Social Distancing Guidelines for Parents
March 23, 2020
We interviewed Kate Eisenberg, MD, PhD, to get the answers you need to live your new normal. A lot of parents have questions about what’s okay and what’s not okay during this social distancing period. While we know that the situation is changing every day, it would be helpful to have a few base guidelines. […]

We interviewed Kate Eisenberg, MD, PhD, to get the answers you need to live your new normal.

A lot of parents have questions about what’s okay and what’s not okay during this social distancing period. While we know that the situation is changing every day, it would be helpful to have a few base guidelines. Dr. Eisenberg is both a family physician and epidemiologist as well as a mom, so she’s fielding many of these questions in her daily practice.

1) My child has a scheduled well-child visit at the pediatrician. Should we go? What about with a newborn?

Great question! Keeping up with routine care is of course important, but this needs to be balanced against the risk of a child and their family being in a medical setting where infection could spread. The newborn visit is particularly crucial, as are visits where immunizations are given. In our office we are moving other types of visits to telemedicine, like well care for older children and teenagers, for the time being. Families should consult with their pediatrician on what is considered an essential visit.

2) Are we allowed to have a single child over for a playdate? What about a sleepover?

The short answer is no – I have gotten lots of questions about outdoor playdates and pairing with just one or two other families. With many states becoming increasingly restrictive on businesses being open and people’s movements, and even our borders closing with Mexico and Canada it’s important to keep to our individual households. In Wuhan they saw significant transmission within families, so avoiding exposures as a family is important.

3) We need to pick up a few groceries. Should I leave my child at home?

Yes, leave your child at home. Any opportunity for a child or other member of your household to be exposed to others is a potential opportunity to be exposed to the virus, even if people around you don’t have symptoms. Even cutting out one opportunity for contact between your child and others is an important step to take. I know this sounds extreme, and that’s because it is extreme! This has never happened before that any of us have experienced!

4) Is it ok for my kids to ride bikes in a group?

I would stay away from anything happening in a group. I think a lot of kids have trouble with understanding and really acting on all the limits we’re setting, even with supervision. I would stick to outdoor exercise with members within your own household. Again, I know this sounds severe but it is a situation where if everyone is testing the limits, someone is going to get it wrong and there could be real consequences to that.

5) Is it ok to order takeout?

Yes, takeout is ok generally – there is no evidence for foodborne transmission with this virus. That being said, you are trusting the restaurant to have stellar food handling practices as the virus can remain alive on some surfaces for at least some time. I think the safest bet is to order food that you can then reheat in the oven or microwave, which should minimize even a low potential for risk associated with takeout.

6) If I have symptoms, should I continue to breastfeed? Do I need to quarantine away from my baby?

This is a tough one because we have very limited medical information on this topic, and we are balancing out the risk of exposure to the baby with the many benefits of breastfeeding. Typically respiratory viruses are not transmitted in breastmilk so the risk is really in having so much close contact with your baby (I can’t even believe I’m saying that close contact with your baby is a risk!). If I were advising a patient, I would say to keep breastfeeing, with lots of handwashing and wearing a mask while in this type of close contact with the baby.

7) My kid has a cough. How do I know if it’s Covid-19?

It’s hard to know! Just because there is this pandemic going on doesn’t mean there aren’t regular colds, strep and flu going around too! In kids symptoms of COVID-19 can be very mild. In general, if symptoms are mild it’s best to stay home in any case to avoid having your family in a medical setting as well as to avoid potentially infecting others. Fluids, Tylenol, and TLC still go a long way! Since there isn’t a specific cure, testing doesn’t generally change the plan, but could be important to avoid exposing vulnerable family members. Testing availability remains limited in many places so you may need to ask your own pediatrician about the approach in your specific area.

8) Is it ok to use playgrounds?

I would actually avoid playgrounds – there is evidence that the virus can stay alive on surfaces for some time, even though we don’t know how long it can actually infect a person. No one goes out and scrubs down playground equipment so I would avoid it.

9) Is it true that viruses die in the sun?

Viruses typically die outside of their host, whether that host is a person or a cat or a horse. UV radiation from the sun could theoretically contribute to a virus living for a shorter time on a surface, but that would depend on intensity and how long something has been in the sun. Overall, exposure to sunlight is not what you want to count on as your disinfectant!

10) I share custody of my child. Is it safe for her to visit both homes during shelter-in-place?

If both households are able to strictly adhere to social distancing, then travel between households seems low risk to me. If one household has a parent or other family member who is a healthcare worker seeing potential COVID-19 patients or other essential employee interacting with the general public, it may make more sense to keep a child in the other parent’s household for a time, if there is room for flexibility in the custody arrangement.

Similarly, if one household is much better equipped in terms of space and supplies during a time when people are primarily staying at home, it may be worth considering keeping a child there for longer. Or if there are high risk individuals in one household, that may play into the decision about how the schedule is structured. If a child is moving back and forth between households and there are risks of exposure, either from a parent working outside the home or with a high risk individual within the household, then it’s important to consider a strategy of risk reduction – hand washing, keeping vulnerable individuals separated as much as possible from the rest of the household, wearing masks when you do go out, those types of measures.

Decisions regarding custody are going to be very individualized because each family’s situation is different. In general, my hope would be that these decisions can be made in partnership during this unusual time to support the best health and least risk to everyone involved.

11) What’s better, grocery delivery or going to the store? Do I need to wipe them down?

Grocery delivery is probably better than going to the store, in my opinion, just to be around fewer people and fewer surfaces touched by many people. I am wiping down surfaces on items delivered to my home myself. I think the risk of transmission by this route is likely small, but until more research is out I think being cautious is reasonable.

12) How long do you think this social distancing is going to last?

I get this question a lot! It’s really hard to know. If you think about how it takes 2 weeks for some people to even start developing symptoms, and then in some cases another week until they get really ill, we’ve got to keep in-person interactions to a minimum for at least 4-6 weeks to really know we’re succeeding, so I think at least some restrictions are going to be in place for a while. Then we have to figure out how to start opening things up again in a way that is safe, which we don’t really know how to do yet!

12) How does this all resolve? If social distancing works and the virus runs it’s course, will it reappear, or will it die out for good?

The thinking among people that are doing the mathematical modeling of this disease is that once we get to a certain degree of people in the population who have immunity, the virus will no longer have the ability to tear through the population the way it’s doing now. The numbers I have seen referenced are 40-70% of the population needing to be immune for things to die down. We also don’t know how the different seasons will affect its spread. It may be that this virus comes up seasonally in the future, like flu does. Ideally we will develop a vaccine so that people can have immunity without having to live through the infection and clearly many groups are working on that. Once we can test for immunity, like checking people’s antibodies to the vaccine like we can do for measles or mumps, that will also be helpful with knowing how we’re doing.

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Saralyn Ward is an award-winning writer, wellness advocate, and mountain mama. She is the founder of The Mama Sagas, writes for several publications and hosts a regular parenting TV segment on Colorado's Everyday Show. When she's not huddled over edits, you're likely to find Saralyn climbing peaks or skiing down them, and reminding herself that the two little girls that call her mom are not the boss of her.

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