Another COVID travel question
November 16, 2020 8:15 AM   Subscribe

Essentially: what is a way for a grandmother to come to Boston from Florida for Christmas that is as low-risk as possible.

I've read lots (all?) of the COVID travel questions here and can't find one close enough to try to answer mine.

We live in Boston. Two adults, both work from home and have since early March. We only see people socially in our backyard and if we're close to them, we have masks on.

We have an almost-8 year old who has been back at his tiny school since mid-Sept. There are only 10 kids in his class, they go outdoors as often as possible and they are masked unless they are eating and distanced. Even in recess, outside - they never take their masks off. We hear from the nurse weekly about how it's going.

My 76 & 77 yr old parents pick him up one day a week and he spends several hours at their house. They, too, do not see people unless they are distanced outside and wearing masks if they are close. My dad is high-risk. He is who I worry about. They decided they were comfortable with this time w/ our kid b/c they are not getting any younger and felt the risk was worth it rather than utter lockdown. When this started we did not see them for 3 months or more and my mom, in particular was getting very depressed.

When my partner's parents came back up north from FL in May, they stayed home for 2 weeks and then joined our bubble. They had our kid once a week, as well at our house. They existed the way we all have, masked, distanced. They drove to their winter home in FL in late Oct.

Dilemma: FLA grandparents always come back for Christmas and stay at our place. Their summer house is not winterized and they cannot stay there. I suggested that the safest way to do this is to have them come and quarantine for 14 days before coming to us. And then we & all 4 grandparents could have Christmas together, with no one else. We have a house in Cape Cod that they could stay in to do this.

FLA grandfather does not want to do this, I think perhaps he likes that he comes for 5 days and leaves. I don't think he wants to make this a 20 day thing. He may think I'm being overly strict, not certain. FLA grandmother is torn. Does not want to be alone on Cape Cod for 2 weeks in December. But doesn't want to give up on seeing us. Side note: my kid adores FLA grandmother, like so much. And this has been such a stressful, awful year already...

Can someone think of a way we can do this? I've read this which basically says: 14 days quarantine.

Could FLA grandmother quarantine at home for 14-days and take a test. And then fly here masked. Stay someplace for 5 days (?) and take another test? Some of you will say, "just stay home, cut it out." There are varying degrees of understanding of my strong stance on the 14 days within my family and I really am agonizing over this. I need to know that I've considered all options.
posted by jdl to Health & Fitness (20 answers total) 2 users marked this as a favorite
Why risk it this year? Have people stay home. It's a drag, but it's a global pandemic that is worse than its ever been.
posted by demiurge at 8:25 AM on November 16 [26 favorites]

You (including the kids) would need to quarantine for 2 weeks first, too, so you didn't give anything to the grandparents.
posted by aniola at 8:25 AM on November 16 [28 favorites]

I think your stance is perfectly reasonable. This is the kind of situation the recommendations were made for. We all want to think "but surely it has to work? I was so looking forward to... [not being alone for 2 weeks/having a familiar ritual happen again to have some comfort/doing things exactly as always with no inconvenience at all]." But the truth is that (at least up here in Western Canada), most exposures are happening in people's homes, at private reunions.

If you insist now, your FIL may think you're too strict. But think of you'd feel if anyone got sick. It really isn't worth it. You and your family CAN make it through this, and flexibility helps. It's always a challenge to ask grandparents to be flexible, so I wish you good luck in pushing for the 14 days (or 10 day minimum) quarantine.
posted by ipsative at 8:30 AM on November 16 [4 favorites]

I also second aniola's recommendation that you also need to quarantine at home!
posted by ipsative at 8:31 AM on November 16

I appreciate that the school bubble feels like a bubble, but it's a bubble illusion that could pop at any second and you're instantly screwed, from a quarantine standpoint, when it does. I don't see how adding two more high-risk people who've been in transit AND will need to quarantine another two weeks when they get home improves this situation in any way without regrets.
posted by Lyn Never at 8:35 AM on November 16 [37 favorites]

Stay the course. If they aren't willing to respect public health guidelines for quarantine after travel during the deadliest pandemic of their lives, they don't get to see you. It sounds like everyone involved has plenty of money but safety from the spread of disease is one thing you cannot buy, you have to practice the same procedures as any other poor schlub.

