Q I am worried about my kids playing with other kids in the park. My nine-year-old is great at social distancing but I have a two-year-old who has a little pal the same age and they have been playing together.
e try to get them to social distance but it doesn't work. I can't bear the thought of not leaving the house. Do you think it is too risky to keep allowing him to play?
A At this stage, with the gradual easing of restrictions and nationwide infection rates so low, I think you are doing the right thing by getting outdoors every day and allowing your children to play with a few friends.
I agree it is impossible for toddlers and young children to stay one to two metres apart. In relation to formal childcare settings, our Government says that children under six years old do not need to social distance and are developing guidelines to keep them in small 'pods' of up to 12 children.
Children over six years old are asked to comply as they are considered capable of understanding social distancing. The idea being, if one of the pod became positive for Covid-19, then the other children in the pod and their families are easy to contact, trace and isolate.
Let's focus on what we know thus far. The transmission risk is much greater when in a contained environment for a prolonged period. We also know the three possible ways of transmission of a respiratory illness like Covid-19.
1) By direct contact with an infected person through fomites in their immediate environment, such as hugging or kissing.
2) By indirect contact on touching a contaminated surface and then touching your nose, eyes, or mouth. Remember good hand hygiene at this stage and you have broken the chain of transmission.
3) By airborne transmission on inhaling very small, aerosolized particles of the virus.
Being outdoors limits the latter two, the exception being direct contact, particularly amongst toddlers and young children. The likelihood of viral transmission when outdoors is extremely low. Admittedly, most academic research on respiratory droplet transmission is performed indoors, thus data on outdoor environments is limited.
Nevertheless there are many variables to consider when outdoors, which in their own way contribute to lower transmission, such as movement of air due to wind speed and direction, and strong UV sunlight which can help kill the virus. Infection rates in children remain very low worldwide. Only 9pc of confirmed cases in Ireland occurred in the 0-24 age group, with a median age of 21. We know that children often have milder disease than adults and deaths due to Covid-19 have been extremely rare compared to adults. Is this because children are resistant to Covid-19 infection, or because they are infected but remain asymptomatic?
These are questions we will find answers to when the studies have been completed. One of the greatest unknowns is the transmissibility among children and from children to adults. The systematic reviews of the available scientific studies conclude that children were rarely the index case in a household infected with Covid-19. Nevertheless, it is still possible that children can transmit the disease, even when asymptomatic.
So, we have to remain cautious. However, from the limited data and anecdotal evidence available, children are not at significant risk compared to adults and are unlikely to be 'superspreaders'. Let's be patient and await the emerging scientific data. Meanwhile do not feel guilty about letting your children play in small groups outdoors.
Dr Jennifer Grant is a GP with Beacon HealthCheck
Health & Living