Q&A: Talking to friends, family, kids, and coworkers about COVID-19 safety

For the most part, physical distancing guidelines for interacting with others during the COVID-19 pandemic haven't changed: Remain six feet or more apart, wear a mask, practice good hand hygiene, and avoid prolonged interactions indoors.

But navigating the interpersonal side of these recommendations can be trickier. Physical distancing runs counter to many of our social norms and complicates the ways we work, celebrate milestones, and generally interact with other humans. Things can get even knottier when people's boundaries and perceived levels of safety are in conflict.

So what do you say to a friend who insists that COVID-19 is no worse than the flu? How do you talk to your parents who keep going to restaurants to eat indoors? What if a beloved family member wants you to come to their wedding or birthday party and you don't feel safe attending? How do you talk to your kids about safety without scaring them too much?

In the following guide, Laura Murray, a clinical psychologist and senior scientist from the Department of Mental Health at the Bloomberg School of Public Health, shares tips for navigating the interpersonal side of pandemic precautions. Crystal Watson, a senior scholar at the Center for Health Security, shares research, data, public health guidance, and other considerations underpinning the advice.

How do I talk with a friend or family member who doesn't seem to be taking the COVID-19 threat seriously?

The response should depend on how well you know the individual. In communicating, we always need to keep our relationship in mind, what we know or don't know about the person, where they are coming from, and how best to interact with them.

Overall, it's important for the messenger to be aware of their thoughts and emotions going into the conversation. For example, if we go into this conversation angry or frustrated and thinking "They are crazy!," then it is unlikely to go well. We won't come across as compassionate, empathetic, and/or understanding.

For some it may be good to start with a question such as "I'd like to better understand your perspective on this" or "Where are you hearing that?" It's always good to understand where the information is coming from. For example, maybe they are confused by all the different guidance or getting information from a non-scientific source.

For specific questions, you could say "I'd love to share an article/podcast/post with you because I'm worried about your health—now and in the future." Here it would be critical to use a source that the person might be responsive to. Less political is usually better—something from a doctor, for example, or even a real-life story written by someone who has been impacted.

The key is to make sure that all of these thoughts are conveyed out of concern.

Consider this:

• Since January, the world has tracked almost 24 million cases of COVID-19 and over 815,000 deaths. The U.S. alone accounts for nearly 6 million of those cases and over 178,000 deaths.
• COVID-19 is much deadlier than the flu: The virus kills about one in 200 infected people. Seasonal flu kills about one in 1,000 infected people.
• Death is not the only consequence to be concerned about with COVID-19 infection. Even with mild or moderate illness, there can be medium-term impacts on lung health, heart health, and cognitive ability in some individuals. The long-term effects are still unknown.

How can I talk with my parents about their risky behaviors?

Check in with how you are feeling and what you are thinking going into the conversation. Remember that you can't control others' behaviors, even those among people you love. Ask yourself: What is your motivation to have this conversation? What are your fears or concerns?

If you decide to speak with loved ones, try to speak with I's. So instead of saying things like "You need to stop going to eat at restaurants indoors," try to use statements like "I get really worried when I hear that you are eating indoors at restaurants."

Another tactic is to ask questions such as "Tell me more about why dining indoors at restaurants is important to you?" Questions like these can help one understand the behavior more—and what the motivations are.

Only once we understand what is driving these behaviors can we know how to help change them.

Consider this:

• We are understanding more about COVID-19 and its transmission, but it is clear that time spent indoors is risky. Wearing masks indoors is an effective safety measure but people have to take their masks off to eat and drink which negates any risk mitigation.
• Even if restaurants are limiting the number of patrons and spreading out indoor tables, poor air circulation and lack of face coverings (because people are eating) is risky. Lower risk from physical distancing does not equate to no risk.
• Safer alternatives—which are not completely safe but may be less risky—include outdoor dining and carryout food.

My friends are having a wedding and I don't feel safe attending. How can I tell them I don't want to go?

Take some time before to lay out your goals ahead of the conversation. Consider how you are feeling and what you are thinking about. Write down some notes such as what the wedding means to you and what message you want to convey.

When talking to your friends, use "I statements" and share your sadness, hesitation, or fear of telling them. Instead of rationalizing your decision, try to stick with your emotions.

Be empathetic to any frustration or anger on the friends' part. We have a tendency to respond with frustration at times. Instead try statements like "I hear you. I might feel the same in your position." Be prepared that you may have to agree to disagree on this but hopefully can respect each other and remain friends.

Consider this:

• There have been outbreaks in weddings of all sizes. Activities like close contact from hugs and dancing increase risk, and weddings keep people together for prolonged periods, providing lots of opportunity for transmission.

What's the best way to talk to my teenagers about taking COVID-19 risks seriously?

As in other situations, the best way depends on one's relationship with their teenager: Is it tumultuous? Respectful? More like a friendship?

Regardless, conversations like these require emotional intelligence. Get yourself organized and work on self-awareness: What message(s) are you trying to convey? How will these be "heard" by your teen? What are your fears and concerns? What information do they have so far?

