Managing Household Tension During COVID19

v1.1 Release: May 14, 2020

Updated assumed incubation period to be 5-12 days long based on this report.

Introduction

The public health impact and broad societal effects of the COVID19 pandemic are leading to mental and emotional health crises in areas that are strongly-affected. The direct physical effects of the disease are broadly known and the focus of most discussion. However, the indirect impacts of COVID and the surrounding social changes on both physical and mental health and wellbeing should not be underestimated.

The risk of discounting the effects of the pandemic on physical, mental, and emotional needs is that there could be substantial increases in emotional distress and stress-induced impulsive behaviors. This has the potential to lead to the disruption of social contracts (including but not limited to romantic and family relationships, business arrangements, and quarantine orders themselves). The longer their wants and needs are denied, the more strongly people are likely to react.

The purpose of this document is to help people manage household tension via a structured method of resetting expectations and identifying needs and wants during shelter-in-place. The goal is to facilitate improved mental, physical and emotional health over longer periods of shelter-in-place. This document will help relationship groups work on expectation setting by productively and intentionally structuring conversations to make certain that everyone’s needs are being heard, acknowledged, and wherever possible, met. It is designed to work for different types of relationship structures including friends, families, romantic partners, roommates and others.

We recommend first reading through this document as a group. Then the document can be discussed one section at a time to make certain that all members of the group are on the same page about the information. Individuals should then take time to consider their needs and wants. After that, the group can come back together to create a new set of agreements and expectations that accurately reflect the shared reality of being on the same team during a pandemic.

Please note that this document is very intentionally structured. It is intended to be used as a step-by-step resource for having productive group conversations.

Epidemiological Units

One of the purposes of shelter-in-place/quarantine orders is to create many small, isolated epidemiological units out of a much larger unit, like a state or a country. An epidemiological unit is a grouping of individuals that all share a similar risk and likelihood of exposure to a particular pathogen. Without any shelter-in-place or quarantine procedures in place, most of the globe could be considered a single epidemiological unit with respect to the novel coronavirus, COVID-19. This reflects the fact that COVID is highly infectious. As a simplistic example, a single sick person flying through 3 airports might initiate the infection of 3 entire cities because everyone has a risk of being exposed through a chain of community spread.

When shelter-in-place or quarantine is ordered, the goal is to separate larger epidemiological units into a number of smaller units. Shelter-in-place orders are designed to construct barriers (via hygiene habits, physical boundaries, lack of exposure, etc.) between these smaller units to prevent or slow down disease spread. Properly sheltered-in-place, one family in one neighborhood might become sick due to an exposure, but the ten other houses on their block (that form ten other epidemiological units) would not.

Epidemiological units share a risk profile. In a unit where people are not socially distancing from each other, one person with a coronavirus infection can easily transmit that disease to other members of the unit. Therefore, the group as a whole shares all of the risks that each of its members take, whether those members like it or not.

If you are sheltering in place alone, you are an epidemiological unit of 1; you control all of the risks you expose yourself to. If you get sick, you don’t necessarily pass it on to anyone else. If your family of 2 adults and 2 kids are sheltering in place together, you are a unit of 4. Parents share a risk profile with their children, and if one of you gets sick, it’s likely the others will, too. If you are not sheltering in place or obeying other quarantine restrictions, you have no idea how large your epidemiological unit actually is. Therefore, you have much less understanding of what risks you are being exposed to.

For the purposes of this document, we’re going to use the term “pod” in place of “epidemiological unit”. For the purposes of this document, your household, or pod, is the group of people you are interacting with and living with, without following all the rules of social distancing, on a regular basis. Consider yourselves a cohesive pod of people banding together, like a group of whales or dolphins sticking together while crossing the ocean

While it is inadvisable (and likely against shelter-in-place orders) to change your pod during shelter-in-place, we encourage you to consider how you may expand or change your pod to account for everyone’s needs if shelter-in-place orders are removed and then called again. We note that many countries are experimenting with different types of pods; Belgium is allowing people to gather socially in groups of 10 once a week so long as the group remains the same, Israel is allowing up to 3 families to share childcare duties to reduce childcare burdens, and Britain is allowing separated couples to move kids between two households. In addition, different types of pods may be necessitated by different types of living arrangements that were in place before the pandemic, or by mental, emotional and physical health needs.

