3 Health-Care Experts With Unvaccinated Kids Explain the COVID Precautions They’re Still Taking
The summer is coming and for an increasingly large share of the population, normalcy beckons. Not so much for those with kids under 12, who still aren’t eligible to be vaccinated.
With 45 percent of Philadelphia adults now fully vaccinated, many are starting to dip their toes back into the kinds of socializing that used to happen in the pre-pandemic days: busy nights out at restaurants, sporting events, dinner parties, even vaccinated-only crowds at bars. (Okay, that last one isn’t quite pre-pandemic normal, but you get the idea …)
As much of Philly begins to enjoy those post-vaccine benefits, though, there’s one group for whom the change isn’t quite as stark: people with young children. Kids under 12 years old are still not eligible to be vaccinated, and they may not be until the fall. And even though children are less likely to contract COVID-19 or develop symptoms, and have a much lower overall risk of being hospitalized than adults, they still account for about 20 percent of new cases each week. According to the Centers for Disease Control, children currently make up about three percent of total COVID-19 hospitalizations, and of those who end up hospitalized, about one in three end up in the intensive care unit, about the same rate as adults.
Health-care workers are more attuned to this than anyone. So as the summer approaches, we spoke to three public health experts with young, unvaccinated children of their own to hear about what precautions they’re still taking and why.
Ashley Ritter, nursing PhD and postdoctoral fellow at Penn, contributor to the Dear Pandemic blog, mother of three (ages seven, five and two): Right before they lifted the mask mandate [outside Philly], with vaccinations rising and everyone wearing masks, we were getting a little more comfortable going out in public with children. Now that that’s been lifted, we can’t really take the kids into the store again. I look at it as risk points. Going to school, you have a number of contacts. These other settings are additional risk. And with the public places not having mask mandates, and not knowing who’s vaccinated and who’s not, it’s a calculus that you can’t really count on. So we just tend to not go into those situations.
Gina Lovasi, epidemiology PhD, professor of urban health at Drexel, mother of one (age 10): My goal is not zero percent transmission risk, but to set my daughter up for a lifetime of health. So I’m looking to do that by following and modeling reasonable hygiene, and modeling that when rules are set by public health authorities, we’re going to follow them. We have, assuming adherence to rules that are set about mask wearing and capacity, been continuing to visit local stores whenever they’ve been open.
Eric Sachinwalla, MD and infectious disease specialist at Einstein Medical Center Philadelphia, father of one (age four): We try to avoid taking her into places where there could be large groups. Prior to the pandemic, we would do things like grocery shopping together. Now my wife and I split that, so one of us goes and other stays with my daughter. … While I think the vaccine is still extremely effective and there’s a much lower risk of me getting sick, there’s still a chance I could get infected with being vaccinated. And since she’s not protected, I wouldn’t want to bring something home to her.
Ritter: Instead of seeing 10 friends and families that have children, we’ll probably keep it to like three or four and keep it outside as much as possible.
Lovasi: We’ve had some non-masked indoor gatherings with one or two friends. I think we’re more cautious than we would have been before the pandemic about calling it off if anybody has been sick recently, but otherwise we’ve gone ahead. We are happy to be guided by whoever is most cautious in the group.
Sachinwalla: We talk about it with the parents beforehand: What do we all feel comfortable doing? Have there been any issues? My daughter goes to school, and we have friends whose kids go to school, so if there are any potential exposures there, we’ll talk about that beforehand. We make sure all the kids are feeling okay, and then at that point we’re usually pretty comfortable letting the kids play without masks on.
Ritter: I sort of look at risk mitigation strategies as layers of protection. The two of three rule — either have masks, social distancing, or be outdoors — if you pick two of those three you’re in pretty good shape. So when we’re outside, the first thing is we don’t put ourselves into crowded situations. If that’s the case, I don’t think you need masks outside. But if it’s a situation where you have multiple families outside, like at a busy playground, I’d probably have my children wear a mask.
Lovasi: A lot of what my daughter has done is outdoor activities such as meeting a friend to skate, or to play croquet or soccer out in a park or grassy area. We allow being unmasked and just ask that hands are washed when coming back indoors. But we’re also guided by the comfort level and preferences of the other family, which has often meant that they are masked.
Sachinwalla: We have brought masks when we’ve gone to playground. She’s interacted with other kids here and there without a mask on. With a playground outside, not super-close contact, I was okay with her not wearing a mask. But if it were really crowded, I’d probably encourage her to put a mask on.
Ritter: We are thinking about an art camp. We’re still really looking at community transmission rates to see if that’s going to be good idea or not. If community transmission rates continue to stay low we might consider that, but we’re not ready to say yes yet.
Lovasi: We signed up for sleepaway summer camp. She was planning to go for the first time last year; that got canceled, so I’m very hopeful that it can go forward this year. This is an art and music-focused camp, and while they would usually invite parents for the performances, they’re all going to be virtual.
Sachinwalla: Her school is open till September. But I’d be thinking about if the camps are for the most part following the CDC recommendations. I think kids should still be wearing masks — I can understand if you’re outside and distancing, it’s little bit harder to wear masks. But especially when inside, I’d definitely be encouraging kids to wear masks as much possible. I’d feel more comfortable if staff wore masks, too.
Ritter: We do have a trip planned for the very end of summer to stay in a hotel with our children. That’s driving. I feel pretty comfortable in spaces where we’re not going to be around a whole lot of other people. But we’re not getting on airplane unless absolutely necessary.
Lovasi: As a family we’re traveling by plane to South Dakota. We’re going to go see Mount Rushmore and are meeting together with family. That will be our third trip since the pandemic started. Previously we flew to California and then to Texas.
Sachinwalla: We just got back from the Shore this past weekend. We ate outside at a restaurant once, and we walked to ice cream a bunch of times. While we were walking to the ice cream parlor, and while we weren’t eating, we kept our masks on, but I think that’s really just personal. I don’t think I’d go on a plane or a train or a bus with her just yet. In my opinion there’s no real risk at a hotel. As long as you’re spending a short amount of time in the lobby or walking in and out, it’s pretty low risk. The evidence really suggests you need to have some duration of exposure to someone.
Risk of Severe Illness
Ritter: I’m not terribly concerned they’re going to get super sick. And as community risk is lower, the risk for them getting sick is little bit lower. But the number of things that get set off when someone gets a stuffy nose right now — testing to find out if they have COVID, waiting till you get results, and, if they were with anyone prior, then calling them and telling them, “You shouldn’t go anywhere for a couple of days” — still causes a lot of anxiety to myself and to groups of people around me.
Lovasi: I see that there is a threat from this virus and I don’t mean to minimize that, but the risk of complications and severe disease or death is very, very low in her age group. And so I see other things also as a threat to her health — if she were to lose opportunities for social engagement, have barriers to feeling connected to school, have a sense of worry coming out of this. My focus has been not only on reasonable hygiene and modeling compliance with the rules, but also navigating the social environment, staying engaged academically and physically with different interests she has so she doesn’t start to become isolated or have other challenges.
Sachinwalla: Thankfully, kids by and large seem to do quite well. But there is a small but measurable number that have had more severe illness. I think if case counts really, really dropped and we were seeing like single-digit cases in our local area or something like that, then maybe we’d change our behavior. But I think if had to put money on it today, I’d say we’ll kind of keep it status quo until she can get vaccinated.