When Can I See My Grandkids?

The pandemic has separated many grandparents from their grandchildren. Here’s advice for safely reuniting your family’s oldest and youngest generations.

Grandparents have had enough. They want to see their grandchildren.

A life in seemingly endless lockdown and isolation from grandchildren is not how grandparents want to spend their golden years. But adult children don’t want to risk exposing an older, more vulnerable generation to the new coronavirus during a family visit. The Centers for Disease Control and Prevention reports that eight out of 10 deaths from Covid-19 are in people aged 65 and older.

But a healthy life is more than just physical health. Loneliness is also a general predictor of decline and death in people over 60. As reality sets in that pandemic living will be measured in months and possibly years, grandparents are asking, “How can I safely visit my grandchildren?”

“This is a tricky one because older people are particularly vulnerable to this virus,” said Julia Marcus, an infectious disease epidemiologist and assistant professor in the department of population medicine at Harvard Medical School. “Of course the safest approach is to avoid any interactions with grandparents, but that won’t be sustainable for everyone, and there are important ways to minimize risk if people do choose to see older relatives.”

“What I would consider quarantine and what other people would consider quarantine are often different,” said Shan Soe-Lin, a lecturer at the Yale Jackson Institute for Global Affairs and managing director at Pharos Global Health Advisors, a nonprofit global health firm in Boston. “One of the gold standard questions is, ‘How many people have you come into contact with over the last week, or over the last month if you can remember that far back?’ I think that’s a clear test question. Everyone says that they are being super careful. Nobody self-evaluates as being completely reckless.”

So as a first step, think about human contacts, big and small, by every member of the household. How many times did someone go to a store? Did you meet up with a friend for a walk? When you jog, how close are you to other runners? At the park, did your children run up to another child before you could stop them? Is a teenage boyfriend dropping by the house? Do you always wear a mask? Do your children?

“If you’re a family and you have some leakage in your quarantine protocol — if you had to go to the grocery store, for instance, delivery people came over, other people entered your house — any time you have a break in that protective bubble I would be extremely cautious,” said Dr. Soe-Lin.

Now that you’ve taken stock, try to seal the “leaks” in your quarantine bubble. While it may be impossible to get your contact risk to zero, you can eliminate the biggest risks (like outside visitors), reduce shopping trips to once a week or less, improve hand hygiene and wear a mask. Once you’re confident in your family’s quarantine vigilance for 14 days, it’s less risky to visit an older family member. But go with a plan.

The safer strategy is to spend time together outdoors — the risk for viral transmission outside is far lower than inside. Everyone should wash their hands, and stay at least six feet apart. Some experts suggest 10 to 12 feet if the grandparent is a very elderly person or has a chronic health condition. Even outdoors, everyone over the age of 2 — and not just the grandparent — should wear a mask. Children are more likely to wear a mask if you explain to them that it’s to protect someone they love. “A sneeze without a mask can spread up to 20 feet,” said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. “It’s also the act of speaking — we expel droplets even in quiet speech. The mask really contains a great amount of them. The mask is protecting all of us from each other.” Masks can be removed for meals, but everyone should stay at least six feet apart from the older person. Don’t share food or drinks — it increases the risk of close contact or catching germs from serving utensils and dishes. If you have hand sanitizer, use it often. And avoid touching the face.

Remember, the biggest worry is being in an enclosed space with someone who has the virus but doesn’t know it. Keep everyone outside, if possible. But if a child must enter a grandparent’s house, monitor them and allow it only when the grandparent is outside. Everyone should wear a mask, and sanitize the bathroom after use. If the grandparent is visiting you, designate one disinfected bathroom just for them and keep children outdoors.

Linsey Marr, an aerosol scientist at Virginia Tech who studies viral transmission, said that before the pandemic, her 74-year-old mother-in-law cared for her two children twice a week. Now they meet outdoors for family meals, with everyone keeping their distance.

“We have a long table outside, and she sits at the opposite end more than six feet away,” said Dr. Marr. “We do not pass around dishes. She has not been in our house for months. We’re worried about her. We don’t want her to get sick.”

The Coronavirus Outbreak

• Frequently Asked Questions and Advice Updated May 28, 2020
  

  • My state is reopening. Is it safe to go out? States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

  • What’s the risk of catching coronavirus from a surface? Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

  • What are the symptoms of coronavirus? Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

  • How can I protect myself while flying? If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

  • How many people have lost their jobs due to coronavirus in the U.S.? More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

  • Is ‘Covid toe’ a symptom of the disease? There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.

  • Can I go to the park? Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

  • How do I take my temperature? Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.

  • Should I wear a mask? The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

  • What should I do if I feel sick? If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

  • How do I get tested? If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

  • How can I help? Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

While parents may worry that all these precautions will create too much stress, research shows that even young children understand the concept of keeping people safe, “kind of like how superheroes help save people,” said Dr. Neha Chaudhary, a child and adolescent psychiatrist at Harvard Medical School and Massachusetts General Hospital.

“Parents can explain the need to keep grandparents from getting sick by keeping their body to themselves, staying behind a particular landmark like a sidewalk or set of chairs, and keeping a mask on their faces since germs come from there,” Dr. Chaudhary said. “Young kids generally understand the idea of something bad happening and trying to do good instead.”

Don’t panic if a child breaches the social distancing barrier and gets close to a grandparent. Brief encounters are not a big risk, and you don’t want to create fear in children. But long hugs, cuddles and sitting in grandpa or grandma’s lap are not advised. If both grandparent and child are wearing a mask, a quick hug from a child around the waist or knees, keeping faces as far apart as possible, poses very little risk, Dr. Marr said.

Long-distance visits to see grandparents are more difficult. You should stay in a hotel or rental nearby, not in the grandparent’s house, and still limit visits to the outdoors while wearing a mask. Even if you drive instead of fly, stopping for food and using public restrooms along the way sets your quarantine clock back to zero. It’s safest to quarantine for 14 days before visiting the older person.

Be aware that the risk of being together during the pandemic will change over time. Areas where new cases and hospitalizations are low and dropping may be safer than places where illness is high and on the rise, Dr. Bitton said. Experts say the summer may be your best opportunity to visit with older family members in many states, partly because you can spend time together outdoors, but also because a surge in cases is expected in the fall and winter, when stricter quarantines may be recommended for the most vulnerable.

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By Tara Parker-Pope, New York Times