As the long pandemic summer comes to a close and many parents are desperate for life to return to at least some semblance of normal, experts and public health officials have noted an increase in some families beginning to engage in social activities that seemed too risky back in the spring.
“There is definitely more chatter and comfort with play dates these days,” said Dr. Nina Shapiro, a pediatric otolaryngologist at the David Geffen School of Medicine at U.C.L.A. “I also see more groups of families with kids out in my neighborhood and hear some large group parties going on in people’s backyards.”
While reports of new coronavirus cases are down in many parts of the country compared with where they were over the summer, data released on Sept. 17 by the American Academy of Pediatrics and the Children’s Hospital Association suggest a worrying trend among children: the infection rate has increased by 56 percent since the beginning of August. (Experts noted that at least some of that increase may have been because of increased testing, though, and some states define “children” as those as old as 20.)
Public health officials don’t yet know exactly how small gatherings like play dates and informal family get-togethers have been contributing to Covid-19 spikes nationwide. There simply isn’t enough solid data. But some cities and states including Chicago, Los Angeles, Maryland and Michigan have noticed a connection.
On Sept. 1, Gov. Kate Brown of Oregon announced in a news release that she was extending Oregon’s state of emergency until November, in part because “small social get-togethers like barbecues and family celebrations have fueled wider community outbreaks in counties across Oregon.”
In a news conference on Aug. 31, Jan Malcolm, Minnesota’s health commissioner, pointed to informal gatherings as a source of recent spread there as well.
And on Sept. 9, Dr. Allison Arwady, the commissioner of the Chicago health department, said during a phone interview that the majority of spread was happening within households and via small household gatherings, “like the play dates,” she said.
“People, understandably, are feeling a little more comfortable from a Covid perspective,” said Dr. Arwady. “They are getting back together with neighbors and extended family and really expanding their bubble.”
But experts warn that even when around close friends and relatives, people still need to take precautions. “Somehow we have it in our mind if we’re gathering with our close family, there’s not the same disease spread risk that there is in public places,” Malcolm said during her news conference. “That is just not the case.”
It’s challenging to spot a sick kid
Janna Diorio, a mother of two from Jacksonville, Fla., said that she has noticed other families starting to regularly socialize again, especially since schools have reopened. “It’s like going to school opened the floodgates,” she said. Recently, driving past a small local park, she noticed about five times more parents and kids playing together, without masks, than she had a few weeks prior. “The local mom Facebook pages are just request after request for play dates and playgroups,” she added.
Paul Guinnessy, a father of a 10-year-old who lives in Silver Spring, Md., also said he has noticed more families congregating recently, even though all public schools in his county were closed and doing remote-only learning. Earlier in September, a neighbor told him that she and other parents of first graders were getting their kids together to enjoy recess outside.
One potential health risk of such gatherings is that many children with Covid-19 don’t have symptoms. And when they do, it can be hard to tell if their symptoms were caused by the coronavirus. A study of 91 children in South Korea, published on Aug. 28 in JAMA Pediatrics, for instance, reported that 42 percent of the children who tested positive for the coronavirus were asymptomatic at the time. Families may join get-togethers without even realizing their kids could spread Covid-19, and potentially pass it on to higher-risk family members like grandparents.
Additionally, the percentage of Covid-19 hospitalizations involving kids in the U.S. has been increasing steadily, from 0.8 percent of total hospitalizations in May to 1.7 percent in mid-September, according to the A.A.P. and Children’s Hospital Association data.
“The fact that children are now making up a larger percentage of overall hospitalizations suggests to me that relative to the general population, more kids are getting infected,” said Dr. Sean O’Leary, a pediatrician and vice chairman of the A.A.P.’s committee on infectious diseases.
Some of those kids could have gotten infected in classrooms that have reopened, he said, but “it’s still not clear how many of those came from outside versus spread within schools.”
How to gather safely
Though it may seem counterintuitive, large, formal settings are often safer than small, informal ones, because they typically require people to follow stringent rules to minimize risk, said Dr. Arwady.
At school, for instance, “even though the kids are in the classroom, their activities are very much prescribed,” said Dr. Ellen Wald, an infectious disease pediatrician at the University of Wisconsin School of Medicine and Public Health. They are typically required to wear masks and sit at desks spaced six feet apart.
In Chicago, Dr. Arwady said, only about 5 to 6 percent of recent cases have been linked to crowded settings like large workplaces and long-term care facilities. Few are also coming from large events such as protests or religious services. The city even ran some in-person camps this summer, yet few children got infected, because strict protocols were in place.
Yet the opposite is often true when people get together casually. With friends and family, we relax; we take off our masks and aren’t as strict about policing our kids’ social distancing. But this isn’t a good idea, Dr. Arwady warned. “I think the settings where people are now feeling safe are the settings where the risk is, in many ways, actually highest,” she said. And if kids who get infected at small gatherings then go to school, they risk spreading it to their classmates, teachers and other school staff.
This doesn’t mean that families must lock themselves in the house for the rest of the year. But it is important for them to follow public health guidelines at all times, said Dr. O’Leary, even when meeting up informally with friends and family (unless they are participating in true pandemic pods, in which families socialize with one another and no one else).
Whenever possible, hold social gatherings outside, Dr. O’Leary advised, and make sure everyone wears masks, especially if they cannot stay at least six feet apart. If you have to be inside, the Centers for Disease Control and Prevention suggest maximizing ventilation by opening windows or doors and having everyone wear masks and, again, keeping at least a six foot distance.
“Kids need to socialize, don’t get me wrong,” Dr. Arwady said. The goal is to “make sure that kids are getting the things that they need for their emotional development, for their mental health, but in ways that keep risk relatively low.”
Melinda Wenner Moyer is a science and health writer and the author of a forthcoming book on raising children.
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