2020 has been a scary year. Especially for kids.
They have had school canceled, endured extreme social isolation, been told visiting their grandparents could kill them and robbed for eight months of many of the experiences that define childhood.
The Centers for Disease Control and Prevention labels traditional trick-or-treating a “higher risk activity,” a rather perplexing epithet given its nature and given what we know about transmission of COVID-19.
Trick-or-treating is conducted outdoors and defined by brief, casual contact. Surfaces (like candy wrappers) are not a significant source of spread. Compared to activities such as going to the grocery store, attending church and attending class in-person, trick-or-treating seems the safest on a long list of things many of us are already doing again.
With proper precautions in place, it could be a flash of normalcy for kids who are navigating a world upended.
Dr. Suzanne Whitworth, director of pediatric infectious diseases at Cook Children’s Medical Center, says it’s too soon.
“Now is not a good time to increase face-to-face contact like the actual walking up to the door,” she told me.
But kids can still enjoy the season by celebrating through less risky, low-contact events, like pumpkin carving at home, or having a virtual costume contest (because we all need more Zoom in our lives).
When asked how she squares this advice with the fact that kids are back in school in person, indoors, all day long — far riskier by any CDC standard — Whitworth said that schools have undergone months of careful planning and have controlled environments. I expect some parents would beg to differ.
Her approach to Halloween festivities isn’t unexpected. Many public health officials still favor extreme measures, applied broadly, in response to the coronavirus.
But we’re eight months into the pandemic, and the constant refrain that all human contact beyond our households is dangerous is beginning to lose the ring of truth.
Especially when the emerging science, particularly as it relates to children, suggests it might be better for everyone if we change our approach.
There is abundant evidence from studies all over the world, that children are less likely to spread the disease. Still more encouraging are the data that show that when kids contract COVID-19, they are not getting very sick.
“If we narrow the focus of this disease to pediatrics, then there has been very little serious disease, and relatively few deaths,” said Dr. Steven Krebel, who has practiced pediatric emergency medicine since 1995.
Indeed, the flu is far more deadly to young kids, yet we don’t cancel school — or Halloween — for flu season.
And because we have kept kids from interacting with each other, we have prevented them from developing immunity to the coronavirus, something Krebel says we have not done before.
“We are choosing to not allow the normal process of herd immunity to occur,” he said.
And the science and emerging evidence does not support such measures in the pediatric population.
That has implications for adults, too. When healthy people (including kids) develop antibodies, they protect more vulnerable populations from getting sick. One could reasonably argue that healthy kids contracting COVID-19 and recovering is actually good for grandparents.
Of course, no child is an island (despite our efforts to make them such), and Krebel acknowledges that kids in households with someone in an at-risk population need to take extra precautions.
But given how our understanding of the disease has evolved, he wonders if it’s time to “seriously consider allowing life to return to normal for those individuals who are shown by the epidemiological data to not be at risk for developing serious illness from the disease or putting vulnerable people in their households at risk.”
Normal, by any standard, should include trick-or-treating.
To that end, he suggests a compromise approach that includes all the things that have already become second nature — social distancing when possible, hand-washing and wearing masks.
But don’t cancel Halloween.