We asked 20 medical experts with kids about their pandemic Halloween plans. Here's what they said

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Parents everywhere are grappling with how to make the most of Halloween during the pandemic.

The guidance from the Centers for Disease Control and Prevention asks families to take precautions if they trick-or-treat outdoors by carrying hand sanitizer, setting up stations with individually bagged treats and wearing cloth masks, not just Halloween masks. But some communities are going further by requesting that parents refrain from door-to-door trick-or-treating altogether because of the challenges of maintaining social distancing at front doors and the risks involved with sharing food.

So for many families, the challenge this year is to find activities that are fun and safe. For inspiration, we asked 20 doctors, public health officials and epidemiologists with children of their own how they are planning to celebrate.

We got a wide range of responses, depending on personal risk tolerance, the age of the kids and the level of Covid-19 outbreak in their community. Here's a summary of what they had to say:

Scavenger hunts

Public health authorities in Dr. Yoni Freedhoff's neighborhood in Canada have asked parents to avoid trick-or-treating. So Freedhoff  an associate professor of family medicine at the University of Ottawa, and his wife have come up with an alternative plan for his three kids. The family is dressing up in costumes, carving pumpkins together and going on a horror-themed scavenger hunt. His kids, ages 11, 13 and 16, will earn their plunder by recalling moments from famous horror movie scenes.

"The kids are excited," he said. "They'd rather be trick-or-treating, but their mother is a rock star when it comes to stuff like this."

Scavenger hunts seem to be a particularly popular option among doctors and public health officials this year. It's a way to stay at home in cold climates, they say, or to engage safely with the community outdoors.

"Bottom line: Halloween isn't canceled, but it has to be adapted," said Dr. Wendy Sue Swanson, a Seattle-based pediatrician.

Her neighborhood has an outdoor scavenger hunt planned for all the local kids in their costumes. Parents have agreed ahead of time to social distancing and masks. "There's no sense blowing all of our efforts for a little candy," she said. "Enjoy the silliness, but don't break down and put yourselves or others at risk."

Covid is never far from the thoughts of Dr. Panagis Galiatsatos, a pulmonary and critical care doctor specializing in respiratory disease. After mulling options, he settled on inviting his nieces and nephews over for a costume party with his kids. He's working on a map filled with riddles to solve, which will lead the kids to hidden candy stashes around the house.

Galiatsatos is confident that Halloween can still be fun this year with a little advanced planning. "As doctors, we don't want to lose sight of the fact that this is a holiday that actively celebrates masks," he said.

Trick-or-treat — with a twist

Emergency medicine physician Dr. Amy Cho is still planning on a trick-or-treat outing with her four kids, but with a twist. If it's not too cold in Minneapolis, where she lives, she'll take her kids to homes with the lights on. They won't knock on any doors, but her kids can help themselves to sugary treats on outdoor tables.

As an extra precaution, her kids will wear mittens and masks under their costumes. And they won't eat the candy for a few days.

"Some people in our friend's neighborhood have even made a Halloween-themed chute out of a PVC pipe to send candy," she said.

Other parents say they plan to keep Halloween as close to normal as they can, but with masks and social distancing. Dr. Ashish Jha, dean of Brown University School of Public Health, says his 8-year-old will go trick-or-treating in a small group and carry hand sanitizer. But he won't be going into people's homes, and the annual costume party is canceled.

Before kids put their hands in candy bowls, he recommends they use hand sanitizer to avoid spreading germs.

Dr. Megan Ranney, an emergency medicine doctor at Brown, is also taking her son (a skeleton knight) and daughter (an astronaut) out for treat-or-treating. Both will be wearing cloth masks. She's comfortable letting her kids briefly approach their neighbors, as long as they're also wearing a mask.

Pandemic pods

For the sake of their sanity, some parents are forming "pandemic pods." The idea is to select two or three nearby families to hang out with, but everyone agrees to follow public health measures, like wearing masks and social distancing.

Chicago-based Dr. Shikha Jain has formed a pod, which she refers to as her "quaranteam," with her neighbors. Back in May, the families put together a socially distanced birthday party in the garage, where the kids took turns to play hopscotch or hit a pinata. Each returned home with an individually wrapped cupcake. It was such a success that Jain is gathering the same group for some Halloween-related activities outdoors, like pumpkin carving and a movie projected on the garage door.

For some doctors, relying on their pod is a necessity. Dr. Dan Buckland, an emergency medicine physician based in North Carolina, has been asked to work a shift at the hospital on Halloween. So his kids will be taking off for a road trip with their grandparents and staying at an Airbnb, where they'll be spoiled with candy.

"There are a lot of experiences they didn't get this year," he said. "We wanted them to have a joyful memory."

Dr. Geeta Nayyar, a rheumatologist based in Florida, has been busy coordinating with her neighbors to set up a series of games for the kids. The plan is for families to hang out in their respective driveways enjoying a drink, while kids dance to music or play with glow-in-the-dark hula hoops. The grand finale will involve a socially distanced parade through the cul-de-sac to Michael Jackson's song "Thriller."

Costume contests

Northern California-based dermatologist Dr. Roxana Daneshjou describes herself as a "fanatic" about Halloween. So this year, her daughter will be attending a socially distanced Halloween outdoor street parade in costume. She's also participating in a contest organized by a 10-year-old, asking families to show off their scariest decorations in their front yards.

Daneshjou has a strong community of friends online. So she's agreed to host a virtual costume contest for those in the medical industry and their kids on Twitter. The winner gets to donate to the charity of their choice.

Other parents say their kids are open to a more low-key Halloween this year, which will involve costumes at home. John Brownstein, an infectious disease epidemiologist and chief innovation officer at Boston Children's Hospital, says his 9- and 11-year-old are concerned about the pandemic. With his day job, it's hard to avoid the topic.

Still, his kids are excited about dressing up. His daughter is going this year as someone she admires: Dr. Anthony Fauci. "My kids are pretty plugged in," he said.

General advice for parents

"The key is avoiding the three C's," said Bill Hanage, an associate professor at the Harvard T.H. Chan School of Public Health. "That's crowds, closed spaces and close contact."

Hanage said he would personally feel comfortable going trick-or-treating with his family outdoors in communities with low disease prevalence. He would also advise that kids wash their hands before eating candy, or that parents leave it out for the day.

"It remains the case that transmission outside is rare," he said. "I'd be comfortable with small-scale local events that worked with those (public health) guidelines."

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