Isolating from your children during the coronavirus pandemic
For many essential workers such as health care providers, other hospital workers, grocery store employees, truck drivers, and many others, exposure to the coronavirus (COVID-19) is either more likely to happen by simply being out in the community, or as even part of their job. All who are lucky enough to be able to remain safely in their homes without extended exposure to the coronavirus are grateful for these essential workers, and in part stay at home to keep them as safe as possible.
As you may have seen on the news, or perhaps even experienced in your own home, many parents and caregivers are making the decision to physically isolate from their children or elderly loved ones. This is a personal, family decision that everyone considers differently. Dr. Erin Leichman of the Pediatric Sleep Council asked Dr. Alban Bailey, an Emergency Medicine physician in New York, about just that.
Dr. Bailey, what did you consider when you decided to isolate from your children during the coronavirus pandemic?
We (my wife and I, both physicians) considered many factors when making that decision, but primarily our exposure to the novel coronavirus as physicians, our children’s and parents’ health and safety through our continued exposure if they were to stay with us, and our children’s safety and routine if they stayed with another caregiver.
Soon after it was apparent that there was community spread of the novel coronavirus in the densely populated urban areas adjacent to us, including New York City, we knew it was only a matter of time before our community would be impacted. In my work as an Emergency Medicine physician, I routinely encounter patients with respiratory illness. Although my wife and I both had increased chance of exposure to the novel coronavirus due to our jobs, we were not able to be tested for the virus. Plus, it was not until mid-to-late March that providers in our Emergency Department were required to use full personal protective equipment (PPE) with all patients. Since COVID-19 is thought to have a 14-day incubation period and about a 5-day time before symptoms start, we knew we could have become infected before full PPE was instituted. Like everyone, we knew that just because we felt well did not mean we couldn’t get others sick if we had been infected. Combined with a shortage of testing, we felt we must isolate. We did not want to risk unknowingly infecting members of our family, and we were fortunate that we had family nearby. We made the hard decision that it was best that our children stay with my mother.
How long did you think this arrangement would last when you decided to bring your children to stay at your mother’s house?
At first, our intention was to isolate for the 14-day incubation period from our last possible exposures. However, as community spread took hold in our area, I started to see with my own eyes how devastating this disease is for many. I also saw that the early characterization of COVID-19 only impacting those with underlying medical conditions does not tell the whole story. Although those patients are more at risk for serious disease and death, young healthy people are also getting sick and dying.
So, although we have passed that initial 14-day window, we continue to be exposed through our jobs. Thus, we have chosen to continue to isolate from our kids and my mom. If they were in our home, we would not be able to practice social distancing and the children, as well as my mother who would be helping out with child care, would continue to be at-risk of exposure.
How old are your children, and how did you explain COVID-19 to them?
My children are in elementary school. Luckily, they had some background knowledge that made it a bit easier to explain the coronavirus to them. That said, a good first step was to figure out what they had learned about the basics – what they already knew. Before their school transitioned to remote learning, teachers and other school personnel had already done a great job of explaining social distancing to them. For example, they already were being told not to hug their friends or to share food and drinks. They were also discussing hand hygiene. Plus, the kids already knew about “viruses and bacteria” as “germs“ that make us sick, and that we like vaccines because they keep us from getting bad “sicknesses.”
So, we were able to use language and examples they already understood, and built on those. When we talked to them about the coronavirus, we told them that it was a very bad virus, or germ, that we do not have a vaccine for yet – so it was going around, some people were very sick, and some had even died. We also talked to them about the things that we do in the house, in the community, and at work to help keep everyone safe.
How did you explain why they needed to stay with their grandmother?
We are lucky. While my wife and I remain in our home, my children are staying with my mother, someone they are quite used to being with. Our kids know we want them to be as safe and healthy as possible, and that is how we explained it to them – in terms of being safe with their Grammy. Plus, they are old enough to know that the safe choice is to stay home. But, they also know that, as a doctor in the emergency department, I need to go to work because I take care of people who are sick with the coronavirus. I also explained that I do not want to get them sick, in case I have the coronavirus.
When they ask how long they might be there, we admit that we don’t know how long it will last. We update them and say that we are still taking care of very sick people and that the coronavirus is still spreading. We plan to continue to update them and reevaluate the situation as time goes on. We also remind them about what we are doing to keep everyone in the family safe, and what they can do at home, too.
What did you do to help your children transition to your mother’s care?
We are fortunate that my mother’s house is completely set up with all of my children’s things, since she often helps us with childcare. I would imagine, though, that some families would have to do a fair amount of packing, preparation, and communication about many aspects of a child’s day. Routines, schedules, medications, and food preferences, would all need to be discussed. I also think it’s important for kids to have items that are comforting to them and that they are familiar with to help them feel stability during this time.
Most of the preparation we had to do was centered around school and remote learning. We are so grateful to our children’s school personnel who had started to send home instructions to set up supplies and prepare work stations. The teachers planned full days of remote lessons. We had to familiarize ourselves and my mother (who was a teacher for years!) with the technology associated with full days of remote learning for young elementary school children.
In what ways are you able to participate in their routines?
We try to regularly participate our kids’ routines. At bedtime, we read Harry Potter, which is the same as our typical routine. Otherwise, we ask my mother to let us know when a good time to connect via FaceTime would be. This usually happens at breaks in their remote learning schedule or at the end of the online-school day. I even was able to participate in an online party for my son’s classroom!
What would you say to other health professionals who are parents of young children who either need to or are considering isolating from their children (loved ones) at this time?
Deciding to isolate from your children is a difficult and personal decision with so many factors to consider. Not everyone has the ability to do that, even if they feel like they need to. But, if a health care provider (or other at-risk worker) has a safe, loving, and stable alternate childcare option, I would say they should consider it. Let your children know what you do, let them video chat with you at work with your PPE on, and tell them it keeps you safe and that you are well. Let them see that you are a hero.