Baltimore Sun

Here’s how to safely visit the el­derly during the pan­demic

- By Mary-Claire Rogh­mann Health · Lifestyle · Family · Health Care · United States of America · Maryland · California · University of Maryland · Virginia · Baltimore · University of Maryland School of Medicine

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 seven 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-oftown 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.

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