Dr. Corey A. Fish (He/Him)
8 Apr 2021Dr. Corey A. Fish (He/Him)

VIDEO: "Back to Normal" for Families a Q&A with Dr. Fish

VIDEO: "Back to Normal" for Families a Q&A with Dr. Fish

Now that most adults and older teens qualify for vaccines, many families are thinking about what going “back to normal” looks like for their families—especially since there’s no timeline for younger kids and preteen vaccines. Last week our CMO, Dr. Corey Fish, did a LIVE Q&A talking to families about the risk of certain common family activities and how you can make determinations about what’s safe. 

Watch the full video or read our transcript, which has been edited for clarity.

Q: When can kids have a normal, unmasked playdate safely?

A: For kids under 12, an unmasked playdate or sleepover with one other kiddo or household is low risk as long as the adults in both families are fully vaccinated. We’ve seen evidence throughout the pandemic that, while kids under 12 can and do get COVID, they get it a lot less than older kids and teens. And when they do get it, they don’t pass it along all that much. That being said, if only some of the adults in playdate families are vaccinated, we’d recommend more caution when planning an unmasked and/or indoor playdate. 

For kids over 12, hangouts and sleepovers carry a moderately high risk. Even if the adults in both households are vaccinated, have a chat about exposure and COVID safety before you sign off on a teen/pre-teen get-together. 

Q: Is it safe to sign my kids up for swimming lessons? 

A: The safety of swimming lessons is going to depend on the age of the kids and the vaccine status of the instructor. We’re assuming a group swimming lesson for kids under 12 here and since you can’t know the vaccine status of the other kid’s parents, we’d feel safest if a) you, the parents, are fully vaccinated, b) the instructor was fully vaccinated and c) swim lessons took place in an outdoor pool or a large indoor space with good airflow and ventilation. Basically ask some questions about safety protocols and use caution while signing up. 

Q: Should children remain masked when playing with children outside of their household and pod? 

A: If you have a group of kids under 12, and the parents are all vaccinated, we would say that playing without masks is pretty safe with kids both within and outside a family pod.  

For kids where you don’t know the vaccine status of the parents, use precautions like only interacting with one household at a time, or keeping interactions outdoors.

A note about pod agreements: We’ve been hearing from parents that many pods have rules along the lines of “If you take your child to a doctor's appointment, or a dentist appointment,  you have to quarantine from the pod for two weeks.” And while we fully support having pod agreements, we’d encourage people to review those agreements in light of the newest scientific info. We know that taking kids to the doctor’s office is low risk—most doctors’ offices are especially aware of COVID risks and many healthcare workers are vaccinated. We’d put doctors visits into a lower-risk category than, say, grocery shopping. So it might be a good time to review those pod agreements to make sure families aren’t penalized for taking their kiddos to routine doctor’s appointments. 

Q: Is a long visit to the grandparents safe? 

If your kids are under 12 and grandparents are healthy and fully vaccinated, we’d say this is pretty safe. 

If grandparents have complicating health conditions, consider precautions like a COVID test before a long visit. 

Even if grandparents are healthy and fully vaccinated, according to data, a visit with kids 12 and over is a big infection risk. If you are considering an extended grandparent visit, use COVID safety measures like testing, quarantining or masking, plus distancing with your kids over 12. 

Q: Can we visit and hold a new baby? 

A: It’s safe for one household of vaccinated adults and unvaccinated kiddos under 12 to meet a new baby as long as babies are full-term and healthy. For kids over 12 the infection risk is much higher so use COVID-safety practices like masking/distancing for kids over 12 with new babies. 

Q: Can we hire a babysitter for date night? 

A: We’re looking forward to going out on dinner dates again! And yep, date nights are safe. As long as your babysitter and all adults are vaccinated this is low risk for your family and your sitter. 

Q: Can we go on vacation or have dinner with other families? 

A: If kids are under 12 and all the grown ups in families are fully vaccinated, this is pretty safe. If you have some vaccinated adults and some unvaccinated adults, we would say a max of 2 total households for vacations or dinners. Kids over 12 are going to be more of a risk. 

Q: What about gatherings of mixed-age households, like kids that are three, nine and 12? 

A: If all the adults are vaccinated within your gathering and everyone is practicing COVID-safety like masking and distancing guidelines generally. This feels like a pretty safe gathering. We think about school situations where, even before vaccines, kids were mixing socially with relatively few cases. 

Q: Should we consider kids under 12 with a history of asthma in a higher-risk group? 

A: We’re always concerned about kids with underlying conditions and and asthma might be a reason to be cautious. That being said, we’re not aware of any data or case reports of large clusters of kids with asthma who have been more severely affected by COVID. If your kiddo does have asthma it would be worth having a specific conversation with their primary care provider about their history and your family’s specific risk profile. 

Q: What can you tell us about vaccine immunities being passed along to babies in-utero? 

A: There's been a few small studies of COVID vaccines and pregnancy. And they've actually found COVID antibodies in cord blood, which means that the babies actually have circulating antibodies, they've also found the antibodies in breast milk. At this point, nobody really knows how long that lasts compared to an actual vaccine shot. But encouragingly, some part of that immunity does seem to be getting passed to babies. 

Q: When might the Pfizer vaccine be available for 12 year olds? 

