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What Parents Need To Know About COVID-19 Positivity Rates

How should percent positive rates influence parents’ choices for their kids this winter? Experts share some basics to have in mind. 

Since the COVID-19 pandemic began, parents around the country have become versed in a new vocabulary, from asymptomatic spread to multisystem inflammatory syndrome in children.

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But it is still challenging to decode all the information swirling around us in order to make informed decisions about what our kids should and shouldn’t do — and how to weigh the risks versus benefits.

And it’s especially hard to know what to make of local COVID-19 positivity rates, because there’s no consensus on what should happen as a result of those rates. How high is too high? When should parents be rethinking various activities? And how will this all change as we head into what we’ve been warned will be a long, very hard winter? Here are some basics to have in mind:

The COVID-19 positivity rate is NOT a direct measure of how many cases are in your area.

The local positivity rate is the percentage of COVID-19 tests performed in your area that come back positive. (It’s often used interchangeably with the “percent-positive” rate.)

“Positivity rates tell you what percentage of the population tested positive within a time frame, often taken in a window of the last seven days,” Priya Soni, a pediatric infectious disease specialist at Los Angeles’ Cedars-Sinai Medical Center, wrote in an email to HuffPost.

“It is NOT a measure of how prevalent the virus is in communities,” she continued, “but rather, reflects how well a certain area is doing with testing capacity.”

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In other words, the local positivity rate could be high if the number of cases is high (suggesting that COVID-19 is pretty widespread around you). But it could also be high if the number of total tests being done in your area is really low.

Experts warn that a 5% positivity rate is cause for concern; 10% is “very concerning.”

The million-dollar question for parents is: What constitutes a “high” positivity rate? And what is the magic number at which parents should rethink things like sending kids to schools, daycares, playgrounds, outdoor playdates, etc.?

Unfortunately, “there’s no uniformity,” said Dr. Sean O’Leary, a pediatric infectious disease specialist with the University of Colorado Denver and co-chair of the American Academy of Pediatrics’ committee on infectious diseases.

For example, I live in New York City, where public schools recently closed because our positivity rate hit a 3% seven-day average. In several neighboring states, however, schools remain open even though positivity rates are higher. I have no idea what to make of this, nor do I have a clear sense of what the 3% positivity rate means (or should mean) for questions like: Should I still be having a babysitter watch my toddler? Should either of my kids be playing with friends?

In the absence of uniform guidelines around positivity rates and what parents should make of them, one threshold to consider is 5%. In May, the World Health Organization advised governments that before they reopen, positivity rates should be at 5% or lower for at least two weeks.

Experts, as well as local policymakers, are reluctant to go on the record about what percent positivity rates are appropriate thresholds to influence parental decisions, but O’Leary offered some thoughts.

In his opinion, New York City’s 3% threshold was “pretty low — lower than I think most places would use, and certainly not without controversy,” he told HuffPost.

“As you get higher than 10% and see rates going up, that’s very concerning. We can probably all agree on that,” he said. “But it’s a bit of a gray area in between there though.”

Parents should take into account other metrics, like hospitalizations, and get familiar with your state’s plans.

Unfortunately, we don’t have uniform data collection on a national level, O’Leary said. So he urged parents to get used to what metrics are available in your area by checking in with your local and state health department, or in some cases, your child’s school district.

“Things I’ve been looking at fairly regularly on my own state’s health department website have been things like percent positivity and hospitalizations, because they’re not nearly as sensitive to testing capacity as many of the other metrics,” O’Leary said.

He urged parents to “get used to following those, because then you’ll have a sense of what direction things are moving.” How you react to those directional shifts will have a lot to do with your personal risk tolerance and factors like whether you’ve got anyone in your home who is at particular risk of severe illness with COVID-19.

“All of this can be very confusing for parents who are trying to make sound decisions for their children and family,” Soni added.

“My advice to parents is to pay close attention to what is going on at a state level. Each state has their own plan for their populations and communities,” and their local thresholds are influenced by things like population dynamics and local hospitals, she continued. “For example, thresholds for states with limited ICU beds per person may need to have stricter criteria for closures as they will max out their resources more rapidly.”

Because ultimately parents have to think beyond our own kiddos and families; we’ve also got to consider the impact our decisions and behaviors have on our broader community.

When in doubt, ask your child’s pediatrician. And mask up.

Though we parents have done a pretty damn commendable job of navigating the pandemic and learning about COVID-19, most of us are not medical professionals.

So if you have any concerns about whether you should be rethinking certain activities for your child, start by talking to their pediatrician or a trusted health care professional to get their take.

Then stick to the basics: wash hands, maintain social distance and make sure you and any children you have over the age of 2 wear a mask. Because if there is one thing public health experts are overwhelmingly clear on, it’s that masks protect others and you.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

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