Parenting in the Time of the Coronavirus

Keeping your family safe in the face of a pandemic.

Posted Mar 18, 2020

Creative Commons Zero - CC0
Source: Creative Commons Zero - CC0

The newly emerged coronavirus disease (COVID-19) is probably all you are reading or thinking about these days. And for good reason. There is no specific treatment or vaccine available, and we are essentially all susceptible.

We don’t know much about it, except that it is most severe—and deadly—for vulnerable people over the age of 60, or those with pre-existing health conditions such as lung disease, high blood pressure, diabetes, or suppressed immune systems. We also know that if it is allowed to spread as quickly as it can without drastic changes to our daily routines, hospitals will be unable to care for everyone who needs treatment.

It may not be much worse than the seasonal flu for the majority of people who get it, but we all have a responsibility to pay attention and do what we can to help slow down its transmission.

If you’re a parent, you already know that the winter season typically means having a house full of germs that pass back and forth from person to person like a ping pong ball for months on end. This doesn’t just happen in the winter months either: Kids are germ factories.

First, they get sick more often than adults do because immunity requires first getting exposed to each specific pathogen, which takes time. Second, children may shed greater numbers of infectious viral particles into the environment than do adults (Ng et al. 2016; Costa et al. 2010; although a 2003 study of SARS-CoV-1 patients found the opposite Chen et al. 2006). Finally, children are much more resilient than adults, sometimes showing fewer symptoms from first exposure than adults would (as appears to be the case with this new-to-humans coronavirus), and are therefore often guilty of unknowingly spreading pathogens to other people.

In most years, parents might just hold their breath and wait for the cold season to pass by, but in the time of the coronavirus, more people are panicking about what to do and how to stay healthy, especially if they have children at home who could easily catch and then spread the disease. So what do we do?

First, it’s important to understand why children are such copious germ spreaders. One simple reason is that before the age of 7 or 8, children have a poor understanding of what illness is and how it’s transmitted.

According to developmental research, if you asked a 4- or 5-year-old how someone might get sick, they are pretty good at talking about germs (e.g., Legare, Wellman, & Gelman, 2009). But, when you dig a little deeper, they make a lot of mistakes too and don’t seem to understand what germs are or how they spread. For example, many of them think that bad behavior like telling lies might make them sick, and that non-contagious illnesses like cancer, mental illnesses like depression, and even injuries have the same contagious properties as the common cold (Bares & Gelman, 2008; Fox, Buchanan-Barrow, & Barrett, 2010).

It is true that you don’t necessarily need to have a sophisticated understanding of germ theory to avoid people that are sick—the grossness of the coughing and drippy nose might be enough to keep you away. But besides being naïve about how illness spreads, children don’t get grossed out as easily as adults do either.

Preschool-aged children will happily eat applesauce that has been sneezed in by an adult (DeJesus, Shutts, & Kinzler, 2015), or even drink juice that has a dead grasshopper floating inside (Rozin et al., 1986). In fact, children’s disgust responses take a pretty long time to develop, and many kids don’t have adult-like disgust responses until middle childhood (Rottman, 2014). So if you think snotting into a tissue is going to gross your children out just enough to motivate them to stay away from their sick friends or at least wash their hands after playing, think again.

One potential piece of good news is that new research from our labs suggests that we might be able to teach kids as young as age 4 some healthy habits if we give them the right kind of information about germs. Kids don’t really learn much if you just teach them a list of dos and don’ts, like “wash your hands.”

If they don’t understand why they are washing their hands, it just sounds like moms nagging them to do yet another thing they don’t want to do. There is evidence that children who have an understanding of how illness is transmitted engage in health behaviors like avoiding contact with germy toys, likely because they understand why such a behavior is useful.

In our lab, we found that 4- to 7-year-old kids who knew that touching a sick person might make them sick later were the ones who avoided touching the toys of someone they thought might have a cold. Importantly, the age of the child didn’t matter—even the youngest kids who knew that interacting with a sick person could make them sick avoided the potentially sick experimenter’s toys (Blacker & LoBue, 2016). The implication here is that even kids as young as 4 and 5 are capable of learning how germs are spread and using that knowledge to keep themselves healthy; most of them just haven’t learned it yet.

