On June 15, Mayor Muriel Bowser (D) joined President Joe Biden in inviting the nation to celebrate July 4th in Washington DC. The invitation was issued only days after mask mandates and capacity limits had been fully lifted in the District.
Resident and visitors will attend parades, fireworks, cookouts and gatherings to celebrate the holiday. “This years Fourth of July celebration is significant to District residents,” said Acting Deputy Mayor for Public Safety and Justice Christopher Geldart at a July 1st press conference on hoiday safety. “It represents a return to normalcy we have long awaited since the beginning of public health emergency.”
For many, this is true. But the public health emergency is not over. While most of the District’s residents have been vaccinated, children under 12 cannot receive the vaccine, leaving many families confused about best practices.
So how safe is it to bring your unvaccinated child to these holiday gatherings? How can you protect them as the city unmasks around them?
Kids Do Get COVID
Children do get COVID. To date over 4 million kids that have contracted the disease, resulting in over 18,000 hospitalizations and just over 300 deaths.
While children tend to have more mild disease with either very few or no symptoms, they are able to transmit the disease to other kids as well as other adults, said Dr. Tina Tan, professor of pediatrics at the Northwestern University Feinberg School of Medicine and a member of the board of directors of the Infectious Diseases Society of America.
Health officials are warning that the Delta variant of the COVID-19 virus is more than 60 percent more contagious than previous variants like Alpha, let alone the orginal version of the virus. Delta could become the dominant strain in the DMV, where it has been detected since late June.
“Basically it [Delta] has the same symptoms and the same findings as the regular variant or the other variants that we’re seeing,” said Dr. Tan. “However, there is some indication that it may lead to a higher rate of hospitalizations and complications –in anyone –and we know that the Delta variant now is being seen here in the United states in the pediatric population.”
While information is still evolving, pediatricians say the presence of the Delta variant amps up the danger for children, said Dr. Sarah Schaffer DeRoo, a pediatrician at Children’s National Hospital. “The fact that children are unvaccinated makes them more vulnerable, of course, because as society opens up and mask mandates are lifted, it puts children at higher risk,” she said.
Dr. Schaffer counsels caution, encouraging families to use discretion with children while out in public, noting that little is known about the long-term consequences of the virus in children.
“We don’t have any experience in the past. We [only] have about a year and a half of evidence to go on,” Dr. Schaffer said. “I worry about the risk of hospitalization and death that is small, but real. And when your family has that one child that’s affected, your risk becomes 100 percent.”
But does that mean you should leave your kids at home this July 4th? Not necessarily, say the medical professionals. But you do have to weigh the risk, both in your own household and in any given situation.
“Unfortunately it feels like a lot of the [CDC] guidelines leave families out of the decision-making,” Schaffer said. “Cities are reopening, but the American Academy of Pediatrics (AAP) essentially recommends the same rules from before mask mandates were lifted, unchanged. That has left many parents scrambling.”
Dr. Tan said that establishing general guidelines is difficult because best practices can depend on the situation —what a family needs and where they plan to be.
However general advice for a given situation boils down to a consideration of the space and the number of people in it. Will you be indoors or outdoors? Can you maintain social distance? Will others be masked? Do you know [no, really know] the vaccination status of others that are present?
A problem, Tan said, is that in most jurisdictions, mask mandates have only been lifted for the fully vaccinated. “But people take advantage of that all the time,” Dr. Tan added. “You don’t know who in the community is vaccinated and who’s not.”
Precautions at the Parade
So families need to weigh the risk for themselves when deciding if they attend a 4th of July parade. Being outdoors at a parade is better than being indoors, Dr. Tan said, because transmission is lower. Still, she advises parents to mask up kids in large crowds outdoors where social distancing is difficult or impossible, including in the crowd at a 4th of July parade.
“I would say that anytime you know you’re going to a place where that there is a potential for large crowds to be, that it would be much safer for an unvaccinated person to wear a mask,” she said.
Dr. Schaffer agrees, and adds that parents should not only consider what they should do, they need to consider what their family —and their child— are actually going to do.
“I think that parents really need to use their best judgment. Is the personal distancing something that is possible?” asked Schaffer, herself the parent of a four-year-old. “Is it something that they can maintain knowing their own children and their behaviors? Is masking something that they’re able to do if they’re in public spaces?”
Parents will have to ask themselves similar questions when a child is brought indoors where the vaccination status of others is unknown, such as into a restaurant or busy store. “We know that transmission definitely is much more likely indoors if somebody’s infected, especially in more enclosed areas. So those areas people should be wearing a mask,” Tan said.
Risk Not Lower
As they wait for the COVID vaccine to become available to the under-12 set (estimated to be in the last quarter of 2021) Dr. Tan reminds parents to get their children up to date on all the other vaccines. “You don’t want to have vaccine preventable disease outbreak in addition to COVID,” she said.
“I think people are getting a false sense of security, [similar to] last summer, where we saw a drop in COVID rates and then towards the end of the summer we saw the rates go up,” the professor of pediatrics said, saying that case rates were something the health community is closely watching.
“I think the most important thing to realize is that COVID’s not gone,” Tan added. “It’s still there in the community, and all these people that are refusing to get vaccinated only allows this virus to spread more rapidly, and the more that it spreads the more that it can mutate.”
While it may seem unfair for parents to place these constraints on their children while the (presumably) vaccinated adults go without, the experts say that children understand this better than adults often think.
Both doctors agree that the situation can be explained to children as young as 4 or 5 years of age using simple, developmentally appropriate language. Be honest, clear and consistent about the situations and public places in which children must be masked and socially distanced. “If you’re consistent with the “rules” then I think that children will continue to adapt readily,” Dr. Schaffer said.
“The children that we have seen are incredibly adaptable,” assures Dr. Schaffer. “They wear masks and forget about them –for the most part they are better than many adults I see at wearing their masks.”