Some of us are mating in actual captivity. Some of us not at all. The pandemic raises lots of issues around safe intimate physical contact, and what it may look like in the future.
Credit…Illustration by Claire Milbrath
These are not sexy times.
As an obstetrician and gynecologist in the Bay Area, I’ve been caring for my patients via telemedicine for the past three weeks because of the new coronavirus pandemic. When I ask patients about new sex partners — a standard question for me — the answer is a universal “no.” They are taking California’s shelter-in-place very seriously.
In fact, many of my patients are more interested in updates about the virus than the medical (and often sexual) problem for which they were referred.
The pandemic has most of the world practicing exceptional hand hygiene and social distancing. This coronavirus is so new that we don’t know what we don’t know, and while fresh information is coming at an incredible pace, one medical recommendation has remained constant: the need for social distancing.
This time has been an exercise in prioritizing needs from wants. So where does sex fall on that spectrum?
Are we even wanting sex these days?
It’s hard to know yet. While some people may turn to sex for comfort or as a temporary distraction, these are unprecedented times and we don’t have much data.
Depression and anxiety have a negative effect on libido. Some people are out of work, too, and unemployment can affect sexual desire. The kind of worry people are experiencing crosses so many domains: job security, health, friends’ and family’s health, retirement and the ability to have access to medical care, to name a few.
One study that looked at the effect of the 2008 Wenchuan earthquake in China on the reproductive health of married women found sexual activity decreased significantly, and not just in the week after the earthquake.
Before the earthquake, 67 percent of married women reported they were having sex two or more times a week. One week after the earthquake, that number fell to 4 percent. By four weeks, only 24 percent reported they were having sex two or more times a week, well below the baseline.
While this study is retrospective data — women were asked to recall their sexual activity eight weeks after the earthquake — and an earthquake isn’t the same thing as a pandemic, it seems unlikely that sexual activity overall will increase.
However, trauma — and these are certainly traumatic times for some — can also lead to sexual risk taking, like unprotected sex or sex under the influence of drugs or alcohol.
ImageCredit…Illustration by Claire Milbrath
What is considered ‘safe sex’ right now?
Your risk for infection with the new coronavirus starts as soon as someone gets within six feet of you. (And of course, if you do have sex, your risk for pregnancy and S.T.I.s remains the same, and the previous definition of “safe sex” still applies.)
You’ve read this elsewhere: Covid-19 is transmitted by droplet nuclei, tiny specks of infectious material far too small to see. They are sprayed from the nose and mouth by breathing, talking, coughing and sneezing.
A person contracts the virus sharing the same airspace — a six-foot radius, the distance droplet nuclei are believed to travel (although with coughing they may travel farther) — and inhaling the infectious particles. Or the droplet nuclei land on an object or surface, making it infectious. Touch that surface and then your face and the chain of transmission is complete.
If you do have sex with someone who is infected with the new coronavirus, there is nothing we can recommend, be it showering head to toe with soap before and immediately after sex, or using condoms, to reduce your risk of infection. (The New York City Department of Health and Mental Hygiene issued these guidelines.)
We don’t know if the new coronavirus is present in vaginal secretions or ejaculate, but it has been identified in stool. Based on what we currently know about transmission of coronavirus, penetrative vaginal or anal sex or oral sex seem unlikely to pose a significant risk of transmission.
Who are the safest partners?
It’s best to limit sex to your household sex partner (HSP), who should also be following recommendations for hand hygiene and social distancing. The World Health Organization currently lists the risk of household transmission as 3 to 10 percent, but this is based on preliminary data. We don’t know what role kissing or sexual activity plays in transmission.
The idea of limiting sexual contact to your household partner and social distancing in general is about ending the chain of transmission to your household should one person become infected.
If your HSP is sick with symptoms of Covid-19, or has been exposed, definitely don’t have sex. They may be too fatigued anyway, but your risk of being infected will likely go up in close, intimate contact. Sleep in separate bedrooms if possible.
If you have more than one bathroom, designate one for the sick or exposed person. Try to stay six feet apart and be fastidious about cleaning surfaces. If they were exposed, living as separate as possible in your home for 14 days is recommended.
ImageCredit…Illustration by Claire Milbrath
What if I’m in a new relationship and had planned to get other S.T.I. testing done?
Many labs are overwhelmed with coronavirus testing, so you may not get results for some S.T.I.s — like gonorrhea, chlamydia and herpes — as fast as before. Given the short supply of test kits for Covid-19, many medical centers and labs are taking swabs and liquid from other test kits to jury-rig testing kits for the new coronavirus, so sampling kits for genital infections may be in short supply.
Ask your health provider because work flows may vary locally and may change day to day. But if you are at risk of an S.T.I., you should still seek out a test as soon as possible.
What if I don’t have an HSP? Am I now celibate?
Yes, I’m sorry to say, those are the recommendations. For now.
But this doesn’t mean you can’t meet people online — start talking on the phone, have video chats, sext or have phone sex if that’s your thing.