So if knowledge is power, the first thing you can do to protect your kids from the coronavirus is to understand what it is yourself, and how it is transmitted, so you can adopt the appropriate health behaviors and pass on the appropriate information to your children.

The coronavirus, or “SARS-CoV-2,” is a virus that has naturally circulated in bats for quite some time, and only found its way into humans in November or December of last year in China (Zhou et al. 2020). We still don’t know a lot about how exactly it made this jump into humans, but it appears to have happened only once. Since then, it has shown to be quite good at traveling from human to human, with every infected person infecting (on average) 2-3 more people before fully recovering (Kucharski et al. 2020).

Current models project that 30-70% of us are likely to get it over the next year. Hopefully not all at the same time, if we follow social distancing guidelines. The disease it causes, COVID-19, is a respiratory infection like—but not identical to—the flu, spread when the virus, from coughs and sneezes (and possibly feces) of infected people, enters our body through the eyes, nose, or mouth, and attaches to the cells in our respiratory tract. There is also evidence that it can remain infectious in the environment on various surfaces for up to a couple of days (van Doremalen et al. 2020).

We don’t know exactly how easily this happens, how many people get sick when they’re infected, or how many people go on to develop severe disease. The numbers continue to shift as we learn more.

We originally thought children were not heavily affected, because there have been very few deaths in people younger than about age 50. But a new report from China details how young children, particularly infants under 1, can have severe responses to infection, including the need for intensive care in ~10% of cases (Dong et al. 2020).

This study, however, was conducted in China during the early stages of the epidemic, and thus includes many cases from a time when only those sick enough to seek medical care were being treated. That said, it is not unwise to treat this disease as something that could potentially land your kid in the hospital—possibly at a time when respirators are in short supply.

That’s the bad news. The good news is, now that you understand what the coronavirus is and how it’s transmitted, there are steps you can take to keep your children and other people safe.

First, we know that the virus that causes COVID19 is pretty fragile, and is easily destroyed with a bit of soap and water, alcohol-based hand sanitizers, or generally any cleaning supply you can throw at it. So, cleaning commonly-used surfaces and washing hands often are basic steps that help limit your risk of infection if you come into contact with a sick person.

Another bit of good news is that national and local governments are (finally) pushing for social distancing measures (and economic means to respect them) which help with the most surefire protective action: limiting your chance of coming into contact with a sick person. Even if you are not in a risk category for serious disease, you may be able to spread it without showing very many symptoms (Li et al. 2020).

This means no more parks with large groups of other families, and playdates should be either virtual or arranged on an exclusive basis with one other child/family. If a family interacts with multiple families, the effective group size goes up and this defeats the purpose of social distancing.

Further, because children are thought to be largely free of obvious symptoms, they should be kept away from vulnerable populations for the foreseeable future if in constant contact with other people, such as going to the store, or if someone in the household is a healthcare worker. Otherwise, after 14 days of isolation, children should not be at any greater risk to vulnerable people than adults.

It’s going to be an obvious challenge to explain these things to your children and get them to take measures on their own to keep themselves and everyone around them safe. If we’ve learned anything so far, it’s that kids are not likely to do these things on their own, and if you just tell them to wash their hands, they may not always follow through.

So when you explain these risk prevention measures to your children, try to articulate why these behaviors are so important; talk to them about how illnesses might get transmitted, so they can flexibly apply what they know to new situations. Talking to them about viruses like the coronavirus and how they spread might be one effective strategy in promoting healthy behaviors, giving kids the opportunity to play an active role in keeping themselves and others healthy in the face of a pandemic.

By Vanessa LoBue and Guest Blogger Jessie Abbate. 

Guest Blogger, Jessie Abbate, Ph.D. is a post-doctoral research scientist who studies the ecology, evolution, and epidemiology of infectious diseases, including emerging human pathogens.

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