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COVID-19 | School of Public Health Expert Insights

COVID-19

School of Public Health Expert Insights

Person in a mask with child in a mask

Re-opening? How families can reassess

By Keri Althoff and Elizabeth Stuart | June 11, 2020


Our communities are beginning to experience “re-opening,” and many are welcoming this change. But the virus is still with us and the pandemic is not over.

People and families who took the message of “stay at home” seriously are wondering how we continue our role in protecting our loved ones while resuming some activities. Continuous reassessment of the risks associated with our choices must become our new normal.

A “north star” is helpful to guiding decision making. One that we have found helpful is: “protecting yourself, your family, and your community.” The epidemiology shows:

  • Reducing ones’ contact with others reduces the probability of becoming infected with COVID-19.
  • Once a family member is sick, the probability of transmission to another person in the household is high.
  • Wearing masks can protect others in our communities by keeping our germs to ourselves and benefiting from others doing the same for us.

It is also important to consider your family’s specific circumstances. If your family includes individuals at high-risk for severe outcomes if they become ill with COVID-19, you may want to maintain higher levels of physical distancing. If your family members have exposure to many people through their jobs or otherwise then your family’s risk to others may be higher than your neighbors.

With your north star in place alongside an understanding of your family’s risk from others and to others, consider a few key questions about potential interactions:

Where will the interaction take place?

Less risky spaces include outdoor space where you and your family can stay six feet away from others. For young children, bringing something to mark your family’s space may be helpful. If the interaction must take place in a home, require visitors to wash their hands upon entry and wear a mask.

If you have a vacation booked for an area you feel is low risk for you and your family, you should also consider the risk to the community you will be visiting because families escaping to rural areas may bring the virus with them.

If you do decide to travel, stay close to home, limit your interaction with others for the two weeks prior, and continue to practice social distancing, mask wearing, and good hand hygiene while away.

Whom will you be interacting with?

Grandparents are missing their grandkids (and parents are missing grandparents), but most grandparents fit into the higher-risk category for severe COVID-19 illness based on age. Evaluating if the grandparents have additional risks for more severe COVID-19 disease, like underlying medical conditions, will help you determine the risk to the grandparents of your interaction.

If you are thinking of bringing a childcare provider into your home this summer, inquire about their social distancing practices, such as what other jobs they may have and how many other people they regularly interact with.

If summer camps are open in your area, choosing outdoor camps with a smaller number of kids, where the kids attending do not change much from week-to-week, and camps that do not require your child to ride a bus (or other shared vehicle) can reduce risk.

Is the interaction necessary?

Grocery shopping is definitely important, and many have figured out how to do that as safely as possible. But what about interactions that are necessary to maintain mental health? If it is important to your child’s mental health that they interact with a friend, consider a physically distant walk or bike ride. Similarly, if you think a small backyard gathering of your adult friends is important to your mental health, keep the gathering outside with bring-your-own snacks and drinks.

Consider numbers as well; you might think that interacting with 5 other families in a week is minimal. But if each of them interacted with 5 other families in the past week your family has now been exposed to 25 other families. Evidence still indicates that people can transmit disease for a few days before coming down with symptoms. Limiting contact with others is still key to slowing the pandemic. Keeping your interactions “hyper local” is important to reducing spread of the virus.

What is the current spread of COVID-19 in my community?

Being aware of COVID-19 in your community is also important to making informed decisions. State and local health departments are posting data on their websites. Keep an eye out for spikes in cases (not caused by sudden increases in testing), proportion of the tests that are positive (the lower the better), hospitalizations, and deaths in your local area as signs of increased risk to your family. See the JHU Coronavirus Map to view these measures in your county. Similarly, remain prepared for potential new movement restrictions or a return to stay-at-home orders.

Finally, if someone is sick with COVID-19 in your household, your decision-making must immediately change. The CDC has clear guidance for how to care for someone in your home in isolation. Isolating the ill person and implementing quarantine for all others in the family is essential to protecting your community.

The path forward for families will most likely not be clear or straightforward. Having a “north star” and reassessing your family’s risk with every decision about interactions with others will be the new normal for quite some time.