Finally, 8 yrs old is old enough to have some sense of what's going on right? Do you want to model to them that you break safety rules because family members are pushy and impatient?

But really nobody should be traveling to gather this year, it's going to be an even bigger pile of dead grandmas by the end of Jan 2021 because of people who think their desire for gathering trumps public health and safety.
posted by SaltySalticid at 8:49 AM on November 16 [20 favorites]

Further, all of the above timelines could be accelerated if you take a Covid test 2-3 days into isolation and it comes back negative. Many saliva tests are available.

2-3 days after the last potential exposure is not long enough to have strong predictive value.
posted by juliapangolin at 8:58 AM on November 16 [11 favorites]

There is no "testing out" of quarantine:

A concrete example is the recent cruise ship : they tested every single person 3 days before boarding. They had an outbreak.

Another example : the white house tested everybody every day, reportedly. They had several waves of outbreaks.

You correctly concluded that a 14 day quarantine, after travel, is the gold standard. Hold firm; they can thank you later.
posted by dum spiro spero at 9:19 AM on November 16 [17 favorites]

One thing to consider:

Your current bubble is not just your immediate family and your parents.

By what you described, your current bubble is your immediate family, your parents, and the 'bubbles' of 9 other kids (their respective families) plus the 'bubbles' of the caregivers at the school.

Accordingly, you need to think about what risks the people in your extended bubble may be taking that you're planning to expose your FL parents to, and also what you need to do to protect them from your choices of bringing in your FL parents into the extended bubble.

Yes you may feel like you're doing whatever you can personally, but if you're already making holiday arrangements, you need to consider what arrangements are happening in your extended bubbles from the kids of the other families - accordingly, any quarantine discussion also needs to mean pulling your kid out of school before your other parents arrive and before you return to school.
posted by Karaage at 9:20 AM on November 16 [18 favorites]

14 days or bust. The 14 days must be a hard quarantine -- no leaving the house for anything but urgent medical needs. No leaving to meet friends in a park. No leaving to go to a grocery store. It fucking sucks. It's the only way.

You cannot test your way out of quarantine. Regardless of any test results at any point, you cannot shorten those 14 days.

Epidemiologist in a hard-hit area, but not your area.
posted by quadrilaterals at 9:36 AM on November 16 [23 favorites]

Thanks for such quick responses and even from an epidemiologist (but not mine, I know!).

Also I did mean to include originally that these are all lovely folks who are not being pushy at all. I just really wanted to do my due diligence to be sure I wasn't missing something.

I appreciate your thoughtful responses.
posted by jdl at 9:40 AM on November 16 [3 favorites]

Your grandparents are presumably in their nineties? I think they should wait. I am hopeful that they will be able to get a covid vaccine as soon as they are available given their age. Health care workers and the elderly will get first priority when the vaccine is available. Even if the vaccine doesn't happen quickly plan instead on them coming up in the spring when they will be comfortable outside In Massachusetts.

My daughter-in-law has grandparents in their nineties in Florida. They will not be visiting her in upstate NY until spring. In the meantime they visit through their phones and computers. I know they would love to spend time with their granddaughter and great-grandchildren, but this is not the time. If your grandparents aren't into technology then send them lots of printed photos and lots of presents on a regular basis, not just for Christmas. Call them more often.
posted by mareli at 9:44 AM on November 16

im writing this from a rental house, where ive been with my 76 year old mom for the last week. we planned this months ago knowing the situation could be bad and frankly i feel awful now because everyone i know is canceling plans with loved ones and we somehow managed to plan (and have resources to make work) around it.

My take is that you are viewing the risk too unidirectionally, and actually having FL grandparents come to you is putting them at significant risk also. You have a child who goes to school? I dont think you've adequately built in the risks those other families may or may not be taking and how they put you and anyone in your circle in potential danger.

Could FLA grandmother quarantine at home for 14-days and take a test. And then fly here masked. Stay someplace for 5 days (?) and take another test? Some of you will say, "just stay home, cut it out." There are varying degrees of understanding of my strong stance on the 14 days within my family and I really am agonizing over this.

