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Sept. 24, 2020 -- For many parents and their children, the best part of Halloween is dressing the kids up as monsters, princesses, or superheroes and trick-or-treating around the neighborhood. Eloise Hardesty of Marietta, GA, is no exception.

“Eloise is 4½ and has been talking about this Halloween for about 11 months,” says her father, Chris Hardesty. “She’s been excited to dress as Elsa [from Disney’s Frozen] for nearly a year.”

Unfortunately, COVID-19 has complicated Eloise’s plans. The coronavirus outbreak has cost more than 200,000 lives in the United States in 2020, and communities around the country question the safety of Halloween activities like knocking on doors for candy.

Hardesty says Eloise has adjusted some of her expectations. “Because so many things have been unusual since early spring, I think that she’ll accept changes to the way we do trick-or-treating. She knows that she’ll need to wear one of the masks she uses whenever she goes out.

“But I am hesitant for her to collect candy from the neighborhood,” Hardesty adds, saying that he and his wife have not yet made a plan for Oct. 31.

Halloween fans may be particularly disappointed to limit their activities this year, as Oct. 31 falls on a Saturday, during a full moon on the night that daylight saving time ends. Turning back clocks means that this Halloween night will be an extra hour longer.

Trick-or-treating may seem safer than some group activities that have been discouraged during the coronavirus outbreak. It generally involves masks, takes place outdoors, and can allow social distancing and touch-free interactions. But many medical experts suggest that it offers more risks than some parents may realize.

On Sept. 8, the Los Angeles County Department of Public Health banned trick-or-treating, haunted houses, large parties, and other Halloween activities outright, pointing to the challenges of social distancing. The following day, the department modified the policy to make them “not recommended.”

On Sept. 21, the CDC updated its considerations for holiday celebrations during the pandemic. Intended to supplement local regulations, not replace them, the document designates activities as lower risk, moderate risk, or high risk, pointing out that, “Many traditional Halloween activities can be high-risk for spreading viruses.”

Higher-risk activities identified by the CDC include “traditional trick-or-treating where treats are handed to children who go door to door,” as well as “trunk-or-treating,” in which “treats are handed out from trunks of cars lined up in large parking lots.”

Changing Their Plans

Hardesty already has concerns about the candy bowl. “I usually let kids pick out what they want from a big bowl. I don't want them rummaging around -- or even getting close to -- a common bowl this year because I see many kids playing around here and not wearing masks. In my mind, if someone isn't wearing a mask, they probably aren't following good hand-washing guidelines.”

The CDC considers modified forms of trick-or-treating to be “moderately” risky, such as taking part “in one-way trick-or-treating where individually wrapped goodie bags are lined up for families to grab and go while continuing to social distance (such as at the end of a driveway or at the edge of a yard).”

Bita Nasseri, MD, of Beverly Hills, CA, advises parents to scale down their trick-or-treating plans. “It would be best to have a smaller group of parents and children travel through the neighborhood to trick-or-treat,” she says. “Creating small pods of families will limit exposure to multiple people and will help make trick-or-treating safer.”

Although COVID-19 is an airborne illness, Nasseri says surfaces and packages can still transmit the virus, especially during the cold and flu season. “There is always a risk of exposure to candy wraps that can host unwanted germs for up to 72 hours.”

Kelly Cawcutt, MD, of the University of Nebraska, acknowledges this risk as well. “I am more concerned about COVID-19 exposure and self-contamination risks during trick-or-treating, compared to transmission of virus strictly from the wrappers,” she says. “The reality is, if the wrapper is contaminated with SARS-CoV-2, you came in close contact with someone who has it. That contact is the highest risk.”

Cawcutt recommends precautions such as washing hands or using hand sanitizer before opening candy, and washing hands after opening the wrapper but before eating it. “For passing out candy, do not let children reach into the bowl.”

Some parents are already thinking of creative ways to distribute candy from a safe distance. “There are inventive candy slides and other options I have seen online to keep kids 6 feet away from others, but still able to get candy without contact,” Cawcutt says.

Nasseri proposes that parents carry their own candy and hand a piece to their children for every house they visit. That can ensure that no one outside a given household handles the treats.

In addition, the CDC says Halloween costume masks should not be used in place of cloth masks: for instance, a plastic Black Panther mask should not be considered as safe as a cloth mask. The only safe masks have two or more layers of breathable fabric that cover your mouth and nose, leaving no gaps around the face.

The CDC also cautions: “Do not wear a costume mask over a cloth mask because it can be dangerous if the costume mask makes it hard to breathe.”

Cloth masks are particularly important, given that Halloween can often involve people yelling “Trick or treat!” or screaming at jump-scares in movies or haunted house attractions, which can increase the chance of getting the virus when unmasked. “Avoid singing, chanting, or shouting, especially when not wearing a mask and within 6 feet of others,” the CDC says.

Health officials also discourage visiting indoor haunted houses this year, but the CDC says it is moderately risky to go to an “open-air, one-way, walk-through haunted forest where appropriate mask use is enforced, and people can remain more than 6 feet apart. If screaming will likely occur, greater distancing is advised.”

Keeping a Distance

CDC and other experts suggest that families embrace “distant” activities. Ramp up your jack-o’-lantern carving and spooky outdoor decorations. Have virtual costume contests or encourage drive-by activities in your neighborhood.

Plan indoor or even backyard movie nights, tailoring choices by the age of your family members: Tim Burton’s The Nightmare Before Christmas for small children, the original Poltergeist for tweens and up, etc. You can even use apps like Discord, Twitch, and others so people in different homes can comment on the same movie at the same time.

Finally, as the weather gets colder, don’t let concerns over COVID-19 make you neglect your usual precautions for other seasonal illnesses. “October is well into the fall cold and flu season,” Nasseri says. “Not only do we not want the spread of COVID, we also don’t want the spread of the flu and cross-reactivity of signs and symptoms.”

Getting sick is no treat.

Show Sources “Holiday Celebrations.”

Los Angeles Times: “L.A. County walks back Halloween ban, says trick-or-treating ‘not recommended.’”

Chris Hardesty, Marietta, GA.

Bita Nasseri, MD, Beverly Hills, CA.

Kelly Cawcutt, MD, University of Nebraska.


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