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ADVICE FOR GRANDPARENTS REGARDING COVID19

Should grandparents visit their grandchildren during this COVID19 outbreak? Here is advice from professionals. We are grandparents and we have not visited our three grandchildren in Austin. And we will not until there is a dependable vaccine. But we now participate in nightly baths with our baby grands via FaceTime and all of us LOVE it! Here is good advice from professionals.

The news on how the coronavirus has been affecting children has been largely reassuring: Most kids who get sick appear to experience only very mild symptoms. Yet as schools and day care centers close, and frazzled parents juggle the need to go to work or to work from home while caring for their children, one question emerges: Is it safe for kids to spend time with their grandparents?

Given what we know right now, the answer is no, said Dr. Cynthia R. Ambler, M.D., a pediatrician at Northwestern Medicine in Chicago. "It appears that children and young adults are an important vector for coronavirus, because they may be infectious even if they don't have symptoms," she explained. As a result, they may inadvertently pass it on to the adults around them. "The research is very clear that people over the age of 60 are more likely to require hospitalization and even die from this virus, even if they're in good health," she said.

A preliminary analysis of the first 4,226 cases of Covid-19, the disease caused by the coronavirus, in the United States, for example, which was published on March 18 by the Centers for Disease Control and Prevention, found that the fatality rate was highest for people 85 or older, at 10 to 27 percent; for people age 65 to 84, the rate was 3 to 11 percent.

The issue of child care is even coming up among parents who work in Dr. Ambler's practice: "We're trying to come up with creative solutions, such as a physician who's not working that day take care of another physician's young children at her home," she said. "That's how strongly we feel about it."

Unfortunately, following this advice isn't as easy as it sounds. About 10 percent of all grandparents in the United States reported living in the same household as their grandchildren in 2018, with 5 percent of them saying they served as the primary caretaker, according to the AARP - a number that may rise for parents who must be at work. Trisha Pytko, mom to 7-year-old Molly, worries that she may have been exposed to the new coronavirus during the second week of March at her job as a high school teacher in Stratford, Conn. "Several of my students came in with bad respiratory-like symptoms but were unable to get tested," she said, adding that a student tested positive at another high school in town. But her mother, who is 66 and has chronic obstructive pulmonary disease, lives with her.

"We're trying to isolate her as much as we can, but it's hard, when we're all in the same house and we're not going anywhere," Pytko said. "It's frustrating, because Molly very much wants to spend time with her grandma and be with her. But until we know for sure that no one was exposed and has the coronavirus, I don't want either of us near her."

Contact-limiting steps are especially important in the first two weeks after school and day care closings, since many people may have been exposed to the virus, said Dr. Cori Cross, M.D., a spokeswoman for the American Academy of Pediatrics and a pediatrician at Children's Hospital Los Angeles. But you should still take these precautions after a few weeks of social distancing, even if you've significantly curtailed your exposure to others. "It's still not absolutely clear how contagious the coronavirus is, and how likely it is that asymptomatic people are spreading the disease," she said.

Here are some tips to keep grandparents - and everyone in your family - safe:

Swap in-person interactions with video chats, if you can

The C.D.C. has very specific guidelines for older adults, which includes avoiding crowds and nonessential travel, keeping a good distance from others and, if the coronavirus is spreading within your community, staying home as much as possible. While grandparents may need their children to help run errands like grocery shopping or picking up medications, resist bringing young kids into their house, even for a brief moment. "Older kids can get the concept of washing hands and staying six feet away, but toddlers and preschoolers will want to run up to Grandma or Grandpa and hug and kiss them," explained Dr. Roberto Posada, M.D., a pediatric infectious disease specialist at Mount Sinai Kravis Children's Hospital in New York City.

Even if your kids can't physically spend time with their grandparents, frequent - even daily - FaceTime or Skype chats are a good idea, Dr. Posada said. "We know that social interaction is important for everyone, especially older adults who may be isolated right now alone in their home," he said. It may also reassure and calm your child to see the same familiar faces every day, even if they're on video. Encourage parallel activities whenever possible - for example, painting or drawing together, or reading to one another.

If you live with a grandparent, take extreme precautions

This may mean isolating grandparents from other members of the household, including limiting them to one section of the home as much as possible, and ensuring that they have their own bathroom, Dr. Posada said. Everyone in the house should self-quarantine as much as possible, going out only for essentials such as groceries or urgent medical appointments. Anytime a parent thinks they need to go out on an errand, they should ask themselves if they really need to do this, or if they can stay at home to prevent being potentially exposed to the coronavirus, Dr. Cross advised.

If grandparents are watching your kids so you can work, make sure you set specific guidelines. Dr. Michael Hochman, M.D., M.P.H., a general internist and the director of the U.S.C. Gehr Family Center for Health Systems Science and Innovation at the Keck School of Medicine of U.S.C., is advising his geriatric patients to keep their distance from their grandchildren every day. Yet he is grappling with this issue himself: His mother and stepfather, who are in their 70s, are still stopping by to check on his three children, aged 9, 6 and 4, while he and his wife work.

"They really want to do it, and our children are so happy to see them, since there have been so many changes in their daily lives right now," Dr. Hochman said. "But we're insisting everyone stay home, and instituted strict hand-washing rules and cleaning guidelines." Both he and his parents also clean and disinfect frequently touched surfaces such as tables, doorknobs, light switches, handles and cellphones, several times a day.

Make sure everyone understands the rules

Both grandparents and grandchildren may be upset and not completely understand why they can't see each other. "It's so hard for very young kids to understand, but you need to say as simply as possible that you need to do this to protect Grandma and Grandpa and keep them safe," Dr. Ambler said. If the resistance is coming from grandparents, gently explain that if they catch the virus, they could become critically ill and even die, which would devastate their grandchildren. She said it might help to liken the need for their distance to a situation in which kids are more at risk for illness, saying, for example, most older adults make sure they are up to date on their Tdap vaccine (which protects against tetanus, diphtheria and pertussis) before seeing newborn grandchildren, to reduce the risk of potentially giving them whooping cough. "If the shoe were on the other foot, most grandparents would give their life for their grandchild," she stressed.

"Explain to them that just as they've taken steps in the past to keep their grandchildren safe, we're now doing this for them, too," she said. "It may be difficult for them emotionally in the short term, but it's an investment in both grandparents and grandchildren having a future together."

Source: Hallie Levine, NY Times, March 20, 2020

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