The current pandemic climate has presented a multitude of concerns and questions on how to navigate children attending larger group settings moving forward. One that many of our families are currently facing is how and when to let their children return to larger organized and/or institutionalized settings. We understand that there are numerous underlying circumstances for each family tackling this decision, and that while this is more of a choice for some families, for others it is a necessity. We cannot make a blanket recommendation for or against your child returning to daycare, camp, athletics, or school. These are uncertain times, and what lies ahead is unknown to all of us. What we can definitively say is that the risk of COVID19 remains very real. With more socializing and travel and group interaction, we will see more cases. As Pediatricians, we also know the importance socialization plays in children’s overall mental and physical well-being. We recognize that the longer children are out of organized educational settings and away from peer interaction, the larger the impact on their overall health.

Current research highlights that children’s (age <12yo) impact on transmission may be smaller than originally thought. How this research continues to unfold will be paramount to understanding how child-centered institutions will play a role in transmission of SARSCoV2. Larger group gatherings will never carry zero risk of contracting the novel coronavirus until there is herd immunity and a vaccine, both of which are months away. Therefore, what we can comment on at this time is who is considered a riskier individual should they catch SARSCoV2, which would impact how and when you decide to increase exposure, and how to reduce you and your child’s risk of such. And we encourage you to continue to reference sources such as the American Academy of Pediatrics and CDC as information changes rapidly.

  1. Higher risk groups: newborns, infants under 1yo, pregnant women, immunocompromised individuals (ie cancer, autoimmune, diabetes, HIV); people with heart disease, chronic kidney disease, obesity, liver disease, sickle cell disease, thalassemia, diseases/disabilities that affect lung function, age >65yo, or reside in nursing home/assisted living facility
    • If you, your child, or a close/frequent caregiver fall in to these categories, we would recommend avoiding unnecessary large group exposure as able. The risk of serious illness is high.
    • Asthma: not the highest risk of the chronic disease populations, but still increased risk of getting sicker if asthma not well controlled; we therefore recommend any child with persistent asthma be on their controller inhaler to help keep lungs healthy should any exposure occur.
  2. How to reduce exposure in large gatherings:
    • Wear a mask if you’re 2 years old or older, including sports as tolerated.
      • Ask that caregivers, teachers, coaches wear a mask.
    • Socially distance (6ft+) – much more difficult for young children/toddlers.
      • Ask if smaller class sizes are an option.
    • Wash hands often, 20sec with soap and water or 70%+ alcohol based sanitizer.
    • Avoid touching mouth, nose, eyes.
    • No shared food. Snacks should be individually wrapped if brought in in bulk for sharing.
    • Bathe your child and wash their clothes (and mask if fabric) immediately after returning from larger gatherings.
    • Ensure daycares and schools are sanitizing well and often, utilizing toys and teaching tools that are easy to sanitize (ie not stuffed or fabric), not allowing shared items.
    • Ensure that there is a systemized screening protocol in place.
    • Screen people yourself (ie ensure no one you’ll be around has been ill with fever, cough, diarrhea, rash, COVID19, etc in the past 14 days) prior to group interaction.
    • If you decide to travel:
      • Via airplane: wear a mask, wipe down hard surfaces with disinfectant wipe, monitor self closely x 14 days once returned to ensure no one develops symptoms. Strongly rec wearing mask for all excursions outside home in this period as well to ensure no covert spread of virus prior to symptom development should they occur.
      • Via car: practice same precautions you would here in Wisconsin, ensure mask on in public places, social distance. It’s never a bad idea to do the same as via airplane travel and wear a mask for all excursions outside home x 14 days after return to ensure no covert spread of virus prior to symptom development should they occur.
    • Ensure if you go to the beach, a family BBQ, etc. you practice social distancing and wear a mask; this is to ensure you don’t inadvertently bring coronavirus back to daycare or school. Protecting yourself and your family outside of larger groups will mean more security and safety for those your children will be around when back in larger group settings.

Drs. Rhonda Boldt, Patrick Fuller, Julie Fuller, Sarah Hambrook, Jill Bresnahan, Jennifer Twente, Bridget O’Brien, and Perry Krumenacher.