This article was last updated on March 13.
Schools across the country are closing and sporting events are getting canceled because of the new coronavirus, and parents have many unanswered questions. In particular, should they continue taking their children to densely populated areas like playgrounds, movie theaters and museums, which may contain many other kids whose personal boundaries and hygiene levels are not always ideal?
Because the situation is evolving rapidly and the virus is new, the advice may change as we learn more. “We’re not seeing much in the way of serious illness among children,” said Dr. Peter J. Hotez, M.D., Ph.D., the dean of the National School of Tropical Medicine at Baylor College of Medicine. “And as a result, we’re not really testing children nearly as much, so we don’t even know the role of children in the transmission of this disease.”
Dr. Sean O’Leary, M.D., an executive member of the American Academy of Pediatrics’ Committee on Infectious Diseases, said it’s still reasonable for people to err on the side of caution as much as possible right now. “We’re in the midst of something that no one alive has really experienced before,” he said.
With that in mind, here are some answers to common questions.
Can I still take my child to public places?
It depends. The situation is changing by the hour, so your best bet is to regularly check your state and local public health department websites for recommendations, said Dr. O’Leary.
But as of now, the general advice is if you live in a community where the virus is actively spreading — like in Seattle or parts of New York or California — you may want to practice social distancing, said Dr. Hotez, which means sticking close to home and avoiding large groups of people.
Several large sporting events and parades, which tend to draw massive crowds in closed quarters, are getting canceled or postponed across the country. The N.B.A. announced it was suspending its season after Utah Jazz center Rudy Gobert tested positive for the virus. The St. Patrick’s Day parades in Chicago and Boston were canceled, and the parade in Manhattan was postponed. The California Health Department announced that it was calling for all gatherings of more than 250 people be postponed or canceled. Gov. Andrew M. Cuomo of New York announced a ban on most gatherings over 500 people, and is suspending Broadway shows for at least the next month.Get an informed guide to the global outbreak with our daily coronavirus newsletter.
Even if you live in a place where the virus does not appear to be actively spreading among communities, you can’t be sure that popular public spaces like playgrounds are risk-free — the virus is estimated to survive on metal, glass and plastic surfaces for anywhere from 2 hours to nine days. New York City, for example, does not regularly clean outdoor furniture and play equipment, said Meghan Lalor, director of media relations at the New York City Department of Parks and Recreation. “We have not yet committed to changing our standard operations due to Coronavirus, but we will continue to monitor the situation as it develops” in consultation with the Department of Health and Mental Hygiene, she said.
But kids need to get outside, and open-air playgrounds are less risky than indoor alternatives, Dr. Hotez said. Try to go to the playground at times when it is the least crowded. It’s not a bad idea to wipe down equipment with antimicrobial wipes before your children play. Remember there are other options for solo outdoor play, like riding on a scooter or a bike.
As always, encourage hand washing when children come in from outside and before and after meals. Kids should sing “Happy Birthday” twice to know how long to wash their hands, and then make sure they are drying them thoroughly. There’s some evidence that paper towels are more hygienic than hand dryers in public bathrooms. Hand washing is also more effective than hand sanitizer, though hand sanitizer can be used when hand washing is not an option.
Should I cancel my kid’s birthday party?
While there aren’t yet clear guidelines from the Centers for Disease Control and Prevention on this front, it’s probably safest to err on the side of caution and cancel at this point — especially if you’re planning a party that’s on the bigger side. “Larger gatherings are becoming increasingly risky,” said Dr. O’Leary. It’s also unclear what you should do about more intimate interactions, but Dr. O’Leary said it’s probably OK to hang out with another family you know well, but make sure nobody is showing any symptoms first. “You want to find that balance of keeping your kids sane by having interactions and keeping them safe.”
The store is out of hand sanitizer. Should I make my own?
Recipes for homemade hand sanitizer are circulating online, but none of the experts I spoke to recommended making your own, even if stores have run out. Many popular brands of hand sanitizer, like Purell or Highmark, have established concentrations of alcohol, generally between 60 and 95 percent, said Dr. Rebecca Pellett Madan, M.D., a pediatric infectious disease specialist at N.Y.U. Langone’s Hassenfeld Children’s Hospital, which helps ensure their effectiveness. Additionally, she said, “we have experience using it in hospitals, and we know how effective it is.” The same evidence base for homemade recipes doesn’t exist yet.
If you are using store-bought hand sanitizer, make sure that it’s at least 60 percent alcohol and that it fully dries before you or your child touch anything — otherwise it won’t work as well. Also keep in mind that hand sanitizers are not as effective when used on “visibly dirty or greasy” hands, according to the C.D.C.
My child has mild cold or flu symptoms. Should I take him to the hospital?
No. Coronavirus symptoms can include fever, dry cough or shortness of breath. If your child has other symptoms, like mild fever, runny nose or sore throat, you should call your pediatrician first before going anywhere. From what we know so far, runny noses — which are a near-constant among preschoolers — are rarely a symptom of infection with the new coronavirus, but sore throats sometimes are. “We want people who are not critically ill to stay out of the hospital,” Dr. Madan said. Keep your child out of school if he or she is sick.
School districts in New York City are changing rules about how long you must keep a child with a fever home. Previous advice was that children must be fever-free without medication for at least 24 hours before returning to school, but now they are asking parents to keep children home for 72 hours after fever subsides.
If your child develops more severe symptoms, such as trouble breathing, an inability to eat or drink or a change in behavior, you should visit a doctor, Dr. Madan said.
If my child is very sick, will she be able to get tested?
Unless your child has a history of direct contact with someone who has tested positive for the virus, a history of travel to affected areas or is sick enough to be hospitalized, it is unlikely she will be tested.
“Availability of testing depends on where you are,” Dr. O’Leary said. “Even in the best case scenario, you can’t test everyone because there aren’t enough test kits at this point.” Older and higher-risk patients are being prioritized for testing because they tend to develop the most severe symptoms after infection.
If your child does get tested, it’s unclear how quickly her results will come back — and the time frame will most likely depend on where you are, which lab is testing her and how long she’s been sick. “It’s all over the map,” Dr. O’Leary said. Anecdotally, he has heard about results taking anywhere from a few hours to seven days, depending on the state and the level of demand.
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Jessica Grose, 10 Questions Parents May Have About Coronavirus NY Times, March 9, 2020 at 1:48 p.m. ET, https://www.nytimes.com/2020/03/09/parenting/coronavirus-parents-need-to-know.html