Shared Reality

The first, and most critical, part of this discussion is making sure your pod shares a common understanding and shared expectations regarding the nature of the virus and the risks associated with it. It is impossible to overstate the importance of being on the same page about the following issues:

What this disease actually is.
How the disease may affect you personally.
How the disease may affect the people in your pod.
How the disease is commonly transmitted.
What the risks of transmission are.
What good mitigation practices are, as a result of those risks.
How long this situation will last.

You will only be able to successfully move forward together as a group if you share the same understanding and expectations around these issues.

If you do not share the same understanding of these issues, the people around you will come to conclusions and make decisions that you do not understand and cannot anticipate. That may expose you to risk that you can not anticipate and/or do not want to accept. Severe tension and stress can be generated due to not sharing a fundamental set of assumptions around the problem you are dealing with. Someone who thinks this disease is not a big deal will not behave the same way (or avoid the same risks) as someone who understands that this disease is life-threatening. Their risk tolerance will be different, and their resulting actions will be different. That tension in and of itself can cause disruption through disagreements, fights, breakups, and other broken agreements.

Below you will find a set of fundamental, well-sourced conservative assumptions about the nature of this disease. These assumptions describe how COVID19 affects people, how it is transmitted, the resulting risks from a variety of activities, potential mitigation activities, and how long pandemic response will likely last. We say assumptions because this is a new disease. There are a number of different strains of it that may behave differently, and the disease is not yet fully understood. At the end of the day, you will have to identify and agree upon what you believe to be true as a group given incomplete information about this disease. That is the only way to make shared decisions that do not unduly, or unacceptably, expose you to risk.

These beliefs may turn out to not align with the facts of the disease when more information is available. However, the key to this exercise is accepting conservative assumptions that are a backstop against worst case scenarios around disease severity, disease risk, time spent in quarantine, and other factors. You are welcome to modify these well-sourced assumptions in accordance with your group's beliefs. We encourage you to make a copy of this document and modify it for that purpose.

If you choose not to believe in these assumptions about COVID19 and its effects, we encourage you to replace them with your own set of comprehensive shared assumptions and derived actions, which have been agreed-upon by your entire group, in order for this exercise to be successful. Ideally, your assumptions should be based on well-sourced, scientific data.

COVID19 Itself

Here are some fundamental assumptions about COVID19 itself, with linked sources.

Source: https://www.statista.com/statistics/1106372/coronavirus-death-rate-by-age-group-italy/

Below you will find a suggested summary of the above information. Please review it and make sure everyone in your pod agrees to this summary before proceeding. If you choose to modify it, make sure everyone agrees before proceeding. If you cannot come to consensus, we encourage defaulting to the most-conservative viewpoint within the group in order to prioritize physical health concerns.

COVID19 can be transmitted by asymptomatic or presymptomatic people before anyone has any symptoms or feels sick in any way. Even if they never get symptoms, up to 30% of infected people will still be contagious and can infect others.
It can be extremely hard to tell if you have COVID19 based on the wide variety of symptoms, even if you are sick with it.
COVID19 infections are contagious for 2-3 weeks.
COVID19 affects those who are older, and who otherwise have related comorbidities, far worse than others. Someone who is 60 or older is 100X more likely to die from COVID19.
It is much less likely, but COVID19 can strongly affect young healthy people, and even children. Death from COVID 19 is possible in other age groups.

COVID19 Transmission

Here are some fundamental assumptions about how COVID19 is transmitted to others, with linked sources.

Here is a suggested summary of the above information. Please review it and make sure everyone in your pod agrees to this summary before proceeding. If you choose to modify it, make sure everyone agrees before proceeding. If you cannot come to consensus, we encourage defaulting to the most-conservative viewpoint within the group in order to prioritize physical health concerns.

COVID19 is transmitted primarily by inhaling aerosolized virus, or touching virus on surfaces and then touching your face.
Coronaviruses survive for long periods of time (sometimes many days) on surfaces.
Indoor gatherings of people, particularly in areas with recirculated air, are some of the likeliest places for virus transmission.
Virus transmission in outdoor environments appears to be much less likely.
Sharing a home with an infected person has a high likelihood of infecting other members of the household. Transmission in a shared home can be direct but also via aerosolization of virus particles indoor environments and contamination of surfaces as those aerosolized particles settle.

