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Treat not trick: Halloween is back with some simple COVID-19 precautions

Nicole Villalpando
Austin American-Statesman

It's time to return to trick-or-treating. 

After last year, when many families picked alternative activities or short routes to known houses because of the COVID-19 pandemic, it really is OK to get back out there on Halloween, health experts say. 

"How much normalcy can you give kids? That's the best," says Dr. Meena Iyer, the chief medical officer at Dell Children's Medical Center of Central Texas. "They've been through so much." 

What's changed? 

We know more about how COVID-19 is spread, and anyone 12 and older has had an opportunity to get a COVID-19 vaccine, Iyer says. 

Fall fun:Pumpkin patches! Haunted houses! 10 fall things to do with kids in Austin

Gianni Kelley anticipates receiving a treat at Halloween Night at Mayfest Park in Bastrop last year. Candy was handed up through car windows. This year, you can go trick-or-treating, but you should continue to wear a mask.

That doesn't mean that it's going to be like Halloween 2019. We still have to take COVID-19 precautions with how we celebrate and with whom.

Kids 11 and younger have not been able to get a COVID-19 vaccine, yet. Even if the FDA approves emergency use authorization for the Pfizer vaccine in kids ages 5 to 11 on Oct. 26, the kids who get it first won't be fully vaccinated for another six weeks. 

Most kids do OK with the virus, but kids can get very sick and be hospitalized with COVID-19. While adult hospitalization have gone down and Austin/Travis County has gone from stage 5 back to stage 3 guidelines, Dell Children's is still seeing spikes in cases, Iyer says. And many of the treatments that doctors are able to use now in adults have not yet been approved for kids.

Kids and COVID-19:Austin kids getting sick with COVID-19, and some are in ICU, Dell Children's doctor says

We also don't want Halloween to become a super spreader event and cause the cases and hospitalization to go back up.

"Kids get infected, and they infect other family members," says Dr. Brian Metzger, medical director of infectious diseases at St. David’s HealthCare. "It's the ripple effect." 

Knowing that there still are risks, we asked local doctors and injury prevention specialists for tips for celebrating the holiday safely. We've also included non-pandemic safety tips. 

Stay home it if you have symptoms

If you've been in contact with someone who tested positive for COVID-19, you need to quarantine until you have a negative test 7 to 10 days after the contact. If you have any COVID-19 symptoms, even if you haven't been around someone who has tested positive, trick-or-treat in your house, not outside. 

Stay socially distanced when you can

While trick-or-treating, avoid going in a large crowd. Instead, go with just your family or perhaps with another family that you are around regularly. 

Try to maintain your distance from others while you're walking from house to house.

Llamacorn Leonna LeBel tied for second in the Round Rock Rattlers Halloween costume contest last year. Use a cloth or surgical mask as part of your costume this year.

Mask up correctly

Yes, trick-or-treating is outside, which greatly reduces the risk for COVID-19, but streets and porches get crowded and it's not always possible to maintain your distance. For this reason, everyone 2 and older should wear a mask.

The mask that comes with a costume does not count. Wear a cloth or surgical-style mask that covers your nose and mouth. Doctors do not recommend wearing a cloth mask on top of the costume mask because of breathability. They would rather you ditch the costume mask and just wear the cloth or surgical mask.

Parents, even those who are vaccinated, should wear a mask, too, to set an example and to avoid becoming a breakthrough case. 

More:10 haunted spots in Austin, around Texas to scare you this Halloween

Debbie Davis readies treats at Mayfest Park in Bastrop last year. Spread out candy on a table instead of using a candy bowl to avoid everyone touching everything.

Hand out candy safely

People handing out candy also should wear a mask even if vaccinated because they are coming in contact with unvaccinated people (the 11 and younger crowd for sure). 

Instead of a bowl that everyone grabs a candy out of, consider using a candy chute (a PVC pipe that promotes social distancing), or setting up a table of candy spread out, or create a scavenger hunt of wrapped candy in the yard. 

If you want to use a candy bowl, you can hand a piece of candy to each kid rather than letting them grab out of the bowl. Sanitize your hands often between groups of kids. 

Rick Bowling hands out candy to kids through a chute from his porch on Halloween 2020 in Knoxville, Tennessee.

Hand out non-candy

For kids with food allergies, this is a tough holiday. It's nice to offer the choice of candy or a sticker, a toy, funky teeth, or some other non-candy treat. Sometimes even the kids without food allergies will prefer the toy. 

