When COVID-19 first hit the U.S. full force in March, we were all resigned to lock down for weeks forgoing in-person visits to anyone outside of our immediate household. Now six months in, many of us are thinking, what now? Should I avoid seeing my elderly parents or cancer-stricken cousin a few states away? After all, infections are steady or rising in many states, including Maryland. But is it realistic to have no family or friend visits for a year or two?
This is clearly a difficult dilemma and one that should likely involve a call to your loved one’s doctor to determine their own individual risks.
As an infectious disease doctor and health care epidemiologist, I have spent the past several months trying to stamp out the spread of COVID-19 infections in nursing homes. I also recently found myself facing this very personal question: Is it safe to see my 85-year-old mother who lives nearby in an independent senior living facility?
In July, my mother very much wanted to celebrate her 85th birthday in person at my home. Due to her age, she is at substantial risk of experiencing severe complications from a COVID-19 infection — as are the other residents in her independent living facility. I knew in my scientific mind that a video-conference party would be safer for her, but I gave way when she persistently asked to celebrate her life with her children and grandchildren. The party was worth a lot to her and she was willing to take the risk of a severe infection.
My sister and her family joined our household for an outdoor celebration in my backyard, totaling eight family members. My first challenge was getting my mother to my house. I opened all the car windows on the drive and my mother and I were both masked. I took the shortest route home to reduce travel time.
At the party itself, masks were worn by all, including when we were outdoors, and we stayed more than 6 feet away from anyone not living in our household. My 25-year-old daughter dubbed herself the “mask and distance police." My mother ate in the dining room by herself and the rest of us ate outside at separate family tables. My brother in California sat virtually at the table with Mom.
More than three months have gone by and mom is healthy and free of symptoms. Since then, she has been coming over for outside visits on our deck most weekends.
The practices I outlined above are smart methods for lowering infection risk if you visit with someone locally who is vulnerable to COVID-19 complications. What if you want to see your elderly parents or high-risk loved one who lives in another state or even another country?
Should you get tested before a visit? Quarantine for 14 days beforehand? Is it possible to stay in their home, or do you need to stay in a hotel?
These are very complicated questions, but as a public health expert, I would say that it is possible to visit your out-of-town elderly parents or friends assuming that:
- You are not limited by any travel restrictions put in place in that state.
- You have determined to the best of your ability that you are not infected with COVID-19.
In nursing homes, we need to be sure that newly-admitted residents do not have COVID-19 before they interact with other residents. To do this, we assure they test negative right before admission and then we quarantine them in the nursing home for two weeks. After 14 days, the incubation period of the virus, we test them again. A negative test means they can interact with the other residents. Similar precautions should be taken before visiting any high-risk relative or friend.
If you live in a household where others are not quarantining, make sure everyone wears a mask indoors when in the same room. Eat and drink alone and remain physically distant from people outdoors. Avoid new people and crowds, including trips to the supermarket and drugstore.
Get retested at 14 days. If both the initial and final tests are negative, you are safe to visit with, again, certain caveats. You need to be very careful not to get infected when you travel.
Driving in a car alone is safest. You can also stay safe during air travel if you avoid crowds and wear your mask the entire trip. When you get to your destination, you can stay in your loved one’s home, but should follow quarantine precautions.
We need to find safe ways to be in touch with our friends and relatives while COVID-19 treatments and vaccines are being developed. This is not the time for complacency. None of us wants put our loved one’s health in jeopardy by our lax practices.
Dr. Mary-Claire Roghmann (Mroghmann@som.umaryland.edu) is a professor of epidemiology and public health and medicine at the University of Maryland School of Medicine and a VA staff physician and health care epidemiologist at the VA Maryland Health Care System in Baltimore.