Transmission Risks

Erin S. Bromage, Ph.D, an associate professor of biology at University of Massachusetts: Dartmouth, has compiled an incredibly helpful list of the personal biological risks around COVID19 transmission. Everyone in your pod should read this article to understand the biology around virus transmission. There are good examples around how people have become infected in restaurants, workplaces, choirs, indoor sports, birthday parties and funerals.

The New York Times created a model of the risks inherent in visiting different businesses. They used cell phone data to analyze customer density and duration of visits to analyze risks and determine which types of businesses risked becoming superspreader locations. We recommend reading this article if you want to learn more about the risks certain businesses may present.

Here are some derived assumptions about the risk profiles of various activities, given the above fundamental assumptions. Note that these risks are focused on analyzing the activity itself. Low, medium, and high risk are assigned based on both the exposure type, and the recurrence of risk. Please review them and make sure everyone in your pod agrees to this assessment before proceeding. If you choose to modify it, make sure everyone agrees before proceeding.

If members of your pod are interested in activities that aren’t listed here, you should discuss them given the fundamental assumptions above and assign them a risk rating.

High-Risk Activities

The following are high-risk activities. Their risk is based on the fundamental assumptions made above and the exposure potential of the activity itself. Some of these risks are unavoidable.

Working indoors in close contact with other people, particularly in buildings with recirculated air conditioning.
Working in hospitals, nursing homes, or other high-exposure locations.
Taking public or mass transportation with crowded indoor environments, such as buses, boats, or airplanes.
Going to crowded indoor venues (particularly ones served by recirculated air conditioning) such as restaurants, bars, salons, movie theaters, or clubs.
Visiting public bathrooms, as toilets aerosolize could aerosolize virus particles in fecal matter and consist of a number of shared contact surfaces.
Close personal contact or conversation (particularly indoors) with potentially-sick individuals.
Hosting a potentially-sick individual in your house, car, or other personal confined environment.
Unmasked indoor exercise in publicly-accessible areas such as gyms.
Unmasked close-contact group exercises or sports outdoors. Any exercise that may involve touching any surfaces (i.e. exercise equipment, balls, bats, etc.) contacted by multiple people.

Medium-Risk Activities

The following are medium-risk activities, given the fundamental assumptions made above and exposure potential of the activity itself. Assignment of medium risk assumes personal risk mitigation strategies are put in place. Such strategies include wearing a mask, maintaining a distance of at least 6 feet from others wherever possible, washing hands, etc.

Occasionally (once a week) going shopping at indoor locations like grocery stores and pharmacies, particularly in buildings with recirculated air conditioning.
Regularly going shopping at outdoor locations like farmers markets.
Occasionally (once a week) taking public or mass transportation, such as buses, boats, or airplanes.
Individual, socially-distanced, unmasked outdoor exercise that involves no contact with surfaces touched by multiple people. Note that masked exercise is not always advisable by certain medical professionals and may cause respiratory issues in and of itself. Given the inability to wear a mask, please make sure you maintain extra social distancing at all times in order for this to remain a medium-risk activity.

Low-Risk Activities

The following are low-risk activities, given the fundamental assumptions made above and exposure potential of the activity itself.

Socially-distanced, masked, low-exertion walks or other sedentary outdoor hangouts with anyone in small (<5 person) groups. Individuals should stay at least 6 feet apart, even while wearing masks.
Individually driving a personal car, riding a motorcycle, or riding a bike.
Ordering supplies or food for delivery, presuming packages are disinfected or otherwise handled as if they had active virus on their surface.

Please review the above summaries and make sure everyone in your pod agrees to them before proceeding. If you choose to modify them, make sure everyone agrees before proceeding.

Pandemic Duration

Here are some fundamental assumptions about the potential duration of this COVID19 pandemic, with linked sources.

It is possible that your locality will oscillate between opening up and locking down, according to hospital capacity or public opinion. This could continue for the next 12-18 months, or longer. Because there is a significant chance of this situation persisting, the pod must agree to operate in ways that are sustainable.
There is no guarantee that having been infected with COVID means you can not be infected again.
18 months is a long time. Everyone on your pod needs to be able to maintain their mental, physical, and emotional health as best they can. In an unsustainable situation, people may suffer significantly over time, and may simply decide to leave to get their needs met elsewhere.
Given the length of time involved, the group needs to create systems and expectations that allow for adjustment if systems aren’t working or people’s needs change.