A: Yes, we’re really excited about the news that the initial trials of the Pfizer vaccine in 12 year olds are very promising. As long as there aren’t any new developments there, we would expect for the timeframe to be about 6 weeks or so before they begin the emergency use approval process. 

 

Q: If parents are vaccinated and still having only limited interactions outside the home, should we feel worried about bringing the virus home to our kids under 12?

A: There’s some new data that’s showing that vaccinated people really don't transmit the virus. So even if you're exposed to the risk of transmission really is not there, according to this study. Nothing is ever zero-risk, but I feel pretty confident in saying that the risk of transmitting a virus if you've been vaccinated is small to nonexistent.

Q: Is sleepaway camp safe for kids? 

A: So we’re assuming a bunk room filled with some number of kids and the kids are under 12, with all of the counselors vaccinated. We feel pretty safe with that. Dr. Corey would be interested to see whether the camp is doing anything like asking people to quarantine for a couple of weeks beforehand ahead of time as an extra precautionary measure. 

Q: Can you welcome visitors into your home that have just come off a plane? Especially with older pre-teens and teens. 

A: Interestingly, airplane travel doesn't seem to be a huge exposure risk for COVID. It seems  counterintuitive, but there's been at least one study that looks specifically at transmission in airplanes. And it turns out that there's less of a risk of contraction on an airplane because of the way that airplane filtration systems are designed. So the airplane wouldn’t influence the risk assessment for us. We'd be looking at the vaccine status of the adults and the age of the kids. With pre-teens and teens there is some risk so I’d suggest talking about family COVID safety measures before joining households. 

Q: Can we make vacation plans for this summer? 

A: It's all speculation at this point. Our own speculation is that I think it's fine to start making vacation plans. We’d encourage you to have good cancellation plans just in case. But we’re reasonably confident about the safety of summer travel. 

Q: What about group camping with six to seven other families where most, but not all adults will be vaccinated?

A:  We’re assuming a situation where each family has their own tent and families are mostly hanging out outside. That feels pretty safe. We’ve known for a long time that the risk of transmission outdoors is much lower than being in small, less ventilated areas. We’d encourage setting a boundary where families aren’t going in and out of each other’s tents as an extra layer of safety. 

Q: Is sharing food during camping safe? 

A: We’re imagining a situation where one person or family cooks for the group, and then everyone is served into their own bowls with their own utensils. And yep. We feel safe about that. We’d advocate against sharing utensils and cups after they’ve been used and, of course, things like double-dipping. But assuming general good cooking hygiene practices, this seems fine.

Q: How do you feel about kids using shared playground equipment? 

A: You might have seen in the news information about COVID being able to survive on surfaces. Most of those studies come from surfaces in hospital rooms where people have confirmed COVID diagnoses. So not really an outside world scenario. We’re not worried much about shared playground equipment. If you’re feeling anxious, a quick sani-wipe of high-touch surfaces like monkey bars can alleviate that anxiety, but we don’t think it's necessary to keep kids safe. 

Q: Thoughts about the need for kids to wear masks during indoor activities like ballet or gymnastics? Or in schools. 

A: A lot of the requirements around masking for kids are government mandates that studios, gyms and schools have to follow to stay open. So our opinion of relative safety doesn’t matter much. But if, as more adults get vaccinated, the state starts rolling back those mandates we’d be fine with that. 

Q: For a family beach trip flying to the East Coast. Are there any precautions you would take? There will be grandparents and our family of vaccinated adults, one other family, two adults and two teenagers that will be unvaccinated. 

A: So the data says that vaccinated people can safely hang out with one other unvaccinated household. Given all the different people in this situation we would probably recommend something like a 10-day quarantine before the trip, or all the unvaccinated folks getting a negative COVID test beforehand. 

Q: What is the risk for children under 12 in a childcare setting, such as a nursery where other families may or may not be vaccinated?

A: Generally, from what we’ve seen, childcare and nursery settings are really safe for kids under 12. Some of those kids are still wearing masks if they’re old enough, but in general we haven’t seen a lot of cases from little kids in care situations. We’d love to see those get to a point where ¾ of the adults are vaccinated before adults AND kids can go without masks, but that’s likely to be another milestone that’s mandated by the government. 

Q: What's your viewpoint on the CDC three foot recommendation?

A: We think it's fine! The original six-foot rule was based around initial data on droplet spread. And now we know that there’s a lot of different size droplets and situations and for school-age kids, three feet feels safe. 

Q: Is it safe for a bunch of kids to travel out of state for basketball tournaments and then return to school? 

A: For us, this is more about what is going on outside of the tournament. None of these group activities happen in a vacuum. At this point the tournament is probably vaccinated coaches and everyone wearing masks so not a ton of risk there, especially for kids under 12. But we’d be looking at how safe the families and kids are being outside the event. Is everyone good about wearing masks? Are many households spending time together unmasked and/or indoors like at restaurants or in hotel rooms? Those are the things that would be questions for us before rating something like this safe or unsafe. 

As with all things, there’s no guarantee of 100% safety. But these answers are based on our study of the latest research and case reports of COVID infection from the CDC. As a parent, you need to evaluate your family’s own unique risk profile and, when in doubt talk it over with your care provider. They can provide insight into your unique situation. 

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