02:52 - Source: CNN
Are these social distancing methods safe?
CNN  — 

Most days, Shannon Miller’s two sons, ages 7 and 4, play outside on their cul-de-sac in a suburb of Dayton, Ohio. But as the hours pass, more kids meet up from all over the neighborhood, until there are a dozen of them. “It’s almost like a block party,” she said.

Once those children try to play with her sons, Miller takes them inside, where they sometimes stand at the window, watching as other kids have playdates. These kids aren’t wearing masks, and they’re often tossing a football or not staying 6 feet apart.

As the weather brightens and states begin to reopen, some parents are relaxing strict rules around social distancing and allowing their kids to play with others. But in a world in which scientific research is politicized — and changing every day — it’s hard to tell how risky playdates are and what’s OK.

That puts parents in a tricky place, having to balance what feels best for them with what seems best for their communities, when playdates are more important, and yet riskier, than ever before. It also pits families and parents against each other.

My social media feeds are full of complaints from parents who are still restricting in-person interaction for their kids and are outraged that others are not. They’ve seen birthday parties and kids playing tag, as if the pandemic wasn’t raging on. They look on with a stew of envy, worry, disdain and smug superiority.

And yet few of those people would complain on the record. Though dozens of people responded to my request for people to discuss having playdates, or watching others have them, few would speak openly — they didn’t want to deal with the crushing judgment that’s so free-flowing during the pandemic. They didn’t want to throw their neighbors, or themselves, under the bus.

The love of community, the threat of stir-craziness

The urge to resume playdates is understandable.

“We’ve all been sheltered in place for two months. People are getting a little stir-crazy and looking for ways to interact with others,” Tanya Altmann, founder of Calabasas Pediatrics in California and a spokesperson for the American Academy of Pediatrics, said.

Meanwhile, the ever-evolving guidelines are confusing. What was verboten one day is suddenly acceptable the next, as we learn more or weigh the costs of human lives against the economy, mental health against physical health, our own survival versus that of our communities.

In many places, people are allowed to go to hair salons or beaches or even eat in restaurants, often with some version of social distancing. If that’s OK, how can kids congregating outside be worse?

After all, comparative immunologist and professor of biology at the University of Massachusetts Dartmouth Erin Bromage, whose blog post about knowing and avoiding risks has been viewed more than 13 million times, told CNN, “In larger spaces with better ventilation or outdoors, the concentration of the virus can be diluted in the larger volume of the air.” That is: Outdoors is likely safer than indoors.

Not to mention the fact that the social isolation wrought by the pandemic is wreaking havoc on kids’ mental health, and some parents feel the mental cost of isolation outweighs the transmission risk, to their own kids or to their community (or both).

Yet the US Centers for Disease Control and Prevention promotes abstinence mostly as the best method. “The key to slowing the spread of Covid-19 is to limit contact as much as possible,” it cautions. “While school is out, children should not have in-person playdates with children from other households.”

The CDC suggests, instead, “supervised phone calls or video chats with their friends.”

There is still no regular testing for the bulk of Americans, there’s no vaccine, and we still don’t know the efficacy of antibody tests or how much having antibodies protects us and others. But there’s only so far televisits can take kids, especially young ones, who have a hard time socially connecting across the wires.

New risks emerge

Early on, it seemed clear that the virus has been kinder to kids, but there is a new twist in that story. Multisystem inflammatory syndrome in children, or MIS-C, has emerged as a complication from Covid-19. Symptoms, which occur two to six weeks after infection, include conjunctivitis, diarrhea, swollen lymph nodes and swollen hands and/or feet.

Some children have become critically ill. At least 27 states have reported cases of MIS-C, totaling more than 350 as of May 27; three children in New York have died.

This disease is rare, but the math dictates that the more kids your child comes into contact with, the greater the risk of getting and spreading the virus — and contracting MIS-C. “Any time you go outside and get near anybody else, it does increase your risk of catching or transmitting,” Altmann said.

She noted that there were many cases where the virus was brought into the home by parents and spread through the family. That path could soon reverse. “Once kids get back out in the community, you’ll see kids picking it up from playground and park and school and bringing it home to parents and grandparents.”