And if someone you meet online is encouraging you to meet in person? That not only tells you how they view their own safety, but, even more important, how they view yours.
What about a ‘Covid sex buddy’?
I’ve heard people talk about this: a sexual partner who agrees to socially distance with everyone else, but the two of you will hook up for mutual release.
I really discourage this (for now): Social distancing means limiting contact with people outside of your household. Each additional person added to the household increases risk. And of course, you are depending on this person to be as vigilant with social distancing as you are — not to mention the risk during transportation between your home and your partner’s. At the moment, the risk is too high.
Might we see people in close proximity hooking up who both tested positive for Covid-19 and are now 14 days post-positive test? It would not surprise me. However, we don’t know much about immunity (protection from reinfection) against Covid-19 after an infection. And because tests are in short supply, many people have presumptive infections but can’t be tested.
With seasonal coronaviruses that cause a common cold, immunity lasts about a year, but with the more serious coronaviruses like SARS or MERS, immunity seems to last longer. But we still don’t know enough to make concrete recommendations in terms of post-illness behavior.
What about sex toys?
Sex toys aren’t likely to be a method of coronavirus transmission if you have been using them alone. However, if you shared your toys within the past 72 hours, make sure they are appropriately cleaned and wash your hands afterward as the virus may stay active of some surfaces for up to three days.
And do not clean sex toys with hand sanitizer or use hand sanitizer immediately before masturbating, because it can be very irritating to the vagina or rectum. Ouch.
ImageCredit…Illustration by Claire Milbrath
Is it safe to buy new sex toys?
Judging from the state of my inbox, it appears that a lot of vibrators are on sale. Is this a good time to take advantage of a deal and the extra time on your hands?
Paying electronically is safer than an in-store purchase: Paying online means no one is physically handling a credit card or cash.
As for the delivery itself, there is lab data suggesting the new coronavirus is viable up to 24 hours on cardboard. Washing your hands after opening and throwing away the delivery box seems like an appropriate mitigation strategy. Letting that box sit for a day (if possible) before opening may be a good idea, although we don’t know how the lab data of the virus survival on surfaces translates to the real world.
Does your online purchase of a nonessential (as much as it pains me to say this, a vibrator is a “want,” not a “need”) put someone else at increased risk? Workers at large warehouses where social distancing isn’t possible may be at increased risk, especially if they don’t have sick pay, so taking time off if exposed isn’t possible.
One option is to consider a local small business that can take your payment over the phone or online and arrange a curbside pickup.
What will safe sex look like in the future?
Right now the only safe sex is no sex with partners outside your household.
If you or your HSP are at high risk, should you take extra precautions to further reduce the risk of transmission — giving up sex and kissing, sleeping in separate bedrooms — in case one of you has an asymptomatic infection? Asking your doctor for guidance here is probably wise.
But what about when we emerge from our homes again — which may be some months away — and start thinking about in-person dating, and even mating?
No one knows if we are all going to have the urge to have sex after this quasi-hibernation. One concern is a potential surge in risk-taking and S.T.I.s. in the immediate aftermath of the pandemic. (After all, you can’t assume that if someone was celibate during the pandemic they don’t have an S.T.I.; most S.T.I.s don’t cause symptoms and could have predated the new coronavirus.)
If that all sounds fairly bleak, well, it is. For now, the new coronavirus probably means less partner sex overall, whether that’s because of the lack of a household sex partner for some or a drop in desire for others. Or both.
Hopefully, though, this is just for now.
Because the more everyone commits to social distancing, the faster we can all get back — and down — to business.
If you have a question about sexual health and the new coronavirus that was not answered here, please post it below. Things are changing at a rapid pace; you can follow the latest coverage of the pandemic here.
Updated March 24, 2020
How does coronavirus spread?
It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.
Is there a vaccine yet?
No. The first testing in humans of an experimental vaccine began in mid-March. Such rapid development of a potential vaccine is unprecedented, but even if it is proved safe and effective, it probably will not be available for 12 to18 months.
What makes this outbreak so different?
Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
What if somebody in my family gets sick?
If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.
Should I wear a mask?
Experts are divided on how much protection a regular surgical mask, or even a scarf, can provide for people who aren’t yet sick. The W.H.O. and C.D.C. say that unless you’re already sick, or caring for someone who is, wearing a face mask isn’t necessary. The New York Times and other news outlets have been reporting that the wearing of face masks may not help healthy people, noting that while masks can help prevent the spread of a virus if you are infected, most surgical masks are too loose to prevent inhalation of the virus and the more effective N95 masks, because of shortages at health centers worldwide, should be used only by medical personnel. But researchers are also finding that there are more cases of asymptomatic transmission than were known early on in the pandemic. And a few experts say that masks could offer some protection in crowded places where it is not possible to stay 6 feet away from other people. Masks don’t replace hand-washing and social distancing.
Should I stock up on groceries?
Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.
Can I go to the park?
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Should I pull my money from the markets?
That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.
What should I do with my 401(k)?
Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”
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