weeks, according to ESPN. “The NHL is going to wind up as the example to follow because the bubble works, and we’re doing it in Canada,” said Dr. Brian Conway of the Vancouver Infectious Diseases Centre.

Making Bubbles Work for You

We asked Cape Cod Healthcare infectious disease specialist Ana Paula Oppenheimer, MD, MPH, how those of us outside professional sports can use the same bubble strategy to help minimize our risk of getting COVID-19. She said her family, including her two daughters (one lives in New York, the other in Cape Cod), has been using the same strategy.

“I think a lot of people have been ‘bubbling’ without calling it a bubble,” she said, adding that it may be difficult to understand quarantine “bubbles.” She suggested other words that may be helpful.

“Instead of being in a bubble, for instance, think of being part of a ‘club’ where everyone has to follow the same rules,” she said. “Or, think of a ‘circle,’ as in your circle of friends.”

Dr. Oppenheimer’s favorite substitute for “bubble” is “quaranteam.” She said being part of a “team” helps people understand they can bubble with their family and a neighbor or a family in a different town or state, as long as everyone obeys the same team rules.

5 Rules to Follow

She outlined and explained the following five rules we need to follow if we want to make quarantine bubbles work:

Rule #1: This group - sets guidelines which we consider safe, and everyone has to obey the guidelines.

“Set the expectations. Let everyone know they must obey the guidelines or leave the bubble,” Dr. Oppenheimer explained. “As long as everyone is following the rules, you can socialize without masks within your bubble. Never be mask-less with people who are not part of your bubble.”

Rule 2: Everybody needs to trust everybody else.

All should be committed and open about their activities. If someone is not able to maintain the rules, they should say so.

Rule 3: You can be close to the people in your bubble, but you don’t need to be too close in all cases.

“Although you may be mask-less with people in your quaranteam, how close you get to one another depends on the person,” said Dr. Oppenheimer. “You can hug your children, but you don’t necessarily need to hug a friend right now. There’s an opportunity for closeness, but you don’t need to be in each other’s spaces.”

Here’s a helpful visual she uses with her patients.

“I extend my arm and have the patient extend their arm. That’s the social distance to keep between two people, even if we are masked.”

Rule 4: Keep your bubble as small as possible.

Studies show that the more contact a group or person has, the higher the infection risk, Dr. Oppenheimer said.

“When we cut down on our contacts, we cut down greatly on the number of infections. And that contributes to flattening the curve,” Dr. Oppenheimer said. “Following the rules can flatten the curve, resulting in fewer COVID-19 infections, deaths and less morbidity (severity of illness).”

Rule 5: You can dismiss anyone from your bubble who cannot obey the rules.

Dr. Oppenheimer explained that this rule gives us a way to deal with people whose behavior puts others in the bubble at risk. Here’s an example.

One of her patients was living with two roommates. They all decided to wear masks and follow the CDC rules, including hand washing, social distancing and avoiding crowds. But one roommate’s boyfriend started staying overnight, with no account of contacts and activities during the day. This was not part of the rules of their bubble. In fact, that broke the bubble, and the patient found it tough to tell her friend she was concerned that her boyfriend might bring them COVID-19.

“Rule 5 gives people within the bubble the right to say, ‘This is not personal. It’s about collective risk and collective well-being.’ In this way, you can let friends and family know you want them to remain friends and family, but you have to let them out of your quarantine bubble to keep others healthy,” Dr. Oppenheimer said.

Bubbles Help Your Mental Health

“We are social. We rely on each other for comfort, fun . . . for everything. The coronavirus has been taking a big toll on that by requiring us to avoid people, follow social distancing, wear a mask and stay away from just about everything we were used to, or risk getting sick,” Dr. Oppenheimer said.

By allowing us to socialize within our small group, bubbles help us to care for our mental health as well as our physical well-being, she said.

“You can visit friends or have a COVID-free social event if you do so within your bubble,” Dr. Oppenheimer said.

Here’s how to follow the rules:

Want to have a barbecue with the people in your bubble? Have one person contact everyone and ask questions. Have you been using the mask when you are out of the house around people? What did you do this past week? Who have you been in contact with? If there is a doubt as to that person’s safety, they don’t attend the barbecue.

“We may feel a sense of invasion of privacy, but this is how we must work through this pandemic,” Dr. Oppenheimer said. “Following the rules, asking all the right questions and being honest can keep people healthy. In this way, you can safely have a barbecue or other event with those in your bubble - without masks!”