Where you live and how you play

Some parents are almost certain they had the virus already and may feel better about porch and stoop visits and hangouts in parks or yards, assuming they are likely immune (even though no one knows this yet) and less likely to pass it on.

That’s the case with Gila Engelman of Brooklyn, New York, mom to a 7-year-old, who said she’d feel fine about her daughter’s socially distanced, outdoor playdates even if she hadn’t gotten sick already, because they’re safe enough.

“They’re running around and playing cops and robbers, but not touching each other,” she said. The kids usually wear masks, she said, but they don’t always keep a full 6 feet apart.

Many people have formed pods or social bubbles, dedicating themselves to one or two other families with promises of hewing close to guidelines and minimizing risk while expanding social activities.

But a pediatric nurse from New Jersey, who could not use her name because of Health Insurance Portability and Accountability Act (HIPPA) laws, took care of six children who were admitted into the hospital — two to the pediatric ICU — all from different social bubbles, within 72 hours.

One person in a particular bubble was a silent carrier who never had any symptoms, and all bubble members were reportedly staying home and having their groceries delivered. “There is no real way to safely form a bubble,” the nurse said.

Different families, different rules

It’s also incredibly hard to discern what’s safe or morally correct when different cities, counties and states — not to mention the President — have competing messages and different guidelines. Ohio, where Miller lives, in now allowing childcare centers, gyms and pools to reopen if they can meet safety guidelines.

Different families will decide what’s best for them, based on geography, health, family members and other factors. “It will be different for every community and every family,” Altmann said. “But the rules will get blurred as kids go to camp and back to school.”

If you’re following a more conservative path, it puts you in the strange position of watching others do what you’ve told your own kids they can’t, sowing confusion and the need for some difficult conversations.

Miller has her kids come inside when the makeshift block party happens, and then conducts a version of the talk many of us have in normal times, about how each family has its own values and rules.

“I try to put it in a way that doesn’t make anyone seem bad or wrong,” she said. She tells her kids: “We just want to make sure we’re careful. I’m not sure why they’re doing this — maybe they’re not watching the news.”

Since her kids do watch the news, they understand the risks of playing together in large groups, the concept of social distancing and sacrificing for the greater good. Still, her kids do get wistful, and a little jealous, when they see kids throwing a football and palling around. “It’s a mix of, ‘Why are they doing this?’ plus ‘Wow, that looks cool.’”

Play it safe

If you are going to embark on playdates, it seems that it’s better to do so outside.

Bromage wrote that, “of the countries performing contact tracing properly, only a single outbreak has been reported from an outdoor environment.” But that research was conducted based on experiences in the winter, when fewer people were congregating outside.

There’s speculation that swimming is a safer activity, but after a high school swim party in Arkansas, several kids contracted the virus. As states reopen and people flock to beaches and pools, we’ll find out how safe it is after the data are compiled.

The truth is, we don’t know what the warmer weather or sunlight mean for safety. Just because we don’t have research proving something’s not safe doesn’t mean it is.

Most official guidelines recommend staying 6 feet apart, even outside, and wearing masks when not with members of your immediate household, or when you can’t be 6 feet apart. Don’t share snacks, and don’t touch each other.

Summer fun now, and an uncertain fall

One thing to consider: The more kids play together in the summer, the more it potentially impacts returning to school. “My goal is getting kids safely back to school in the fall, and if that means having a mellow summer at home then I’m all for that,” Altmann said.

Get CNN Health's weekly newsletter

Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

What can kids do instead? In families where parents can carve out time to focus on their kids — a difficult prospect, when so many are working — play with them as much as possible, she suggested. Try to have some family fun. “The most important thing you can do for your kids right now is to spend time with them and create memories,” Altmann said.

But for those of us whose kids are antsy and anxious and desperate to see their friends, and whose work won’t let us dedicate our entire days to the kids, it’s likely we will let them create some pandemic memories with their pals, too. Chances are, they will remember those special and important playdates for the rest of their lives.

Lisa Selin Davis is the author of “Tomboy: The Surprising History and Future of Girls Who Dare to Be Different.” She has written The New York Times, CNN, The Wall Street Journal, The Guardian and many other publications.