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Mighty Well | Mighty Well Mask | Co-Founders Maria and Emily

Informed consent in the time of COVID

I often find myself returning to the topic of consent.  It is so crucial to so many aspects of life, and something we are very ill-equipped in our society to actually achieve.  Lately, I have been noticing how consent and body autonomy apply to COVID safety.  

COVID boundaries — where you draw your line between what’s safe or unsafe, or how much risk feels reasonable for you — are tricky.  We don’t know everything we need to know about COVID: why do some people seem to be super spreaders?  Will my chronic conditions make me more susceptible to catching COVID, or having a severe case?  How much immunity does the vaccine provide for those of us with funky immune systems?  How well does the vaccine eliminate spread in asymptomatic cases? How long will the vaccine last and how will we know if booster shots become necessary?  Who is at risk of being a long-hauler, and what causes these long-term symptoms?

The science that we do understand was not readily available a year ago — we now know that masks make a huge difference.  Outdoor transmission is not 10% as the CDC originally estimated, but likely 1% or even less.  Risk of contracting COVID from touching surfaces is largely nonexistent.

And so, without access to all of the answers we seek, and with recommendations frequently changing, every action we take throughout the day requires decision-making.  As we become decision-fatigued, we create boundaries.  This way, we can develop habits and use auto-pilot instead of constant decisions.  The process of creating or reassessing boundaries can feel emotionally exhausting, and every time our knowledge or our social group’s norms change, we have to go through all the work and feelings over again.  

So, considering an activity that feels outside of our current boundaries can feel like a big deal.  For people with a history of trauma, anxiety, or underlying health problems making the stakes especially high, all of the emotions involved are heightened.

It is with this context that we need to look at consent.  

Our actions may directly conflict with someone’s safety and sense of safetyAs I’ve examined previously, both are important.  For all you know, someone near you may be immunocompromised or otherwise high-risk.  What is safe for you might be quite unsafe for them.  You could literally be putting their life at risk without realizing it.  In many situations, their physical safety may not be in such dire straits, but their sense of safety might be.  Perhaps you’re crossing a boundary that they’re not quite ready to let go of yet.  Maybe they want to be able to go to work without feeling anxiety or second-guessing whether everyone is vaccinated.  Or maybe they’ve had to isolate pretty intensely for a year and are now finding large gatherings to be overwhelming, so they would simply enjoy themselves more if the party were held outdoors.

If we choose to take off our mask in an indoor space, we may be affecting someone whose boundary does not include being indoors with unmasked people.  They now have to decide whether to vacate the building (obviously inconvenient) or reassess their boundary on the fly (emotionally exhausting).  If we throw a BBQ but neglect to mention in the invite that it is going to be largely indoors, crowded, and maskless with unvaccinated people, anyone whose boundaries involve following CDC guidelines is going to have to make a stressful decision upon arrival.  And if they do decide to stay (let’s face it, we are social creatures who often make different decisions in-the-moment than when we’ve had time to think), they may end up regretting the decision later or, worse, getting sick.

Asking for consent — for example raising the issue at a staff meeting to get the team’s thoughts or asking people in the room with you if they feel ok with you going maskless — before taking the action gives everyone a chance to express their boundaries and/or take their own precautions.  It shows you value their safety and sense of safety.

Part of consent is also about disclosing relevant information.  Getting sexual consent from someone without mentioning that you recently contracted an STI and haven’t been treated for it is not adequate.  Given this knowledge, they may not feel able to give consent, or would feel comfortable giving consent after treatment, or with added protection.  

The same holds true for COVID consent.  I may feel comfortable having a long conversation with you outdoors.  But if your partner just tested positive, I might feel less comfortable.  If you are not fully vaccinated, I would not only feel less comfortable, but you might be creating real risk for my compromised immune system.  With this information, maybe I’d like to reschedule for a later date, or wear masks, or sit 6+ feet apart.  If you schedule this interaction without mentioning these important details, you have taken away my body autonomy, my ability to choose what’s best for my health and safety.  You’ve taken away my opportunity to give informed consent.

the bottom line

So, what does all this mean for you?  The key is to communicate, and to be understanding when someone’s boundaries are not the same as yours.  When you mess up, communicate again to apologize and repair your relationship.  In general, do your best at the following:

  • When interacting with people in-person, communicate about your boundaries and ask about theirs.  

Ex: “Hey, I’m vaccinated so I feel comfortable moving indoors / taking masks off.  How do you feel about it?”

  • When planning for future interactions, be transparent about the details as they relate to COVID and remind folks that they can come to you with questions or concerns.  

Ex: Specify in your invitation whether there will be unvaccinated folks present, and include details like “We may move the party indoors if we get chilly, and food will be stored indoors for freshness.  We tend to not worry about masks, but please reach out if you have any concerns or questions.  We want to make sure everyone is comfortable!”

  • Communicate any necessary personal information — such as vaccination status, recent COVID exposures, and high-risk activities — when communicating about boundaries, especially if something has changed.

Ex: “I know last time we hung out you were cool to go maskless.  Just so you know, I was exposed at work to someone who tested positive for COVID.  I am vaccinated, but I understand if you’re not comfortable.”

  • If someone does express a boundary different than yours, respect their decision.  Just like it’s never ok to pressure someone who has told you they are uncomfortable sexually, please do not tell someone their COVID boundaries are unreasonable.  You do not know their health status or current state of anxiety.  If it’s someone you have a strong relationship with, you can kindly ask (a few) questions or present the research that helped you feel comfortable with your boundaries, but do not push or try to guilt them into changing their boundaries.  They will resent being asked to change before they are ready.

Ex: “Oh, you prefer to wear masks even outdoors?  I used to until I read in the NY Times that less than 1% of cases are actually transmitted outdoors, and that those cases were long conversations with faces close together.  I totally get it though, and I’m happy to wear a mask if you’d like.”

  • Provide opportunities for connecting with people who do have strict boundaries.  If everything in life suddenly becomes indoors, undistanced, and unmasked, people who are uncomfortable or high-risk will become horribly isolated.  Try making your meetings and social gatherings inclusive by providing outdoor and distanced options.

Ex: “I’m sorry the game night wasn’t an environment you felt comfortable in!  I miss you — is there a way we could hang out that would feel safe for you?”

  • Keep in mind that people with more restrictive boundaries are likely getting a lot of flack for their decisions, so any opportunity to send them warmth or reminders that you accept where they are at will make a huge difference!

Ex: posting on social media “Just want to let all my friends know that I accept you and your COVID boundaries, even if they look different than mine!” or sending a text saying “Hey, I know you’ve been feeling a bit isolated with people no longer wearing masks and such.  I hope you know I love you and will make sure to respect your boundaries if you want to hang out sometime!”

These are complicated times.  Thank you for taking the time to think about others and how your actions may affect them!

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