From the WebMD Archives

June 15, 2020 -- Carolyn Ellis and her mom describe themselves as a very “huggy” family. So both knew it would be an adjustment when COVID-19 triggered social distancing, lockdowns, and quarantines. But neither of them realized just how hard it would be to go months without hugging.

“My mom and I are super close. She lives 5 minutes from our house and comes over to help us a lot with our young boys, so we normally hug every day,” Ellis says. “In any stressful time we’ve ever gone through, my mom is always there, helping and hugging. So we were definitely missing that,” she says.

Ellis says that loss of personal touch was upsetting for her and her mom, 73-year-old Susan Watts, and confusing for her two boys -- 2-year-old Henry and 4-year-old Freddie. Freddie didn’t understand why Grandma started to back away the first time they met for a socially distant walk when he ran toward her with his arms outstretched for a hug.

“My mom said it was devastating to have to back away from your grandson’s hug and to see the confusion and heartbreak on his face,” Ellis recalls. “When we brought the boys home that day, my mom said she just sat down and cried after we had left.”

After about 2 months without hugging, Ellis decided it was time to find a solution. So she and her husband created a “hug curtain” by attaching plastic sleeves to a large, heavy sheet of contractor-grade plastic, hanging it from their clothesline in their backyard. They dubbed it the Hug Glove, and on Mother’s Day, they invited Watts over to try it out.

The video Ellis’s husband took the first time his wife and her mother hugged has since gone viral. Watts appears a bit bewildered as she first walks toward the plastic sheet. But once she slides her arms in and wraps them around her daughter for a loving squeeze, she giggles in delight.

“This feels so good,” mom and daughter say through huge smiles -- as they hug for a long time, neither letting go.

“My mom lives alone, and I knew she really needed this hug, so I did this as a gift for her,” Ellis says. “But then my mom kind of melted into the hug and I started crying as I realized how much I had missed hugging her.”

Ellis says judging by the reaction to the video, her family isn’t alone. She says she’s been overwhelmed with emails and messages from people asking if she’ll make a Hug Glove for them or give them instructions to do it themselves. “The reaction of the world tells me that everybody needs a hug right now. It’s not just fluffy stuff. There is science behind it. The mental health impacts are real,” she says.

The Importance of Touch

The CDC says social distancing -- staying at least 6 feet from people not in your household -- is the best way to avoid being exposed to the coronavirus and make it less likely for you to get COVID-19. So not surprisingly, in a poll done in late May by Morning Consult and Politico, 2,000 Americans and 18 public health experts ranked hugging someone outside your household as a risk of just under 7 -- on a scale of 1 to 10.

Understanding the reason why we can’t hug and touch those we love during this pandemic is one thing. Dealing with the effects of that are still proving very difficult for many. Some say we’re having “skin hunger.” Others refer to it as hug deprivation or touch starvation.

“It is normal to struggle with the loss of touch,” says Devita Streva, a licensed social worker and a psychotherapist in the mental health field for 30 years who works as psychosocial oncology therapist at the Ohio State University Comprehensive Cancer Center in Columbus. “Touch is a legitimate physical and emotional need. It’s part of the human experience, and losing that and not knowing when you will get it back is hard.”

Even as more communities reopen, touching is still the final frontier for many. Experts say not knowing when it will be safe to hug, touch, and comfortably interact with others without concern adds to the sense of skin hunger or touch deprivation many are feeling. Some public health experts have said they don’t think we’ll ever return to certain habits like shaking hands. For many -- including those who are older, considered high-risk for COVID-19, or who love people who are especially vulnerable to the virus -- it’s especially hard because the prospect of hugging loved ones again feels very far off.

“Many patients are expressing profound sadness about this and saying how isolated they feel,” says Valentina Ogaryan, PhD, a licensed clinical psychologist at UCLA Health in Los Angeles. “Those who are older and don’t live with a lot of family members say they even miss the more minor and nuanced encounters that used to bring a touch here and there, like a handshake, smile, or pat on the hand or back from a neighbor or someone at the grocery store.”

