What To Do About Drinking Alcohol With COVID-19 Coronavirus And Social Distancing

Surprise, many Americans like alcoholic beverages. That’s why you probably hear more about wineries than fruit puncheries and Happy Hours in beer-serving bars rather than in smoothie bars. But with social distancing measures in place and many bars, restaurants and liquor stores closing due to the COVID-19 coronavirus pandemic, are you wondering how you and others may do with less access to alcohol?

Keep in mind that the social distancing that is occurring is no dry run of a drier run. It’s the real thing. With no vaccine and no specific treatment for SARS-CoV2, the only real option right now is minimizing mixing among people and keeping everyone at least six feet apart from one another to make it more difficult for the SARS-CoV2 to spread from person-to-person. Thus, New York State after Governor Andrew Cuomo has ordered all non-essential businesses to keep their employees home. California has issued similar orders. Other municipalities and states either have already done the same thing or may soon follow suit.

That means many sources of alcoholic beverages like bars, restaurants, and liquor stores are closing their doors indefinitely. Such establishments aren’t considered essential and need employees to operate because vodka vending machines aren’t really a thing just yet. Therefore, things may be rather dry for you for the foreseeable future unless you’ve managed to stockpile bottles and cans in the tee-pee that you’ve made out of toilet paper rolls in your living room or have an online source.

So what might you be missing in the coming weeks, assuming that you are the average American? Well, let’s use the numbers presented in mid-January by Mike Stobbe writing for the Associated Press during the “Dry January” social media campaign. According to data from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), on average, each American drinks about 2.3 gallons of alcohol over the course of a year. This translates to about 500 drinks, give or take, depending on how many of your drinks tend to have umbrellas in them. If this number were evenly spaced throughout the year, it would translate to approximately nine drinks per week. That may be more than the number of pairs of underwear that you wear in a week, barring any accidents and ahem extracurricular activities.

That means that alcohol may not be an insignificant part of your life and may be on your mind as you enter into what may be a dry March, April, and who knows how long. A four-week shut down of alcohol selling establishments could mean missing on average 36 drinks. An eight week closure into May would be 72 drinks. You can probably figure out the numbers for other durations, assuming that you haven’t had too many drinks right now to do so.

Of course, drinking excessive amounts of alcohol is never good and an especially bad idea during the COVID-19 coronavirus pandemic. As a 2015 issue of Alcohol Research: Current Reviews summarized, a number of studies have shown how excessive alcohol consumption can weaken your immune system and make you more susceptible to pneumonia, acute respiratory stress syndromes (ARDS), and sepsis. Yep, those are exactly the things that you worry about when you get infected by SARS-CoV2, as I detailed previously for Forbes. Alcohol can affect the production and function of many of your immune system cells such as macrophages and neutrophils. It can also weaken the cells lining your respiratory tract and the tiny little hairs called cilia that help sweep up and out bad stuff from your respiratory tract. Indeed, that smooth lob or the mullet that you are wearing on top of your head right now isn’t necessarily the most important “hairs” on your body.

However, this doesn’t necessarily mean that you have to completely cease alcohol consumption during the pandemic. There’s little evidence that moderate alcohol consumption, which the NIAAA website lists as up to one drink per day for women and up to two drinks per day for men, will adversely affect your immune system. In fact, studies have suggested that moderate alcohol consumption can be associated with positive psychological benefits as summarized by review articles published in the journal Drug and Alcohol Dependency in 1985 and in 2000. This includes reduced stress, tension, and self-consciousness and increased overall affective expression, a scientific way of saying that you will come up with better pick-up lines and the like. There are also correlations with increased happiness, euphoria, and conviviality. Studies have not shown though whether you are more or less likely to use the word “conviviality” while drinking in moderation.

Could these psychological benefits be helpful during the not-so-convivial prospects of extended social distancing? Social distancing in general, quarantine, and isolation are similar in that they all involve separating you from other people. Isolation occurs when you have a contagious infectious disease and the goal is to keep you completely separate from others so that you can’t infect them. Quarantine is when you have come into contact with someone who is contagious but don’t have signs of the disease yet. Quarantines tend to be as strict as isolation. Various social distancing measures may not be quite as strict as quarantine but do also involve keeping people separate from each other.

Fun is not the first thing that you may think of when you are subject to such measures. There is a long history of people rebelling against enforced lock-downs. That’s because people don’t like it. A team from King's College London (Samantha K. Brooks, Rebecca K. Webster, Louise E. Smith, Lisa Woodland, Simon Wessely, Neil Greenberg, and Gideon James Rubin) recently published in The Lancet a review of studies looking at the psychological effects of quarantine. Not surprisingly, various studies revealed that quarantine is associated with a range of bad psychological outcomes such as depression, stress, insomnia, exhaustion, post-traumatic stress symptoms, confusion, anger, and emotional exhaustion.

