One of the most difficult aspects of the Covid-19 pandemic is that it is has forced families and friends to miss out on life events. Weddings, birthdays, bat mitzvahs and everything else in between have been canceled or sent to Zoom. Last week, instead of attending a normal graduation ceremony, we drove my oldest around the track of his high school and he was handed a diploma case through a window.
Perhaps no occasion is more painful to miss, however, than the birth of a grandchild. After all, babies only grow, and a missed opportunity to see a newborn can never be replaced.
When the pandemic raged in March and April, little data existed on where and in whom the coronavirus was spreading, so public health officials understandably urged maximum caution. They had good reason to do so. Many people were infected, lots didn’t even know it, and we lacked the testing to know where and who they were.
Things are different now. As hospitalizations decreased and the infection rate slowed in some areas, much of the country has begun to loosen restrictions. While a month ago it seemed impossible for grandparents to meet their latest grandchild, families now want to know if it’s safe — and how to do it.
We will never reduce the risk of infection to zero. But there are steps we can take to minimize risks. If families are willing to follow them, it should be reasonably safe for babies and grandparents to meet each other.
So far, data suggest that newborns are not at significantly high risk complications related to coronavirus. The occasional case report may raise alarm, but, in general, they don’t appear to be getting seriously ill from Covid-19. New moms and dads are at slightly higher risk of serious complications than their children, but unless they have chronic illnesses, few would be expected to be severely affected.
Covid-19 is most problematic in older people (e.g., grandparents) because they are the ones who are most likely to become severely ill or die when they get infected. More than 40% of the people who have died from the coronavirus lived in nursing homes. Even outside of that setting, it is thought that the infection fatality rate (the percentage of people who die from infection) among older adults is significantly higher.
New parents should be mindful that they’re at higher risk of being infected because they just spent a significant amount of time at the hospital. Because of that, most experts I spoke to recommended that parents socially distance with their newborn for at least two weeks and said visits from anyone aren’t safe during that time.
But careful isolation (i.e. quarantine even if you feel well) can make the risks minimal. After two weeks, people can be reasonably sure they’re not infected.
“I would say, self isolation for a new mom, dad, mom/dad, dad/dad or mom/mom for two weeks, then go for it. To be equally safe, grandparents should isolate for two weeks as well,” said Gregg Gonsalves, Ph.D., a professor of epidemiology and law at Yale University.
After that, it’s just logistics.
We don’t want anyone getting exposed on their way to meet each other, so I would not recommend air travel as part of this equation. In general, I’m not yet comfortable with the idea of air travel for older adults. So, ideally, grandparents should drive to meet their grandchildren alone. If they can’t, then bringing the baby to them (again, alone) is best. If it’s a long drive, bring food and drink along, try not to stop and — if you must stop — continue to practice good hygiene (hand washing) along the way.
Don’t plan a party. The group should be held to as few people as possible. Ideally parents, baby and grandparents only; siblings who’ve been isolated along with the family are probably OK too. Anyone else who wants to experience the happy moment can join in by Zoom or FaceTime.
All the other rules about meeting a newborn still apply. Everyone should be healthy, and no one should have cold, cough or flu symptoms of any kind. Everyone should wash their hands and be conscious of what they’re touching in general, especially faces. Everyone should also be up-to-date on their vaccines, according to current guidelines. A baby’s pediatrician is a good resource for all of these recommendations, since they are routine even when there’s not a pandemic going on.
The good news is that it’s likely even safe for grandparents to hold a newborn if everyone is careful. Keep all contact as minimal as possible — we want to protect grandparents! — but if they must have a photo or won’t sleep until they’ve held their grandchild, it’s probably OK.
I can’t stress enough, however, how important it is to follow all these rules. If your family is not willing to strictly isolate for at least two weeks, I wouldn’t do this. If you’re not willing to keep the group small, I’d be concerned. Certainly, if you live in an area with a high or increasing prevalence of disease, you might want to think about waiting or being extra careful (i.e. not allowing grandparents to hold the baby, staying at least six feet away from each other, wearing masks or perhaps only meeting outside).
Some may think that even with all these precautions in place, it’s still not safe. If they define “safe” as absolutely, positively no risk whatsoever, then they may have a point. But the coronavirus isn’t magical. It isn’t devious or able to get around sensible, careful preventing measures.
“It’s a risk, but we’re all going to have to start making these tough decisions based on our own risk tolerance and circumstances and priorities. Part of the role of public health is giving people the information they need to weigh such decisions thoughtfully,” said Caitlin Rivers, Ph.D., an epidemiologist at the Johns Hopkins Center for Health Security. If everyone involved is committed to isolating, distancing and being very careful, the risk is minimal.
As the fears of an out-of-control outbreak fade, and as we begin to loosen restrictions, being careful and following the rules can make it safe enough for grandparents to start planning to meet their newborn grandchildren.
Natalie Dean, Ph.D., an assistant professor of biostatistics at the University of Florida, said, “I think if people are very careful for two weeks and have no symptoms or exposures, then close relatives could visit and hold the baby. My mother-in-law came down two weekends ago, after quarantining in preparation. In the end, there needs to be a balance.”
Rapid, reliable testing would make so much of this easier, but in the interim, careful and thoughtful planning can still bring the old and the very young together.