Parents suffer whiplash. After two years of pandemic restrictions, several states — including California, Oregon, Illinois, Delaware, New Jersey, Connecticut and New York — announced they would end indoor mask mandates. In some cases, this includes relaxing mask requirements in schools.
In this context, the US Food and Drug Administration has said it will delay the authorization of the Covid-19 vaccine for children under 5 years old. And while coronavirus cases are declining, they remain at a high level in much of the country.
What should parents know about Covid-19 safety for their children? Can activities such as play dates, dance lessons and movie going resume? If masks become optional at school, does that mean your kids have to take them off? What about children who are worried about the coronavirus and are not ready to stop certain precautions? And what is the advice for parents of children under 5?
For this updated parent’s guide, I spoke with CNN medical analyst Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and a mother of two young children.
CNN: Seems like there’s been a sudden change over the past two weeks. Have circumstances really changed so much when it comes to Covid-19 safety for children?
Dr. Leana Wen: I think there has been a marked change, although I would say the change started in November when vaccines were first licensed for ages 5-11. Children who were vaccinated as soon as they became available were fully vaccinated in time for winter vacation. The hope was that they and their families could have a fairly normal Christmas, New Years and other winter celebrations.
The problem was that the Omicron variant appeared just before the holidays. In many parts of the United States, it has grown rapidly and overwhelmed hospitals. Children did not have time to enjoy the normality that vaccination promised to bring. When Omicron first arrived, we also didn’t know how well vaccines protected against it.
Now we know that vaccines work well to protect against serious diseases caused by Omicron. Cases are also declining rapidly in most communities. This is why many elected officials, many of whom have been very cautious about mitigation measures, have announced an easing of restrictions. I think they are right to do so, because things have changed a lot in a short time.
NC: Does that mean parents can safely have indoor play dates and take their kids to the movies now? What about indoor dancing, soccer, choir, swimming, and other extracurricular activities that some families have postponed?
Magnifying glass: This is an important question to consider. Just because restrictions are lifted doesn’t mean everything is suddenly safe. Covid-19 infection levels are still quite high in many communities that are ending mitigation measures. The measures required by the government are coming to an end, but that does not mean that individuals have to make all the risky choices. There are many things we could do that are risky, but we don’t always choose to do.
Almost everything we do carries some level of risk when it comes to contracting Covid-19. The question every family should be asking is: how much do we want to continue to avoid the coronavirus? And what price are we willing to pay for it?
Many families will decide that they have already done all they can and are ready to do. If everyone in their household is vaccinated and boosted when they are eligible, it would be reasonable to decide that they will no longer restrict their children’s activities. For a vaccinated child, the risk of serious illness from Covid-19 is very low. Many parents would no longer want their children to give up activities and would like to resume indoor games, movies and all extracurricular activities.
Others will still want to be cautious. They may be concerned about the possibility of long-term symptoms from Covid-19 infection. Perhaps they live with someone who is immunocompromised or otherwise vulnerable. They could decide on a case-by-case basis to reduce the risk as much as possible while trying to keep the cumulative risk low.
For example, they may keep play dates away unless the other children are also all vaccinated. They can allow their children to go to the cinema, but require them to wear a high quality mask (N95, KN95, KF94) all the time. They can ask their children to choose the sport(s) or extracurricular activity they like the most and cut out the least valued activities.
The fact is, families will make different choices based on their medical situation, risk tolerance, and the value of getting back to normal. In a way, it’s no different than many other decisions families make, using criteria that are unique to their individual circumstances.
CNN: If masks become optional at school, should kids wear them or take them off?
Magnifying glass: This again depends on each family’s medical situation and their willingness to continue to avoid Covid-19. I would ask another question: what does being maskless mean to them? A younger or learning-disabled child might benefit more from optional mask policies. A child may also not want to mask up because their friends don’t mask up either. All of these reasons are worth considering, bearing in mind that masks reduce coronavirus transmission – especially a high-quality mask.
CNN: What about children under 5 – should they continue to wear masks at school? What about their older siblings?
Magnifying glass: All families, including those with young, unvaccinated children, should decide how important it is for them to continue to avoid Covid-19. Covid-19 infections are not always mild, especially if the child is not vaccinated, and there is always a potential risk of long-term symptoms. Those who want to continue to prevent coronavirus infection should continue to wear masks, and that includes children under 5 and their older siblings. There will be many families who no longer prioritize preventing Covid-19 infection – such as families who may have just contracted and recovered from coronavirus. Under these circumstances, it would be reasonable to resume pre-pandemic activities and forego masks in some cases.
CNN: There are a lot of kids who may not be ready to get rid of pandemic restrictions. What is your advice for them and their parents?
Magnifying glass: First, start by empathizing and reassuring your child that these are completely normal feelings. I think we can all understand how, after two years of living with so many precautions, it’s hard to pull them off.
Second, take it slow and doze off in the more pleasurable activities. Maybe your kid isn’t ready for an indoor maskless birthday party with 50 people. How about getting together with two close friends for dinner or a sleepover?
Third, focus on the positives. If your child missed a sport or activity, how will it feel to start doing something they really love again? If you haven’t been able to travel, will it be fun to go somewhere they’ve always wanted to visit? If you were too busy before the pandemic, consider this opportunity not to add all the activities to your schedule. And continue to check in as a family as you all adjust to this time of transition together.