Mitigation Practices

Individual Mitigation Practices

The following COVID19 mitigation practices have been directly adopted from public WHO guidance, and should generally be considered medically-informed best practices. We recommend not modifying these without significant input from appropriate medical professionals.

Regularly and thoroughly clean your hands with hand soap and running water. If it is unavailable, regularly and thoroughly clean your hands with alcohol-based hand sanitizer (70% alcohol is ideal).
Maintain 6 feet (Note: US social distancing requires 6 feet instead of the 3 feet the WHO recommends) of distance between yourself and others not in your pod at all times. If you are exercising without a mask, maintain much more distance (10-12 feet) if at all possible.
Avoid going to any crowded places.
Avoid touching your eyes, nose and mouth.
Make sure you, and the people around you, follow good respiratory hygiene (i.e. covering your mouth and nose with your bent elbow or tissue when you sneeze or cough, and immediately wash the affected area afterward).
Stay home and self-isolate even with minor symptoms (cough, headache, mild fever, etc.) until you recover to avoid infecting others. The CDC recommends not returning to work until 7 days after the end of symptoms.
If you have a fever, cough, and newfound difficulty breathing, call your hospital in advance of going to let them know and ask if there are any intake procedures you must follow, and follow any explicit directions of your local health authority.

The following additional COVID19 mitigation practices have been derived from the above list, and a number of other sources.

The CDC recommends Americans wear cloth masks (up to and including home-made cloth coverings) as a herd defense strategy when venturing outside of their home. Note that such masks are not intended (or effective) at protecting individuals from the virus itself; they are intended to protect larger groups from sick individuals. Thus, they are only effective if a majority of people are using them. If you are wearing a cloth mask in a large group of people who are not wearing cloth masks, it will not protect you from getting COVID19.
If you are performing a high-risk or medium-risk activity, try to wear a personally-protective mask like an N95 respirator or equivalent, or a face shield if a respirator can’t be found. If you are personally at high risk of COVID19 complications, or have individuals in your pod that are at high risk of complications, also consider wearing goggles and gloves. Please note that N95 respirators are rare, and if you do not already have one, consider using alternatives (like KN95 masks) to preserve existing supplies for healthcare workers.
Minimize the number of things you touch outside the home.
Wash your hands (or use hand sanitizer if hand washing is not possible) after handling any items that may have virus on them. This includes but is not limited to your own protective mask/gloves/goggles, gas pumping handles, groceries, delivered packages, delivered containers of food, and other commonly-used public surfaces (door handles, mailboxes, ATM/credit card pin pads, etc).
Wash your hands or use hand sanitizer before touching anything in your home any time you leave home and come back. Consider taking a shower immediately after returning from particularly high-risk activities. Consider decontaminating your phone, keys and wallet if you’ve been handling them while outside of your house.
If your work has you performing constant high-risk activities, consider instituting heavy-duty regular decontamination practices such as:

Taking your shoes off before entering your house, and leaving them outside.
Stripping clothes in a contaminated entryway to your home, leaving them in that entryway (ideally placing them in a bag that can be taken directly to a washing machine) and showering before seeing or contacting anyone else.
Isolating your keys, wallet, and anything else you regularly carry on your person or in your pockets. Leave them in the contaminated entryway, and do not allow housemates to contact them.

Please review the following WHO guide for best hand washing practices in public places:

Group Mitigation Practices

The following group COVID19 mitigation practices have been derived from the above fundamental assumptions and public guidance.

Everyone in your pod must agree to, and actively practice, the individual mitigation strategies above.
You must develop procedures around how to lock down your pod in case of symptom development or positive tests.

This exercise will be dependent upon the identification and sharing of everyone’s needs and risk tolerance, to be completed below.
A group house in San Francisco created a set of guidelines for how to operate during various severities of outbreak, which can be found here and used as a conservative example.