I feel you so hard on this, ive DONE it and am agonizing over it. The other thing missing from the above question is how testing turnaround looks - in NYC (from experience) and SF (from friends) it seems like on-demand no-questions testing is common but not everywhere, we just had to try much much harder than id prefer to get a test this week. I would second the "you cant test out of quarantine" - different doctors disagree but your odds of a false negative within a few days of exposure are high so getting/being sick on the plane and still testing negative 4/5 days later is higher than would make me comfortable. My sympathies, this is a deeply shitty situation.
posted by Exceptional_Hubris at 9:47 AM on November 16 [4 favorites]

Our (pre)school bubble popped and suddenly 4 staff members were sick. They are closed now and plan to reopen before Thanksgiving, but we have decided, since we have a grandparent who recently traveled to see us and is staying through December, that we are not taking our kid back until after the holidays.

The grandparent arrived by car and was terrible about observing quarantine once she got here. We gambled in a way that makes both me and my partner deeply uncomfortable, but she is at the "fuck-it" age and would not keep her mask on inside our house. Our kid is turning 5 this week and is also terrible about mask compliance (we work on it, but her preschool had masked adults and unmasked kids.) We are just holding our breaths and staying home, and thus far (1 week in) our luck appears to be holding.

I don't recommend this approach, to be clear. I think that keeping the grandparents away altogether is easier than trying to negotiate once they are present.
posted by Lawn Beaver at 9:52 AM on November 16 [5 favorites]

This is where I struggle with AskMefi, I want to reply to everyone and I KNOW that's not how this works.

But Exceptional_Hubris you are so right-on about the directionality of my question. I was so one-sided and didn't even realize. I was talking like they were immune or somesuch. Thank you for sharing your experience and I hope everything turns out OK for you.

And Lawn Beaver! I'm sorry about pre-school and grandparent stress. Hope you all stay healthy.
posted by jdl at 10:14 AM on November 16 [1 favorite]

Thank you for asking this question! This is a really stressful time and it's good to be considering all of your options. Me and my immunocompromised friends thank you for your diligence. I hope that you'll err on the side of extreme caution, especially because there are a lot of people in your exposure bubble.

Your suggestion of them quarantining in a separate house for 14 days is the only passable course of action. This is not a fun process and requires great responsibility on the part of the isolating person, because isolating for 14 days includes continuing to isolate if you develop any symptoms. Even if you develop symptoms and test negative, you still need to isolate.

Testing cannot be counted on for accuracy and the two-week isolation period is the only ok chance at safety right now. The MIT source you linked also has good advice about using testing as a barometer.

False negative results (a test that says you don’t have the virus when you actually do have the virus) have extremely high likelihoods.

For PCR nasal and throat swab tests: The reported rate of false negatives is as high as 37%.
For Antigen nasal and throat swab tests: The reported rate of false negative results is as high as 50%.
Source: Harvard Health Publishing
Source: Harvard Health Center Resource Guide

This means that is is very likely that someone with COVID will still test negative for COVID, even if they are tested multiple times at different points in their symptoms. One or two negative test results will not guarantee relative safety for anyone.

It will not work for FLA grandmother to quarantine at home and then take a test, because she will come across multiple exposure points on her journey to see you.

“at home for 14-days and take a test. And then fly here masked”
Flying masked is a time when she could become exposed. Even if you are wearing a mask, you are still at risk of becoming exposed if you are coming into contact with other people the way you would on a flight. Additionally, if she isolates at home with FLA grandfather, the grandfather would be exposing her to whatever he is doing if he is not isolating.

“Stay someplace for 5 days (?) and take another test?”
This is not enough time to know if she will develop symptoms or if she is currently shedding COVID. The test will not accurately tell you either.

I know this is a hard time, but to give you an idea of what other people are doing: I have visited my parents twice since April, and both times I stayed in a separate building on their property for over 2 weeks before coming within 10 feet of them. The first time I did this I got cold symptoms and had to stay isolated for another 2.5 weeks. I am also isolating in my normal life, but I live in a crowded apartment building and could contract COVID through aerosol transmission anytime I walk outside my front door. I am skipping Thanksgiving and the holidays this year. Obviously it sucks but that's the deal in a global pandemic.

