It’s recommended that COVID-19 cases remain on a steady decline for 14 days before having areas relax the stay-at-home orders. The reason for declining cases is that public health systems can start to quickly identify new cases and do contact tracing to prevent further spread. The challenge is that one area may have a decline while a neighboring area may not have met the criteria for declining cases. And, if one area opens up while the neighboring area does not, you still have issues around people traveling between areas and being a source of COVID-19 spread.

As you evaluate going out in public again, my advice is to be conservative. Go slow with decisions to re-enter into day care, summer camp and other basic things we do in life. It will take about two weeks or more to see how COVID-19 spreads after an area makes a change.

When I assess for any in-person activity for my family, there are a few things I take into consideration. Here are some questions to consider:

  • Does my child have any underlying conditions that make them more at risk than other children?
  • Do I have people in my home (or myself as a parent) who have underlying conditions that put them at higher risk?
  • What plan has the organization shared about how they’re actively working to reduce the spread of COVID-19?
    • Has the organization developed a plan to “make it easy to do right and hard to do wrong” when it comes to the prevention that we know reduces the spread of COVID-19?
    • Knowing the age of your child and how they act at home, has the organization created plans to support social distancing, hand-washing, eating separately and not buffet style, use of bathrooms, etc.?
    • Are masks required? Masks are recommended to help prevent the spread of the virus since a large proportion of COVID-19 transmissions are from people who had no symptoms when they infected others.
    • If the organization is indoors, how are they handling the air filtration?
  • How has my community been responding? Do I see lots of testing for COVID-19? Could I or my child or a family member easily get a COVID-19 test if needed?
  • Do I feel confident that the organization would handle an outbreak quickly, effectively and appropriately (with prompt contact-tracing notification)?
  • Am I prepared to go back to “stay at home” should the COVID-19 cases rise in my area again?

We all know that we won’t go back to our usual routines, so we will have to start to understand how we will function in the “new normal.” As a parent and pediatrician, I am assessing this daily and currently waiting to see how the slow re-opening is affecting my area.

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About the author

Bridget K. McCabe, MD, MPH, FAAP

Medical Director of Clinical Quality and Informatics at Teladoc Health

Dr. Bridget K. McCabe is a dual board-certified physician and the Medical Director of Clinical Quality and Informatics at Teladoc Health, where she is scaling clinical quality across the national and international network of virtual providers. She also serves as the Executive Medical Director of The Institute for Patient Safety and Quality of Virtual Care, the first Patient Safety Organization dedicated to quality improvement in the virtual setting. She is board certified in pediatrics and clinical informatics, and holds a medical doctorate with distinction in the field of neuroscience and a Master of Public Health in Clinical Effectiveness from Harvard University.

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