While we all vary in terms of what kind of touch we need, studies have long shown that expressions of affection -- whether you give or receive them -- have real and measurable health and wellness impacts on our physical and mental health. A variety of touches -- from hugs to handshakes, a pat on the arm, back or head, kisses on the cheek, or hand-holding -- can:

  • Calm the nervous system
  • Boost the immune system
  • Activate oxytocin, sometimes called the cuddle hormone, that’s critical for bonding, especially between a mother and child at birth. Research shows oxytocin also affects our general well-being, induces calm, and enhances relationships.
  • Reduce the stress hormone cortisol
  • Lessen pain, improve healing, and lower blood pressure and heart rate
  • Improve mood and reduce stress, anxiety, depression, sleep disturbances, loneliness, isolation, and more

“We understand touch as essential. It’s a universal need and natural method of communicating joy and intimacy,” Ogaryan says. “Touch is powerful on so many levels. For many people, it is a source of healing relief. For others, it’s an attempt to comfort.”

Hugging During a Pandemic

The Ellis family isn’t the only one craving that comfort and connection and looking for ways to make it happen during a pandemic. Plenty of videos have gone viral in recent months of people hanging plastic in their doorways, covering themselves in blankets, or donning blow-up unicorn and dinosaur costumes to create a barrier between them and the person they want to hug. Is this a foolproof way to prevent COVID-19? Doctors doubt it.

“It's important to clarify that COVID-19 is a disease transmitted through respiratory droplets, not through touch. If you are close enough to someone that you are hugging through plastic, you could definitely still infect them,” says Leana Wen, MD, an emergency doctor and public health professor at George Washington University who was previously Baltimore's health commissioner.

Carolyn Ellis says they realize their system might not be perfect. But they’re confident the plastic is thick enough to offer protection – and they also clean both sides regularly and thoroughly.

Public health experts stress we’re still learning about this virus, so it’s hard to quantify the risk of a hug for everyone. They say if you really need one for your mental health, then seek one out. But they stress that you do need to consider what the risk might be for you and the person you’re hugging and take the steps you can to lessen the risk.

Wen offers one option: If a grandparent wants to hug a grandchild, for example, both families can stay home and take the same precautions, essentially becoming one unit. “Everyone in the family can make a pact to reduce their own risk. That way, people can hug and touch just as they would their own family members,” she says.

Elizabeth A. Stuart, PhD, a professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, co-authored a recent article that offers a way to help people decide what is and isn’t safe for them to do in various phases of this pandemic. She says before doing things like hugging, it’s best to ask yourself several questions, including:

  • Is the interaction or potential exposure necessary?
  • Where will it take place?
  • What are the levels of COVID-19 in your community?
  • Who are you interacting with?
  • How vulnerable are they and you?
  • What quarantine practices have you both been following?
  • And what kind of other social interactions have you and the person you’re hugging had?

“We’re learning a lot more about the highest and lowest risk settings, and certainly it seems high-risk is in close quarters and indoors for extended periods of time. So we can extrapolate that to hugging and say outdoor hugging, quick hugging, and hugging where you are not breathing on each other as much as possible would be best,” Stuart says.

Some are suggesting that people avoid talking or crying while hugging and perhaps even hold their breath during a hug since the virus transmits through respiratory droplets, but Stuart stresses nobody knows for sure how much protection this will give you. “I don’t think we know for sure because we are in new and uncharted territory with this virus and making educated guesses,” she says. “In general, I think we can certainly say the less breathing on each other, the better. That would certainly include mask wearing, turning your faces in different directions, and possibly holding your breath.”

Stuart says grandparents hugging little grandkids may want to let them hug their legs -- rather than getting face-to-face -- or try hugging them from behind while you turn your face away. But she stresses that even with this advice, there are no guarantees that it protects either person from getting infected, particularly if one of them is especially vulnerable to COVID-19 because of their age, a reduced immune system, or other risk factor.