Everyone in your pod must agree to immediately share any symptoms they may have with the entire group.
You must all agree to take collective action immediately based on symptom sharing or positive test results, no matter how large your group is.
You must assume everyone is potentially infected or sick if one person tests positive, and adjust group actions accordingly.
Any risky activities that aren’t outlined explicitly upfront should be brought up to the entire group before being acted on.
Risky activities that were encountered unintentionally should be brought up to the entire group as a heads up.

Note that the larger the pod, the harder it will become to: reach consensus, meet everyone’s needs, mitigate risk effectively, decide on or change policies, communicate about risky activities, and the like. Additionally, the larger the group, the less epidemiologically effective the pod, and the higher the overall risk to everyone involved.

Please review the above summaries and make sure everyone in your pod agrees to them before proceeding. If you choose to modify them, make sure everyone agrees before proceeding.

Switching Gears

It is important for everyone in your pod to understand and appreciate that the existing relationships and living arrangements created before the pandemic may not fulfill all of the needs of all parties involved post-pandemic, in the context of 12-18 months of rolling quarantines and shelter-in-place orders. This does not mean your relationships and living arrangements have to be discarded. It does mean they need to be critically evaluated before continuing to make sure everyone is able to get their needs met.

The above sections have all required your entire proposed pods reading, understanding, and coming to consensus on the nature of the pandemic problem at hand. Now that you have accomplished that, the next step requires personal reflection that is best accomplished alone. If you are working through this document as a group, we recommend taking a break and having everyone read and work on the following section individually. We further recommend everyone having an opportunity to sleep on the information presented above, and on the results of the work in the next section, before any decisions are made.

Attempting to do the below in a group will result in group dynamics affecting individual answers to questions. This may have the effect of suppressing certain critical needs for the sake of those group dynamics. If this happens, the agreements you all make will not work out in the long run, and people may leave the pod.

Identifying Needs & Wants

Given the potential duration of the pandemic and resulting cycling lockdowns, it is critically important that everyone in your pod gets their fundamental needs met. You can operate under the assumption that anyone who is not getting their needs met is likely to leave the pod otherwise. This could look like an amicable parting of ways after shelter-in-place is lifted, abruptly moving out of a group home, breaking up a romantic relationship, or otherwise disengaging. Where a pod includes children or teenagers who do not have the option of leaving the pod, there may be an increase in behavioral problems, anxiety, or depression.

It is often difficult to identify your own needs and separate them from your wants. It is often even harder to voice those wants or needs to others. Some may have difficulty listening to other people’s needs without perceiving them as personal attacks, or perceiving them to be demands to take action on those needs. In anticipation of these difficulties, we have written the sections below to help individuals work through identification and sharing of their needs and wants with others.

Definition of Needs & Wants

For the sake of this exercise, we define a need as a fundamental human desire that can be satisfied by concrete actions taken by others or yourself. A need is something which if left unsatisfied for 12-18 months during these pandemic conditions, would result in you personally losing mental, physical, or emotional equilibrium, and which would force you to create a drastic change in your living situation to protect yourself.

An example of a need could be “I need to reduce my risk of COVID19 as much as possible until there is a vaccination, because I am in a high-risk category for complications or death.” Another example of a need might be, “I need to have some time alone each day or my depression will become overwhelming.”

For the sake of this exercise, we further define a want as a fundamental human desire that can be satisfied by concrete actions taken by others or yourself. A want is something which, if left unsatisfied for 12-18 months during these pandemic conditions, would likely result in you becoming upset, sad, or irritable but would not necessarily cause you to lose equilibrium, or would not force you to take drastic action in your living situation.

An example of a want could be “I want to occasionally go out to restaurants again if they are open.” or “I want to go rock climbing.”

The goal of this exercise is to establish expectations across your pod around everyone’s needs and wants, to provide solutions that meet everyone’s needs if possible, and to address as many wants as possible.

Identification

Everyone has needs and wants that allow them to remain mentally, physically, and emotionally healthy over long periods of time. Even if you experience shame in having these needs and wants, it is okay to share them. In good times, some people may temporarily suppress certain needs and wants for the sake of group or relationship harmony. Over long stressful periods, however, this strategy can result in people reaching a breaking point.

The first step in being able to have your needs met is to identify them. Write out honest answers to the questions below. If you have strong reactions to questions, that may indicate a need. Moderate reactions may indicate wants. A lack of an emotional reaction may mean you have no particular needs or wants around that topic.