Try to open the conversation with questions about where they are coming from, what information they might already have, what they are thinking about COVID, what their fears may be—if any—and what their friends are saying. Keep in mind that teens are developmentally at an age where their social networks are the largest influencers.

You also need to actually listen after you ask these questions—even if some of the answers are hard to hear or frustrating. Again, use "I" statements to state your fears and concerns around safety.

Consider this:

• Many young people have mild or even no symptoms. But every single person should be thinking of themselves as a bridge to someone who is more vulnerable, and the way to protect those who are at high risk is to keep ourselves from getting sick.
• There are still a lot of unknowns around why and how younger people can wind up with severe COVID-19 infections. COVID-19-related Multi-System Inflammatory Syndrome in Children seems to affect slightly older children between 6 and 15, and can result in heart dysfunction.
• Recent data suggest that children are infected at similar rates to adults, and that children over the age of 10 transmit the virus about as efficiently as adults.

My boss says we will be resuming domestic work travel this fall. How can I say I don't feel comfortable with this, even if I am not at "high risk" of serious illness?

Just as with family and friends, conversations with coworkers and supervisors should take into account factors like your relationship with your boss, the culture and climate of the organization (e.g., psychological safety), and the communication so far around this decision (e.g., transparency; the need for resuming travel in-person vs. virtual meetings). These will guide your approach, and possibly even help you decide who to approach.

Get organized by writing down your thoughts around concerns/fears and goals. You could list reasons for those concerns—for example, providing care for someone who is high risk or needing to be available to provide care if needed. Also think about what alternatives you would be willing to consider and why. It's even better if you can talk this through with a trusted individual and role play different scenarios.

Consider this:

• Some states have established and are enforcing quarantines that would also apply to business travel. The CDC has compiled these restrictions.
• Consult the Johns Hopkins COVID-19 state-by-state tracker to show outbreak status in select areas to help inform the conversation.

My company has mandated a full-time return to the office. We are supposed to wear masks and practice social distancing, but most of my coworkers don't follow these practices and some even joke about them. How can I feel safer at work without alienating myself?

Considerations for the best way to manage this depend on variables such as:

• the size of the company
• leadership
• the climate of the organization (e.g., psychological safety and transparency)
• the presence/role of HR, and
• your relationship with the company, its leaders, and your co-workers.

Your goals are also important. For example, is the goal to change company policy? Or have the company leaders enforce the rules? Or to have some co-workers understand your position and respect your space? Write down these goals clearly. The more you are self-aware of your thoughts and emotions around them, the better.

Consider this:

• Currently, there are no legal protections in place for workers who are afraid of coming to work because of COVID-19.
• If you must go back into this environment, measures you can take are to wear a face covering while near others, ask to join meetings virtually, politely ask others to keep their distance, and sanitize high-touch surfaces that you come into contact with.

If my kids are returning to school this fall, I need to make sure they understand the complexity of the pandemic so that they take guidelines seriously. What's an effective way to explain this to them without scaring them too much?

A first consideration is the developmental age of your children. We need to explain things differently depending on this.

Older kids are able to cognitively make sense of more things and usually need more understanding, while very young children may need less information. It's a great idea to google child development charts to get a quick look at what stage your kids might be at.

A second consideration is your own expertise concerning your kids. What do you know about them and what they need? Are they the type of children that ask a lot of "why" questions and do better with information, or would you describe your kids as "worriers" that do better with direction and reassurances?

Take time to sit down and write out what your main points are. Considering your child's attention span, write down how many minutes you have to get your points across. Then, practice a couple of times. This may sound strange, but could be important, particularly if you have kids prone to anxiety, as sometimes our missteps as we are communicating can create nervousness. You may even consider giving smaller pieces of information over time.

It's also good to keep in mind that kids learn through repetition, so work in ways to remind kids often of the behaviors you are asking for. Work in rewards for these behaviors when you can. Anytime we get reinforced for a behavior, we are more likely to do it again.

Check in often and be sure to let your kids know that these health behaviors are hard and can be uncomfortable. It's important that kids feel comfortable reporting mishaps. Self-disclose your own mistakes and discomforts.

Consider this:

• Johns Hopkins Medicine has assembled five things kids need to know about COVID-19
• Medicine for Greater Good, in partnership with the eSchool+ Initiative, is developing a COVID-19 course for kids. Parents, teachers, and caregivers can email them to schedule a 30-minute Zoom to discuss the curriculum. The course should be available in September.

Guidance for other scenarios

Much of what we talk about here is emotional intelligence, which is key to managing interpersonal relationships in life, family, work/business, friendships, etc.

Emotional intelligence can be learned, and needs to be practiced. Its principles are embedded in each of the scenarios above. They include:

• self awareness, knowing yourself
• self regulation, thinking before acting, and creating an open, trusting atmosphere
• motivation/optimism/positivity
• empathy or understanding and reading others, and
• social skills such as collaboration, communication, and persuasion.