“Scientists are doing the best we can, but there is a lot that just is not known,” Stuart says.

What Can Replace a Hug?

Building connections can also ease feelings of loneliness and isolation. Video chats are a great way to do that. Streva says if that isn’t possible, you can evoke a similar feeling of connection by looking at a photo of someone while you talk to them on the phone. “Mirror neurons are activated when we look at others' facial expressions, which evokes a "mirrored" emotion and can make us smile,” she explains. “Even just looking at their photo while you talk can enhance the connection.”

Ogaryan agrees and says mindfulness activities may help you envision what it will feel like when you are able to finally hug the person you miss. She says writing in a journal to help process feelings of loss and sadness and getting outside to see other people, even if it’s from afar, can reduce feelings of loneliness and isolation. And while it doesn't take the place of a hug or touch, she says if you want to help someone from afar right now, be more intentional in your communication with them, rather than relying on big group chats on Zoom, so that they really feel seen and heard.

“We need to help people get creative about maintaining interactions that provide joy and contact,” Ogaryan says. “None of these become substitutions for touch, but even just waving to a neighbor to say hello can help you feel less isolated and alone.”

As for the Ellis family, they’re now hugging Grandma regularly thanks to their Hug Glove.

“My mom is a really strong woman, but she’s been honest with me and said it’s hard being on her own and not knowing how long this will go on for,” Ellis says. “It is difficult for the kids and me, too, so we put the hug glove up a lot. It’s a bit of a process, but we keep doing it because it’s totally worth it. Being able to hug -- even through plastic -- brings such joy and relief to our family. Sure it looks fun and silly, but we have realized we just really need our hugs.”

Show Sources

Carolyn Ellis, Guelph, Ontario, Canada.

Valentina Ogaryan, PhD, licensed clinical psychologist, UCLA Health, Los Angeles.

Devita Streva, psychosocial oncology therapist, the Ohio State University Comprehensive Cancer Center, Columbus.

Elizabeth A. Stuart, PhD, professor, Johns Hopkins Bloomberg School of Public Health, Baltimore.

Leana Wen, MD, emergency doctor and public health professor, George Washington University, Baltimore.

Holistic Nursing Practice: “Jayne's Story: Healing Touch as a Complementary Treatment for Trauma Recovery.”

Iranian Journal of Public Health: “The Effects of Sleep and Touch Therapy on Symptoms of Fibromyalgia and Depression.”

Western Journal of Communication: "Relational and Health Correlates of Affection Deprivation.”

Journal of Psychosomatic Research: “Breast Cancer Patients Have Improved Immune and Neuroendocrine Functions Following Massage Therapy.”

Journal of Affective Disorders: “Oxytocin role in enhancing well-being: A literature review.”.

Issues of Mental Health in Nursing: “Mental Health Wellness and Biofield Therapies: An Integrative Review.”

Journal of Holistic Nursing: “The Effects of Therapeutic Touch on Pain.”

Indian Journal of Physiology and Pharmacology: “Effect of Skin to Skin Care to Neonates on Pulse Rate, Respiratory Rate SPO2 and Blood Pressure in Mothers.”

PLoS ONE: "C-tactile afferent stimulating touch carries a positive affective value."

Sage Journals, AERA Open: “Animal Visitation Program (AVP) Reduces Cortisol Levels of University Students: A Randomized Controlled Trial.”

Frontiers in Psychology: “Oxytocin and Cortisol Levels in Dog Owners and Their Dogs Are Associated With Behavioral Patterns: An Exploratory Study.”

Scientific Reports: “Huggable Communication Medium Decreases Cortisol Levels.”

Johns Hopkins Bloomberg School of Public Health: “Re-opening? How families can reassess.”

Politico: “So how risky is it to use a public bathroom with multiple stalls? Have a housekeeper or handyman visit your home? Play soccer with people outside your household? Attend an outdoor barbecue with about 20 people?” “Social Distancing.”

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