Please note that these needs and wants should all be internally focused, or should be needs from types of relationships in your life. These should not be direct requests from individual people. This should be an identification of the desires you personally have that you can act on, and/or that other people can choose to help fulfill.

What would make you feel physically safe in your home over the next 12-18 months?

How do you feel about potentially catching COVID19?
How would you feel if you ran out of medicine, groceries, or toiletries during shelter-in-place?
How do you feel about exercising, either indoors or outdoors?
How safe and secure do you feel in your home right now? Is that how safe and secure you want to feel?

What would make you feel emotionally safe in your home over the next 12-18 months?

How do you feel about how much you’re connecting with friends and family?
How do you feel about the ways in which you’re connecting with friends and family (video calls, phone calls, chats, etc.)?
How do you feel about your connection to your romantic partner (if applicable)?
How do you feel about your current level of physical intimacy?
How do you feel about your current level of spontaneity?
How do you feel about your current amount of alone time?
How do you feel about your current amount of friend time?

What would make you feel mentally stable in your home over the next 12-18 months?

How do you feel about your routines right now?
How do you feel about how predictable your life is right now?
How do you feel about how stable your life is right now?
How do you feel about your work environment right now?
How do you feel about the cleanliness and order of your home right now?
How do you feel about how quiet your home is right now?

What would keep you entertained enough in your home over the next 12-18 months?

How do you feel about how much group entertainment you’re getting right now?
How do you feel about how much solo entertainment you’re getting right now?
How do you feel about your hobbies or other personal activities right now?

What would keep you relaxed and decompressed at home over the next 12-18 months?

How do you feel about your ability to relax in your house?
How do you feel about your ability to decompress after work?
How do you feel about your ability to enjoy your weekends?
How do you feel about your ability to enjoy your time with other people in your house?

What are your needs around child care at home over the next 12-18 months?

What are your needs and wants around alone time during working hours?
What are your needs and wants around alone time during non-working hours?
What are your needs and wants around home schooling or long distance learning support, if applicable?

The next step after answering these questions is to write out your needs and wants, in order of priority. If you’re very worried about your physical health and safety, you should put those needs first. We suggest a format of identifying the concepts of your needs and wants in list form. Once you have that list, you can begin identifying concrete actions or steps that can be taken to fulfill those needs and wants in bullets underneath high-level concepts. This illustrates both the needs/wants that are most important to you, and what can be done by yourself or others to fulfill them.

The following example needs and wants demonstrate the kind of answers an introvert and an extrovert might offer in response to some of the questions above. They are formatted to clearly reference themselves and roles other relationships in their lives may play.

Example: Sample Introvert

Needs

When these prioritized needs are not met over the course of 12-18 months, I have trouble maintaining mental, emotional and physical equilibrium, and I would need to drastically change my living situation if they weren’t possible to satisfy.

I need to feel physically safe and secure in my home at all times

I need to know who may be visiting, and when, in advance
I need to be able to return to my home at any time, for any reason
I need to have a 2 week supply of food, medicine, and toiletries at all times

I need to share my home with my romantic partner

I need to spend most of my nights with my romantic partner
I need to be able to be social with my romantic partner and some of our shared friends on a regular basis
I need to be able to be physically intimate with my romantic partner

I need to be able to be alone, in peace and quiet, in common areas in my house at times

I need to not have to be in my bedroom in order to have quiet time
I need to have a quiet and calm work-from-home environment that is not in my bedroom
I need to be able to have some quiet and calm alone time after working hours in a space that is not my bedroom

I need to be able to see individual friends in person from time to time

I need to be able to go on walks with my friends, even if they are not part of my pod

I need to regularly visit nature from time to time

I need to be able to go on walk through nature at least once a week

Wants

When these prioritized wants are not satisfied over the course of 12-18 months, I would become sad, upset, or irritable, but do not expect I would need to drastically change my living situation in response.

