How to Stay Safe AND Sane in the Face of Disease -- Advice from a NICU Parent

You've just been told school is cancelled. For weeks. To prevent the spread of disease.

I'm sorry friends, I've been there. When we were told that Jonathan needed a third winter of isolation, I wanted to cry. And it was the best choice we could have made. You see, to a micropreemie, RSV is a lot like COVID19. And we did not want to see our little one intubated again.

Isolation for a micropreemie meant this: No large gatherings, no church, no grocery stores. If we broke these rules, even once, even just to attend a wedding of a loved one, we risked him loosing much needed in-home therapies. So we never broke these rules.

And it worked. When we did take Jonathan out of isolation for his first year of preschool, he got sick. He was hospitalized and he needed oxygen. But he didn't need to be intubated, he wasn't at risk of death, and his hospital stay was minimal. We'd given him time. And sometimes, in the case of micropreemies & the new Coronavirus, time is a huge gift.

HERE'S WHAT YOU NEED TO KNOW ABOUT HOW TO STAY SAFE AND SANE WITH SMALL CHILDREN AT HOME AND SEVERE ILLNESS IN THE COMMUNITY.

IN GENERAL:

• DO take health professionals seriously. They know what they're talking about. 
• Don't gather with lots of people
• Limit time in grocery stores & don't take small kids to the store. Let's face it, they're not good at not touching things.
• Stop the spread of this coronavirus. We didn't get the flu shot when Jonathan was a micropreemie because we were afraid of getting the flu -- we were protecting him from exposure. We used sanitizing wipes at the grocery store, hand sanitizers at church, and practiced social distancing at work -- not because we were afraid of being sick, but because we were afraid that if we got sick, we'd be exposing HIM to the illness. Now the tables are turned. Kids are fighting coronavirus well. But adults aren't. And we need to stop the disease. We do that by stopping all exposure.
• DO scrub in. Take your rings off for the season. Any time you enter a new building or come home from work, scrub hands up to the elbows and sing the ABCs as you lather. Get under those fingernails. Keep using those good scrub-in techniques every time you use the restroom or a tissue, etc. Get some good hand lotion so that when your hands get all dry from all the hand washing, you prevent cracking & bleeding.
• Teach your kids good hygiene skills. Wash, wash, wash. When you eat, when you use the restroom, when you touch your face. Stay clean.
• Social distancing works. If you can't touch their outstretched arm and they can't touch yours, that's a good amount of distance. It doesn't mean don't cuddle with your kids, they need cuddles to feel safe and loved. Just ONLY get that close to your kids -- distance yourself from others.

IF YOU HAVE AN IMMUNOCOMPROMISED FAMILY MEMBER:

• CONSIDER changing clothes when you get home. When our daughters came home from school or when we came home from work, we changed right into our PJs and scrubbed in. We didn't touch the isolated micropreemie until after we got changed. It became part of our routine because RSV lived on clothing. Coronavirus may be different, but it is an easy step to take. 
• Don't take that family member shopping with you. Just don't.
• If you feel sick, even just a little bit, limit or eliminate exposure to that family member. For us as parents, this meant swapping who took care of the little one.
• Practice social distancing. Where possible, keep the family member six feet away from others.

SCREENING VISITORS

Grandparents came over, my daughters still had occasional play dates, and my son had in-home therapy three times a week. How did we manage? My rule of thumb was fairly simple:

• Tell visitors to stay away if they're feeling sick.
• Ask visitors to change clothes and scrub-in.
• If potential visitors think these measures are extreme, just don't have them over. It's a sign that they're probably not taking illness as seriously as they should.
• If a colleague didn't know how to cover a cough appropriately and used his hand instead of the crook of his arm, I noticed. If he said "I just have a small cold, it's okay." I remembered that RSV looks like a small cold in adults, and as soon as he left the office space, I sanitized EVERYTHING.
• Coronavirus is similar. It doesn't look like much in some, and can be deadly in others. If people are downplaying their own symptoms and not keeping to themselves, then I need to keep myself away from them.

BUT HOW DO I STAY SANE?

• DO go outside. Perhaps don't go to the farmer's market, but if you have a back yard or even just a patio, play there.
• When it gets nice outside, OPEN WINDOWS. Fresh air does wonders for the soul.
• Play music.
• Limit exposure to others, but don't cut off all ties. If people are well, haven't been exposed to those who aren't well, and are willing to scrub in -- then allow small groups to visit. Keep groups smaller than eight, keep social distancing, and use your best judgement about activities. Again, back yard activities are great. 
• Facetime. Use technology to connect to other people. Not just by facebook posts, but by real interactions like (remember when?) phone calls.

AND HOW DO I KEEP MY KIDS SANE?

• Have some structure in place. But keep it loose. 
• Tell kids they must do two chores. Bonus there: then you're house is clean and you feel more in control.
• At the same time give kids a chance to just play, knowing that (like summer break) too much freedom just leads to boredom and cranky kids.
• Plan ONE creative activity a day. Don't over-plan or you'll burn out.  I hate pintrest, but if you're so inclined, seek out pintrest for ideas.
• Play-do
• Board games
• Make a science experiment
• Plant a garden
• Paint a room
• Create box monsters
• Have some time focused on school / educational goals.  If your school isn't moving to online learning, you can still help kids meet their goals. You might not have time to homeschool, but have your kids touch on math and reading/writing skills each day. Have 15 minute refresher sessions. Make it fun, or make it the chore they have to do before they can play Minecraft. Either way, keep the brains going. You and your kids will feel better with some of this structure still in place. And small amounts of time focused on learning really does make a big difference. [When Jonathan was in isolation, we made sure there were five minute blocks of his day scattered throughout where we practiced the skills that occupational and physical therapists had as their focus for that week.]
• Go for walks and bike rides. Invite friends along. It's a great way to get outside, and as long as you're not in a busy city, you're probably practicing social distancing.
• If your community doesn't have active cases, invite a friend over at a time. Don't have a huge party, but kids can still have play dates as long as they're scrubbing in. In some cases, this is inevitable as family and friends are needed to cover childcare responsibilities. Just keep the group small and have hand sanitizer in place.

Note: I am not a healthcare professional and all advice should be seen as non-medical. Use reason and seek the advice of true professionals.