Elizabeth Jones, 56, a creative director who has multiple sclerosis (MS), never considered herself very affectionate. But when COVID-19 hit earlier this year and she was forced to hole up in her Manhattan apartment alone for 75 days, going without hugs was one of the toughest aspects of the experience.

"There were times when I had breakdowns, where I'd cry and think about how much I hated being alone and how much I wished I had someone to hug," says Jones, whose MS was diagnosed in 2002. Still, she didn't dare come out of quarantine, much less hug anyone. "Given that I'm on an immunosuppressant medication, I definitely worried that I was at higher risk of getting the virus or would have trouble fighting it off," she says. "Instead of leaving the apartment, I relied on friends to place food outside my door, and we'd wave and say hi from down the hall."

People with MS or Parkinson's disease, among other neurologic conditions, may be especially nervous about physical contact during the pandemic. Yet going without human touch can feel punishing, particularly for people who live alone. "Touching increases mood-lifting brain chemicals like dopamine, serotonin, and oxytocin—the bonding hormone," says Maria De Leon, 53, a retired neurologist who was diagnosed with Parkinson's disease 15 years ago.

One way to hug safely is to form a "social bubble" with a few loved ones or close friends who are following the pandemic behavioral restrictions. Make a pact with these people to be safe so you can become part of a community where hugging is allowed, experts suggest.

De Leon, who lives in Nacogdoches, TX, isn't hugging anyone outside her household. "I stay on the safe side since I know that getting any kind of illness or stressing my body can put my symptoms into overdrive," she says. But she hasn't eliminated all in-person socializing. When a friend visited, "we sat on opposite ends of a long table, each with masks, and spent two hours coloring and talking," she says. "When she left, we kind of leaned into each other side to side. But I can't wait until we can finally hug for real."

Despite being in lockdown with her husband and an ultra-affectionate golden retriever, Carol Brewer, who was diagnosed with MS six years ago, also misses hugs. Yet she continues to be careful, not just about hugging but even when walking around her small Colorado town. The 61-year-old retired biology professor has gone months without hugging friends or her elderly mother, who lives nearby. "It's so isolating," she says. "It's tough to think about being in this situation for the next six to 12 months or longer. And the pressure I'm feeling from others to get out there and hug and to just be normal feels kind of unfair—as if people think I'm being paranoid."

It's smart for people with MS to be concerned, says Fred Lublin, MD, FAAN, professor of neurology and director of Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Hospital in New York City. "MS itself doesn't affect a person's ability to fight off infection, but anyone who is badly disabled or who has breathing problems should be extra cautious." The impact of immunosuppressants on COVID-19 vulnerability is unknown, he says. (For more about MS and COVID-19, read Why Does COVID-19 Affect Men More Severely Than Women?)

Hugging doesn't have to be completely off limits, however. "There isn't a one-size-fits-all answer," says Matthew Miller, PhD, associate professor at Canada's McMaster Institute for Infectious Disease Research. "But in general, there are some physical measures that people can take when hugging to make it as safe as possible."

Balance the risk of exposure against the risk of social isolation, Dr. Miller advises, and make sure you and anyone you hug are wearing masks and have been washing hands and following other health guidelines. "COVID-19 is primarily transmitted via respiratory droplets, so you don't want to be face-to-face with someone for prolonged periods of time," says Dr. Miller. Hugging outdoors is better than indoors. And it's crucial to avoid any kind of contact, even contact that doesn't involve touching, with somebody who has cold- or flu-like symptoms.

It also makes sense for each adult to assess his or her own risk of exposure, says Dr. Miller. "Consider the case rates where you live and how many people you come into contact with during a typical day," he says. People who work with the public—in health care or food service, for instance—may want to avoid hugging altogether. "But people who work at home, only go out occasionally to get essential items, and are good about wearing masks and washing hands might determine that their own risk is negligible."

After months alone in her apartment, Jones felt confident enough for a visit with friends who live nearby. "They picked me up and drove me to their place," she says. "Because they'd been careful and had both tested negative for COVID-19, we all hugged."

Soon after that, Jones decided to do something even more daring: She left the city to visit two close friends for a few days. "We didn't actually hug, because we wanted to be careful," says Jones. "But just being with them, a weight lifted from my shoulders. It felt like everything was going to be okay."

Brewer isn't ready to hug her mother yet, but she's glad she can hug her husband—and her dog. "She's 85 pounds of golden-retriever love," Brewer laughs. De Leon feels grateful that she has plenty of people to hug at home: her husband; her daughter, who returned home from college during lockdown; and her mother, who moved in with them temporarily. Add to that her volunteering, art therapy, and dancing lessons-all done online-and, De Leon says, "My social interactions haven't really decreased."

Everyone can benefit from maintaining such interactions, even if they don't include hugging. "We do worry about the negative effects of social isolation," says Dr. Lublin. "That's why it's important to do Zoom calls and visit people while social distancing," he says, adding that he gives his grandchildren virtual hugs as often as possible.

How to Hug Safely During COVID-19

Before you get close, keep these strategies in mind, suggests Matthew Miller, PhD, associate professor at the McMaster Institute for Infectious Disease Research.

• Wear masks. Both you and whomever you hug should wear masks that cover the nose and mouth.
• Keep it short. A hug should last no more than 10 seconds.
• Turn away. Point your faces in opposite directions to avoid breathing on each other. If you hug children, have them hug you around the waist, with their head turned away.
• Get creative. "Try hugging people from behind so you're not breathing in each other's faces," says Dr. Miller. You can even kiss them on their head while standing behind them.
• Stay dry-eyed. Masks work only when they are dry. If you're tearful, it's better to save the hug for another time.