Sanitize, sanitize, sanitize

We now know that COVID-19 doesn't live very long on most surfaces, but you want to be aware of those high-touch areas where germs lurk. For example, it's better to knock on the door with your knuckles than ring the doorbell with your fingers. 

Bring hand sanitizer with you, and use it to keep hands clean. You don't have to do it at each house, but certainly every few houses or every block. 

Remember not to touch your face or mask, but if you do, pull out the hand sanitizer. 

Do not eat the candy as you go. First, you want to bring it home to check that everything is properly sealed and that nothing looks funny or is spoiled. Second, you don't want to ring a doorbell and then put your hands in the candy and eat some. 

After you get home, wash everyone's hands thoroughly before diving in. If you want to be extra careful, you can let your candy sit overnight before eating it.

A bottle of hand sanitizer is set out on a table with candy during Halloween trick-or-treating last year. Consider doing the same this year.

Watch for cars

Halloween has the most pedestrian/automobile accidents of any day of the year. A study of highway data from 2004 to 2018 found that on a usual day, an average of 16 kids die from being hit by a car. On Halloween, that jumped to 54. 

Cross at a corner and look both ways. Do not walk between cars where drivers can't see you.

Use glow sticks, glow bracelets, reflective tape on a costume or a flashlight to help drivers see you. 

Drivers also should watch for kids and drive slowly, expecting kids to dart out. Put down the cellphone. 

Avoid costume mishaps

Dress for the weather and for walking. It's Texas: It could be pouring. It could be in the 80s. It could be in the 40s. Wear comfortable shoes, and a raincoat or warm coat if needed.

Avoid costumes that drag on the ground and create a tripping hazard. Avoid costumes that block your peripheral vision. (Another reason to ditch the costume masks.)

Buckle up

If the costume causes you to have to loosen a child's car seat, that car seat might not be as safe. Take off the costume while riding in the car and put it back on your child once you arrive. 

If you are using a wagon or stroller to walk kids from house to house, remember to buckle them into the stroller seat and use a wagon that has seats and a seat belt, which you will buckle each time. 

Walk, don't run

Kids get excited (especially if they skipped last year) and then they trip and fall and break a bone, or they dart out into traffic. Your runners or younger kids would love to hold your hand (or at least that's what you'll tell them).

Have a small first-aid kit

You won't regret having bandages and sanitizing wipes with you. If your kid has an allergy and needs an Epi pen, make sure you have that, too.

And don't leave your cellphone at home.

Establish a meeting spot

Kids get lost and separated. Have a plan. Maybe it's that they know to meet at the end of a street, at a bank of mailboxes or a fire hydrant if they get lost. That helps you narrow down where they could be.

Do they know your phone number and address? If not, write it on them. Use a sticker on their back that they can't reach to pull off. Write phone numbers in Sharpie on kids' arms if needed.

For the teens, establish who they will be with, what route they are going to take and when they will be home. Make sure they have their cellphone with them and that they know what to do with it in an emergency.

Don't overdo

Injuries (and meltdowns) happen when everyone is tired. Quit while you're ahead.

Beyond trick-or-treating

Parties: This is not the year for a big Halloween party. If you have a small gathering, it should be outside. 

Hayrides: They are fine to do, but avoid a crowded one. See if you can go with just your small group. If it looks busy, skip it. 

Pumpkin patches: Try to go at less crowded times. Wear a mask and hand sanitize after everyone has touched the pumpkins. 

Corn mazes: Avoid them if they are really crowded. Wear a mask in case you run into someone around the corner.

Bobbing for apples: That was always gross. Don't do it.

Haunted houses: Know what the precautions are beforehand. Are they limiting the number of people going inside? Do they require a negative COVID-19 test or proof of vaccination? What is their ventilation like? Avoid them if they are very crowded, especially if they are indoors. Know that even if you think it isn't crowded, you have lots of actors in there as well as guests. Also, people are screaming, which spreads droplets more than talking. If you decide to take the risks, wear masks. But not the ones from a costume. 

Sources: Dr. Shyam Sivasankar, pediatric emergency medicine physician at St. David's Children's Hospital; Dr. Sunaina Suhag, Austin Regional Clinic pediatrician; Dr. Lisa Gaw, pediatrician and director at Texas Children's Urgent Care Westgate; Dr. Brian Metzger, medical director of infectious diseases at St. David’s HealthCare; Dr. Meena Iyer, chief medical officer at Dell Children's Medical Center of Central Texas; and Lindsay Pollock, injury prevention coordinator at Safe Kids Austin.