I want to not catch COVID19 if it’s reasonably avoidable

I do not feel like I need to guarantee I don’t catch it, because I am in good health and am low risk
I would like to avoid it if reasonably possible, but my need for mental and emotional health over a long period of time comes first

I want to be able to share my home with my closest friends from time to time

I want to be able to play board games with my friends once a week
I want to be able to have a picnic with my friends once a week

Example: Sample Extrovert

Needs

I need to not catch COVID19 because I am in a high-risk group

I need everyone on my pod to not engage in high-risk activities if at all avoidable
I need to be immediately informed if anyone accidentally engages in a high-risk activity
I need to keep a 4 week supply of medication and food at all times in case I get sick and have to take care of myself

I need to remain connected to as many of my friends as possible

I need to be able to be on video or audio calls for 1-2 hours per night in my bedroom or in common areas if available
I need to be able to have spontaneous group hangouts in common areas after working hours with some members of my pod
I need to have regular planned events (like family dinners) with some members of my pod
I need to be able to go on walks with friends who are not in my pod

I need to be able to exercise regularly

I need to be able to jog on my own 2-3 times a week
I need to be able to go on walks with friends 2-3 times a week
I need to be able to do yoga in common areas of the house 1-2 times a week

Wants

I want to be able to watch movies and TV in common areas after working hours

I want to be able to watch TV shows 3 times a week in common areas

I want to have a pet for emotional support

I want to have one or two cats eventually

Collection

Once everyone in a proposed pod has created a document with their needs and wants in the format listed above, they should designate one person to collect all of them. Share your list of needs and wants with this person once you are done. Schedule a time to meet as a group after everyone has shared and collated their list.

The person collating needs and wants should put them all in a table, with everyone’s needs and wants in order and side-by-side:

Example Needs Comparison

Person #1	Person #2	Person #3
P1’s High-Level Need #1	P2’s High-Level Need #1	P3’s High-Level Need #1
P1’s High-Level Need #2	P2’s High-Level Need #2	P3’s High-Level Need #2
P1’s High-Level Need #3	P2’s High-Level Need #3	P3’s High-Level Need #3

Meeting Needs & Wants

The next step of this process is to publicly share everyone’s needs and wants to the entire group in the form of a single, cohesive document. As scary as this may seem, it is critical to the long-term success and health of the group for everyone involved to understand everyone else’s needs, as you may be supporting each other in this household for the next 12-18 months. Everyone in the proposed pod is responsible for reviewing everyone else’s prioritized needs and wants. Only once this is complete can decisions be made about how a pod could help fulfill these needs and wants.

Fundamental Rules & Expectations

There are a few fundamental rules that must be obeyed for the next part of this exercise to be successful:

Fundamental assumptions about the virus, its transmission, and the risks involved that have been agreed upon previously may no longer be changed. Attempting to change everyone’s shared reality in response to a conflict of needs will only result in gaslighting, uncertainty, and pain. Any new activities proposed during this exercise must achieve group consensus on risk and mitigation.
Risk tolerance and risk mitigation activities in response to fundamental assumptions about the virus may only be changed if the entire group consents. If you cannot come to a consensus about how the group behaves in response to a shared reality about the virus, you should not be in a pod together. Major changes to mitigation activities at this point in the process should be considered large red flags that this pod may not be compatible.
Individual needs and wants may not be deleted from the collated list - only reprioritized at the exclusive request of the person who holds them. Many people do not feel comfortable defending their needs and/or wants in the face of group dynamics, and consensus-building can be an awkward process at the best of times. This process explicitly requires that all listed needs and wants remain present and visible.
It must be generally understood that it is the entire pod’s responsibility to help meet physical safety and security needs collectively during this pandemic, but it is not necessarily the responsibility of the proposed pod to meet everyone’s needs and wants across the board. The purpose of this exercise is to explicitly surface everyone’s needs and wants, in part to help determine if this pod is compatible and can help meet a significant portion, or all of them for everyone. Nobody can compel their pod to provide for their needs and wants. They can only establish the boundaries and expectations around what it takes to ensure their continued participation in the team.
Furthermore, while pod members may feel free to reject the responsibility of meeting someone’s needs, it must be understood that this is not a costless, consequenceless action in every case. The party with unmet needs is equally empowered to decide the situation or relationships involved no longer work for them, or to determine new boundaries or additional ways of meeting those needs themselves. Nobody can compel their pod to provide for their needs, but nobody is also required to maintain interpersonal status quo in response to unmet/unmeetable needs.
It must be generally understood that the pod composition may need to change soon in some way (by either increasing in size, decreasing in size, changing housing configurations, or other mechanisms) in order to help meet everyone’s needs and wants.

