Can We Hug Yet?

At the start of the pandemic, hugs wouldn’t have ranked high on most people’s list of major deprivations. But after months of social distancing, a lot of grandparents, siblings, and loved ones are surely desperate to give one another a good squeeze.

There’s evidence that this urge to hug has deep biological roots. The skin is the human body’s largest sensory organ, as well as the first to develop in utero; we all feel life before we can see, smell, hear, or taste it. Research on newborn-parent interactions has found that a mother’s nurturing touch — holding, cuddling, massaging — plays an important role in infant development and behavior, and the benefits of physical affection seem to persist throughout life. Studies on both kids and adults have found that holding hands, hugging, and other forms of affectionate touching can ease stress and induce measurable reductions in heart rate and blood pressure.

All this helps explain why eschewing hugs may come with real health consequences — especially for those who are isolated from others. But to curb the spread of Covid-19, the CDC and other public health authorities recommend social-distancing measures that discourage hugging.

While some experts agree with these guidelines, others say hugging — especially if people take a few simple precautions — may be a relatively low-risk, high-reward activity.

“If you’re going to hug, just agree not to talk while you’re doing it. And your faces should be lateral — so cheek to cheek.”

What makes a hug “safe?”

Many of the current Covid-19 guidelines are based on science’s understanding of other viruses. When it comes to the novel coronavirus, specifically, the research is inchoate and evolving day to day. This makes it hard for experts to nail down the true risks associated with different behaviors, and not all agree on hugging’s position in the risk hierarchy.

“I never stopped hugging,” says Shanina Knighton, PhD, a researcher, nurse, and infection prevention expert at Case Western Reserve University in Cleveland, Ohio. Knighton says that there is no conclusive data showing that hugging can transmit Covid-19, and that her understanding of how viruses spread suggests that hugging is a low-risk activity — especially if neither person is showing symptoms.

“You do have to be purposeful about how you do it,” she says. For example, talking or exhaling directly into someone’s face during a hug is a bad idea, especially if someone is symptomatic and neither person is wearing a mask. “If you’re going to hug, just agree not to talk while you’re doing it,” she advises. “And your faces should be lateral — so cheek to cheek.”

This advice is in line with the opinions of some other experts. On June 4, the New York Times ran a piece in which an airborne pathogens expert at Virginia Tech used non-coronavirus infection data to model the risk of virus exposure during a hug. That model found that, as long as neither person is talking or coughing during a hug, the risk of transmission is low. The piece also said that keeping embraces short and free of tears is a good idea.

But not everyone agrees. “I think hugging is a substantial risk,” says John Swartzberg, MD, an infectious diseases expert and emeritus clinical professor at the University of California, Berkeley School of Public Health. Swartzberg says that the Virginia Tech scientist’s conclusions in the Times piece are “perfectly reasonable” based on the available data. The problem is that the available data is woefully incomplete. “For example, we don’t know what the infectious dose is — whether it’s one viral particle or 1 million,” he says. “No one really thinks it’s one particle, but anyone who tells you they know what the right number is, is guessing.”

Talking or exhaling directly into someone’s face during a hug is a bad idea, especially if someone is symptomatic and neither person is wearing a mask.

Some research efforts have found that speaking or even breathing can expel virus-containing droplets into the air. “If you’re hugging someone or are in very close proximity, you could inhale those particles,” Swartzberg says. “We know the larger particles we expel tend to drop within six feet, so that’s why we have the six-foot social-distancing rule.”

While he believes that hugging is hazardous, Swartzberg says that everyone “needs to do their own calculus” when it comes to the risks they’re willing to take. “If you’re talking about two young people hugging, the risk of them getting very sick and dying is small, and for children the risk may be approaching zero,” he says. “But if someone is in their seventies or older, the risk could be exceedingly high.”

Knighton, meanwhile, says that huggers likely don’t have much to worry about as long as they’re taking the precautions she described above and are also washing their hands before an embrace. Especially if two people are outdoors where, by some estimates, the risk of virus transmission is many times lower than indoors, she says that any risks associated with hugging are outweighed by the benefits.

“Hugs are essential,” she adds. “They’re an emotional connection we all need.”