This shouldn’t be too surprising because humans, which presumably include you, are social animals. You normally do all kinds of social things such as talk with friends, go to parties, and yell “wooo” not by decree but because you want to do so. Taking away all of that contact can make things difficult. The social distancing measures that are in place right now for most people aren’t as strict as quarantine or isolation. But all social distancing measures have the impact of keeping you from your normal interactions and daily routine.

Moreover, some may view enforced social distancing measures as violating their freedom such as their freedom to go where they want, to interact with whomever they want, and, for some seemingly, to get infected by microbes. Such rumblings have already emerged on social media even though social distancing has not been in place for that long. Therefore, there is concern that people will not comply with social distancing measures or even worse rebel, which will render the social distancing measures ineffective.

So what can help alleviate the negative psychological outcomes of social distancing? What can make people more likely to comply with social distancing and less likely to rebel or revolt? Can alcohol play a role? The review article also broke down the potential drivers of worse psychological outcomes from quarantine. Not surprisingly, one was the duration of quarantine. After all, being quarantined for two minutes is not the same as being quarantined for two weeks. But is there a particular breaking point? Well, a study of patients quarantined during the 2002-2003 SARS outbreak published in Emerging Infectious Diseases found significantly higher post-traumatic stress symptoms among those quarantined for over 10 days versus less than 10 days.

Alcoholic beverages probably won’t help with the duration of social distancing, unless drinking makes you forget how long you’ve been social distancing. However, drinking until you forget is typically not a recommended way to proceed.

Ah, but can alcoholic beverages affect some of the other potential drivers of negative psychological outcomes identified by the review article such as frustration, boredom and inadequate supplies? As the authors of the review article stated, “confinement, loss of usual routine, and reduced social and physical contact with others were frequently shown to cause boredom, frustration, and a sense of isolation from the rest of the world, which was distressing to participants. This frustration was exacerbated by not being able to take part in usual day-to-day activities, such as shopping for basic necessities or taking part in social networking activities via the telephone or internet.” The authors also wrote that “having inadequate basic supplies [e.g., food, water, clothes, or accommodation] during quarantine was a source of frustration, and continued to be associated with anxiety and anger 4–6 months after release.”

Hmm, “day-to-day activities” and “basic supplies” don’t explicitly call out alcoholic beverages. But if you normally are consuming around nine drinks a week, alcohol could very well fit into these categories. History has seen situations where people were denied alcohol such as the 1920-1933 Prohibition in the U.S., that didn’t exactly go well.

Here’s a History channel segment on the Prohibition:

A PubMed search didn’t yield any scientific studies that explored what happens when you deny moderate drinkers alcohol for an extended period of time. But you gotta wonder what might happen in the coming weeks.

Will lack of access to alcoholic beverages make social distancing harder to stomach, so to speak? Should maintaining a beer, wine, and liquor supply chain be part of social distancing approaches? Fred Minnick has already written for Forbes about how closure of legitimate liquor establishment may prompt the emergence of a “Black Market.” Gee, when has not being able to get something ever led to people trying to get it illegally? Could an “underground supply” of liquor disrupt social distancing even more with curbside pick-ups and back alley deliveries leading to essentially undocumented social mixing? Could a healthy supply of wine and spirits keep the spirits up during social distancing and make it more likely for people to comply? This is uncharted territory in so many ways. But the point is that entertainment and creature comforts need to be considered when trying to make social distancing work, especially for a longer time.

There have been some efforts to compensate for the reduced supply of alcohol. For example, as CBS Los Angeles reported, the California Department of Alcoholic Beverage Control will allow restaurants to provide alcoholic beverages to-go when ordered with food for pick-up or delivery. Get ready for lots of French Fries with beer orders.

So what does all of this mean for you? First of all, if you are not a drinker then do not start drinking just because of the pandemic. In general, you’d be hard-pressed to find any scientific study or medical guideline that has “begin drinking” as a conclusion. Find some other way of alleviating your boredom such as wrapping yourself in toilet paper so that you look like a mummy. This also may help facilitate some of your online and video chat interactions.

Secondly, be realistic about how disruptions in your routine may affect you. So if sharing a glass of wine with some friends is your traditional way of unwinding on a Friday evening, try coordinating with your friends to stock up on some bottles of wine while you still can. You can do the toasting over a video chat like Zoom, Facetime, or Skype. To make the toast even more realistic, consider lightly clanking your glass on a lamp stand or that dancing pole that you have in your bedroom. You may find that your other drinking-related social events may be somewhat replicatable online or over the phone, although simulating a crowded nightclub may entail constructing a bunch of toilet paper mannequins.

Mathematical and computational models and science say that social distancing works to “flatten the curve.” But enough people have to do it and do it well for it to work. And, as Depeche Mode once sang, people are people. Many people need some degree of comfort and entertainment to comply with the challenges of social distancing. It may not be enough to just tell everyone to stay at home and forsake what they are used to doing. It’s also important to concomitantly come up with ways to help people continue their routines as best as possible. Basically people have to be in the right spirits to social distance.