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This pediatrician says no coronavirus break playdates

Steve Silvestro, MD
Conditions
March 16, 2020
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Strange times right now, huh?

The spread of COVID-19 is expected to be massive because the virus is sneaky

I live in Maryland, and our schools are shut down statewide due to coronavirus (COVID-19).

That means that since I’m a pediatrician, I’ve been peppered with questions from patients, family, and friends wondering what they’re going to do with the kids for at least two weeks (and, realistically, probably four or more).

They’re all asking about one thing—coronavirus and playdates.

When the world is shutting down to prevent the spread of a pandemic disease that risks infecting 40-70% of the human race in the next 12 months, can other families still come over to play?

My answer is a resounding “nope.”

It’s not an answer any of us parents (and I’m one, too!) really want to hear, but it’s the right answer. And those who follow my podcast and blog know that I’m usually one to play things down, to quiet the alarms—but not this time.

Here’s why:

Spread of COVID-19 is expected to be massive because the virus is sneaky

There’s a reason governments and medical experts are freaking out about this virus—even while we’re telling you that the average person’s health risk is really low.

COVID-19 is expected to spread so widely across the world, that even though most people will be just fine if they catch it, we may still have millions of people who die.

How?

To understand this and why playdates are a no-no, you’ve got to know why COVID-19 spreads so easily:

  • This is a new virus, so we don’t have great natural defenses against it
  • Many people can have mild or even no symptoms—but can still infect others
  • Even when you do develop symptoms, you’re usually contagious for five days before you feel sick—which means you’re contagious before you know you have it
  • The average infected person infects 2 to 4 others
  • The number of infections in an area multiplies by ten every 16 days
  • Mortality rates are low-“ish.” Ebola kills up to 90% of the people who get it—so while it’s a terribly deadly disease, killing most of its hosts means it’s harder to spread so widely. COVID-19 kills 0.6 – 4% –just enough to be bad, but far too few people to keep it from spreading.

Because of these easy-to-spread factors, Harvard epidemiologist Marc Lipsitch expects 40-70% of the world population will have been infected with COVID-19 within the next 12 months. In the U.S., the CDC expects as many as 214 million Americans will be infected during this pandemic.

Why we care even if most people will be fine

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And yet, if you are young and healthy, you’re likely to be fine if you catch COVID-19. You might have no symptoms, you might get common cold symptoms, or it’ll feel like a really bad flu—but based on what we currently know, you’re likely to come out the other side okay.

So I’ve been telling my friends that for most people, your individual health level of worry should be minimal.

However, I’ve also been saying that the governmental/institutional/health expert level of worry is all hands on deck.

Why? Besides the human aspect of anyone’s death being a tragedy, we experts are also freaking out because of numbers.

Because we’re expecting 40-70% of the world population to get sick, even if only 0.6% die from COVID-19, that’s still millions of people. In the U.S. alone, the CDC’s predictions are that between 200,000 and 1.7 Million Americans will die from this.

That’s a big deal.

So again, we health experts and communicators are trying to walk the line of letting folks know that most people shouldn’t personally panic, while we also need to be sounding alarms and taking drastic steps as a society to prevent such an unthinkable tragedy.

We didn’t close schools so we could all hang out together anyway

So how does this all apply to playdates?

When COVID-19 first hit our shores, we tried “containment”—isolating people who had the illness. For a whole host of reasons (mostly institutional and political failures), this didn’t work well enough.

Now we’re on to “mitigation”—which you’ve probably seen in your Facebook feed as “social distancing.” The idea here is that now that this virus is out in the community and we have no medical way to prevent its spread, it’s up to us to keep far enough away from other people that we decrease the odds that we’ll get sick.

And remember, because many people can be contagious despite having no or mild symptoms, “social distancing” doesn’t just mean avoiding people who cough—it means staying a safe distance away from other people, period.

Making matters worse is that we know that the COVID-19 virus has a half-life in the air of 2.7 hours, and as long as 15 hours on some surfaces. A half-life is how long it takes for half of something to go away, and we say that it takes three half-lives for something to be mostly gone. That means COVID-19 can be found in the air for 8 hours, and on surfaces for 45 hours!

So again, back to playdates …

All of this basically means that in order to not have this sneaky, easily caught, deadly enough virus spread to 70% of the population, we need to spend time with our own germs and only our own germs.

Schools, businesses, and large gatherings are shut down for this very reason.

Having a playdate—even if it’s a small one—defeats the purpose of everything shutting down.

If your family of four has another family of four coming over for a playdate—and that family had another family of four over just yesterday—you’re not now exposed to only four people’s germs, you’re exposed to eight. Worse still, let’s say your kid’s friend’s mom went grocery shopping before coming over and stood in line with twenty people. Now your primary and secondary exposure is to twenty-eight people’s germs—a whole classroom.

This sounds very alarmist and a little bit absurd, I know. But remember—any of those people could be contagious with mild or no symptoms (not to mention the guy hacking up a lung in the checkout line).

We’re not in normal times right now—we’re in a pandemic scenario. Alarms are already going off. Now we’re trying to stop hitting the snooze button.

My recommendations for playdates

So what am I telling my friends, family, and patients now that our state has closed schools?

  • No indoor playdates
  • No crowded indoor activities (bounce houses, gymnastics, etc.), even if they’re still open
  • No outdoor playdates on playground equipment (remember, 45 hours for three half-lives for the virus to leave the surface)
  • No outdoor playdates for kids who are prone to dog-piling and wrestling
  • Outdoor playdates otherwise likely okay for general play—at least for now
  • Avoid crowded outdoor activities (ice skating rinks, etc.)

If you’re still set on getting together, here’s my suggestion: Pick your best friend’s family. If you can trust them and they can trust you, agree that your families will only hang out with each other. This way you’re at least minimizing possible exposure.

The greatest generation

This isn’t how we want to live. I know—me neither.

But this isn’t the time to get what we want. We’re in the midst of a worldwide, life-threatening pandemic—and we need to pitch in 100% in order to save lives.

The generation who lived through World War II—our parents, grandparents (and for some reading this, great-grandparents!)—we call them “The Greatest Generation.” We don’t give this honorable title just to those who fought in the war. We use it to describe everyone in that generation, because they all pitched in to “the war effort” whole-heartedly. It didn’t matter what a person’s own individual risk was. A family in Ohio had little chance of being bombed by the Nazis—but they grew victory gardens, rationed food, and stopped driving to save gas. Individuals acted as one, united in an effort of sacrifice for the greater good.

This may be our “Greatest Generation” moment. And playdates? Let’s hope that’s all that’s asked of us.

We hope it will only be a few weeks, but we can’t be sure it won’t be longer. We’re social creatures, especially our kids. So it is important to find ways to make the best of this once-in-a-lifetime situation. Stay tuned to this space for ideas for things you can do with your kids to keep them active, happy, learning, creative, and growing as people during these next few weeks.

We got this—together.

In the meantime, be well, find the fun, and wash your hands.

Steve Silvestro is a pediatrician and host, The Child Repair Guide Podcast. He blogs at his self-titled site, Dr. Steve Silvestro.

Image credit: Shutterstock.com

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