Also, I want to echo the other commenters mentioning that you will be putting your visitors at risk too if they decide to come.

You should have masks when folks are visiting you in your backyard, even if you are not close to them. Even if you do this, you are still at some risk of exposure, even if it is low.

When the kids play at recess, even if they have masks on, they are still at risk of catching and spreading COVID. We had a fancy school nearby open with similar policies but even smaller class sizes, and there was a positive COVID case on week one. We will never know how many kids actually had COVID, and which family members they spread it to, and which workers who worked for their families were exposed, and which pod members were exposed, or which teachers were exposed, etc.

Another mefite linked this information about transmission.

I found this helpful given that it is very difficult to get info about aerosol transmission. Since March and probably earlier, there has been lots of evidence that COVID spreads through the air (not just through droplets). Anecdotally, I feel like this is something that the CDC and general public advice has not been forthcoming about. So maybe that will help evaluate the risks involved too.

I hope some of these resources help. Good luck with your decision and wishing safety for all involved!
posted by sweetjane at 10:25 AM on November 16 [9 favorites]

I'm posting to contribute on hopefully lessening the 'agony' front.

At our house we've decided the Winter Holidays are generally about a) community care b) food and warmth and well, survival and c) in a Christian/Santa Claus focused tradition, more along the lines of the spirit of giving and self-sacrifice. It's kind of always been in our celebrating like adopting a family in need and volunteering at a food bank.

So, even though we also acknowledge that it sucks that we have not had non work- and school- related social contact other than outside since March and since September (and it does, we're all a bit down right now), we are trying to fit Christmas Apart, Together into our understanding of celebrating and not outside of it.

My 9 year old especially picked up on this pretty quickly and is working on some long distance care packages to reflect that. I think it helps to understand our actions as a part of celebrating the holidays, not a cancellation of celebration or our ability to care for each other being removed.
posted by warriorqueen at 10:53 AM on November 16 [5 favorites]

I'm guessing Covid is spiking in Boston like it seems to be in many places. I think the drive north and back to Florida will be more dangerous around Christmas than it was in October. I'm surprised that older folks didn't realize that going to Florida for the winter meant skipping Christmas this year. I'm worried that your son's activity at school will add increasing danger and risk to your parents, though it sounds like they're aware of the risk. But also please remember that Covid could hurt you and your partner; it's not like only old folks are at risk.

Here's one idea: offer some kind of deal to the Florida grandparents. Skip Christmas this year, and they get a few weeks with kiddo this summer/post-vaccine (if they'd want that). Or else you will all travel to Florida next Christmas. Something like that. And then set up kid on Facetime or whatever with grandparents every morning of Christmas break. Maybe they can have a special time where kiddo opens presents while Florida grandparents watch.

I just think we have to reconsider these traditions this year. This winter is going to be so much worse than what we've seen. It's already bad, and people are still going to travel for Thanksgiving, and it's going to be even worse in December. I know you know this, and I'm not judging you for trying to figure this out. But, like, what if your spouse died from Covid? What if you did? That's part of the risk assessment here. You have plenty of time to think through some alternate traditions for this year, you know? And we have a vaccine in sight.

(I write this from the west coast; my elderly dad, on the east coast, is not well. I might not ever see him again.)
posted by bluedaisy at 11:03 AM on November 16 [6 favorites]

Where are they planning on wintering, if not in Florida? Could grandma and grandpa quarantine there together and then come to your place, since she doesn't want to be alone in Cape Cod? Or is it too far away, leaving points of contact between there and your home?
posted by kate4914 at 11:29 AM on November 16 [1 favorite]

Last post, I swear.

I'm convinced. I mean I kind of already was, but I needed to hear that I wasn't missing anything. It's quite clear that all parties involved would need to hard quarantine for 14 days.

I've also considered, as our numbers rise, not having my parents see our kid for a while. We did it because the percent positive was so low when school started back up, but... here we are in November and it's getting worse.

I think I have a pretty good plan for opening gifts in the living room w/ the FLA grandparents on the tv and maybe even a multi-cam set-up so it can feel as in-person for everyone as possible.

bluedaisy I hope you get to see your dad.
posted by jdl at 1:52 PM on November 16 [11 favorites]

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