Matchmaking & Creating Agreements

Work your way down your table of comparative needs and wants. Ask yourselves the following questions as a group:

Are any of these needs and wants complementary in ways we didn’t expect?
Are any of these needs and wants mutually exclusive due to conflicts in risk tolerance, use of resources, or other reasons? Can you solve them with creatively rearranging the household, spending some amount of money or time, or other means?
Are there easy ways for members of the pod to meet each other’s needs? Can those ways of meeting needs become expectations of behavior?
Are there easy ways to meet people’s needs with simple tools like scheduling the use of common areas, scheduling alone time, scheduling walks with friends, or the like?
Are there ways you could get help meeting needs from friends, loved ones, or your family while respecting shelter-in-place?
Are there ways you could change your pod after this shelter-in-place is over, but before a next shelter-in-place is called, that could help meet everyone’s needs? Can you open that discussion?

Use these questions to create a list of agreements between members of your pod that help everyone meet their own, or others’, needs and wants.

Mutually Exclusive Needs

Everyone’s needs and wants should be compared and contrasted to determine if there are mutually exclusive needs. Mutually exclusive needs may include, but are not limited to:

Members who need to perform many high-risk activities being in the same pod as members who have very low risk tolerance for catching COVID19 (i.e. for physical, mental or emotional health reasons) and who can not come to an agreement on mitigation procedures that would work for all parties. Generally speaking, needs for health and physical safety during this pandemic should come first.
Members who have significant conflicting needs for shared resources like common areas, vehicles, activities, or the like.
Members who have conflicting needs around feelings of security, such as a strong difference of opinion on how much preparation of supplies are necessary.

Generally speaking, we advise prioritizing health and security needs above all others, as those are fundamentally threatening to the people who hold them. Those are most likely to result in pod dissolution than others, in the immediate term.

If money, time, some reasonable amount of effort, or help from family/friends/loved ones can resolve other mutually exclusive needs, please consider those options.

If you still find you have mutually exclusive needs, try to determine if you can come up with a compromise, or devise a solution that could become possible after shelter-in-place.

Potential Incompatibility

Warning signs that pods may be incompatible long-term include, but are not limited to:

Members proposing large changes to mitigation activities or shared reality as a direct result of reviewing shared needs and wants.
Members insisting their own needs be removed or entirely deprioritized as a direct result of reviewing shared needs and wants. This may satisfy short-term disagreements, but will simply push tension, stress, and hard decisions into the near future instead of now.
Members pushing back and questioning others’ needs through minimization or discrediting; “Is that really a need? Are you sure it’s not a want?”

Pod members should keep this in mind as they discuss their agreements.

Formalizing Agreements

Once everyone’s needs and wants have been discussed, and mechanisms and agreements have been identified that can help meet everyone’s needs and wants to the extent possible, the next ideal step is documentation in the form of a written agreement.

Everyone’s prioritized needs, agreed-upon procedures for how to act individually, agreed-upon procedures for how to act as a group, procedures for what to do in case of positive tests/symptoms, and all the resulting inter-member agreements should be documented and agreed upon by consensus. This will be a complicated, long document, but it will be a helpful reference in times of stress and confusion.

Revisiting Agreements

In order to make space for the stress of the pandemic resulting in new needs or wants, a regular schedule should be set (we suggest once every two weeks) to revisit the agreement and make sure that it remains accurate. All members should expect that needs and wants may shift over time, as everyone copes through this stressful time. All members should be allowed to speak about what’s working for them, what’s not working for them, and discuss any changes to their personal needs or wants that they’ve identified in the intervening period.

It is possible that members of the pod will be called back to work, or otherwise need to suddenly change their regular activities (and thus their risk profiles). In such cases, everyone in the pod should be notified, and a meeting called if risk profiles are expected to change significantly.

If a local shelter-in-place order is lifted in a manner that is considered early to the team, consider continuing under the assumptions of the agreement you have put in place for an agreed-upon period of time. If shelter-in-place is called again after infections continue to rise, or if the team agrees by consensus based on local caseload, consider reactivating the agreement in advance of government policy decisions.