What is social distancing?

To slow the spread of the 2019 novel coronavirus (COVID-19), health officials have urged the public to practice social distancing.

The Centers for Disease Control defines social distancing as avoiding mass gatherings and maintaining distance (approximately 6 feet) from others when possible. The CDC also recommends remaining out of congregate settings or crowded public places where close contact with others may occur, such as shopping centers, movie theaters or stadiums.

Tips for practicing social distancing:

  • Avoid shaking hands, hugging, high-fiving or otherwise greeting with contact. Instead, use a wave or nod.
  • Avoid non-essential travel.
  • Avoid crowds.
  • Contact your employer regarding work-from-home policies.
  • Stay home if you are sick.
  • Avoid medical facilities, long-term care facilities or nursing homes unless you have a medical reason for being there.

How does social distancing help?

COVID-19 is spread through respiratory droplets, which can be expelled from people through coughing, sneezing or talking. Once the virus lands on a surface, it can survive for some time and potentially infect anyone who touches that surface before touching his or her eyes, nose or mouth.

Temporary closures at places where people gather — such as schools, community centers and workplaces — allow for social distancing to happen. Closing these places means people cannot gather, which creates necessary space between people. The key to slowing the spread of COVID-19 is to limit social interactions as much as possible.

Do healthy people need to practice social distancing?

People are thought to be most contagious when they are showing symptoms. Many people, including children, with COVID-19 may show only mild symptoms. Some spread, however, might be possible before people show symptoms. In these cases, they can still pass this virus onto others who may be at higher risk, including older adults and people who have serious chronic medical conditions.

What can I do while practicing social distancing?

The California governor’s March 19 order instructs all California residents to stay at home, except for critical infrastructure work or essential activities like going to the grocery store, pharmacy or bank. Read the full order here.

During this time, you can help protect your family from transmission through washing hands frequently with soap and water for at least 20 seconds, and cleaning and disinfecting surfaces often. Avoid touching your face with your hands and teach your children how to properly cough and sneeze into their elbow or a tissue.

At home, surround yourself with relaxing colors, sounds and scents. You can use this time of solitude to do something you enjoy and be creative.

It’s still a good idea to exercise and get fresh air during this time. It is important though, to maintain safe distances, ideally 6 feet, while doing so. If possible, stay in a closed yard.

Here’s a CHOC psychologist’s tips for establishing structure and routine for kids during this time. And here’s a list of activity ideas for kids during COVID-19.

Maintaining social connections

People may experience anxiety related to the disruption of their normal routine caused by COVID-19 and social distancing. Continue to reach out to friends and family using methods such as the phone, video chat, email and text.

When can I stop practicing social distancing?

The governor’s March 19 stay at home order is in effect until further notice.

This article was last updated on March 25, 2020.

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How to talk to kids about disappointment during COVID-19

By Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

With schools closed and the practice of social distancing in effect, it is certainly understandable for children to feel disappointed right now about missing out on birthday parties, field trips or holidays they had been looking forward to. If your child or teen feels disappointed right now, let her express her feelings, and validate them. Share your own disappointments and how you are managing your feelings.

As a parent, it is difficult to see your child experience disappointment. As adults, we have the perspective of knowing that there will be other birthday parties, field trips and celebrations in their future. During this time, children will be most comforted by parents’ words of reassurance that you will get through these challenging times together, and that life will return to normal eventually.

Remind children why things have changed

It can be helpful to remind them about why things are different right now. Remind your child that as a community, we are coming together to “flatten the curve” and prevent the spread of COVID-19.

Discuss changes in plans earlier vs. later

For most young children, it will be helpful to start to discuss changes in plans earlier than later. Start slow and return to the topic several times, each time adding a little more detail. Ask for your children’s input on how they can still honor the event though they may not be physically able to go somewhere or have in-person interactions. For example, they can create a birthday card for a friend whose party was canceled and mail it to them and call or video chat them to wish them a happy birthday.

Limit children’s exposure to the news

At this point, children are home from school and it is clear that something has drastically changed in their world. While it is important to keep very young children away from the daily news which can include death tolls and speculations, parents should be honest about what we are trying to accomplish by social distancing. Here’s an explanation of social distancing. It could be helpful to ask them what they already know, debunk misinformation, and provide additional information for better understanding and clarification.

Advice for older children

Older children and teens are likely more aware that there are some special occasions that they many never get back, such as school dances, play performances and graduations. Assure them that their school and teacher will do what they can to make it up to them.

Let them use their imagination

Have fun thinking about what makeup birthday parties, field trips and other gatherings with family and friends would look like. Let them use their imaginations on what decorations they would have, food they would eat and people they most want to see.

Celebrate special events in a creative way:

  • Host a virtual party — decorate a backdrop, make a music playlist and create a themed game.
  • Join friends for a virtual museum tour. Many museums and other attractions are offering free virtual visits during this time.
  • Help your child prepare a special meal or dessert for the holiday or special day.
  • Go into nature for a special adventure with those you live with.
  • Call your friend on their birthday and sing them “Happy Birthday.”
  • Share a virtual meal with friends and family.
  • Host a virtual game night.

Building resiliency

Although this pandemic is not the situation that we would have chosen for our kids to face, experiencing adverse events, with their parent’s support, will help kids build resiliency. They will be able to look back on this time and reflect on how they were creative in finding ways to connect with their friends online, how they found new ways to entertain themselves at home, and how they persevered over new challenges, such as attending school online.

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Establishing structure and routine for kids during COVID-19

By Dr. Cindy S. Kim, pediatric psychologist at CHOC Children’s

During a time of crisis when so many things are unknown, creating a routine helps children in several ways. Creating a routine for kids during COVID-19 can provide structure and predictability during times of uncertainty. Structure also promotes reassurance and a sense of safety. Routines can also promote positive physical and mental health.

Children inherently turn to structure and routine for reassurance during times of uncertainty. Structure and routine help to maintain balance and normalcy. The more a child can anticipate what’s up ahead, the better they are prepared to face daily challenges and expectations.

Here are some suggestions in establishing a routine for kids during COVID-19:

  • Don’t get carried away and over-commit to an extensive schedule. Start small and slowly build into is as you see it working for your child.
  • Set aside some time to review the schedule and expectations with your child. This will ensure that they understand what is expected of them as well as when they can have free or play time.
  • For younger children, consider using a visual schedule format. This could be in the form of a chart, a clock with activities placed on it, or any other format your child can understand.
  • Start with a good wake up and bedtime routine. The goal is to stay as close to their daily school schedule as possible to allow for a smooth transition. This allows their physiological system to maintain a healthy balance between activity and rest periods. This is essential for regulating key hormones linked to our mood, hunger, and sleep to name a few.
  • Encourage your child to change out of pajamas and participate in regular grooming and hygiene activities such as brushing their teeth, washing their face, taking showers, etc.
  • Schedule time for meals and snacks, the way they would normally have them during a typical school day.
  • Set aside a quiet workspace for your child to complete schoolwork. Most schools are in the process or have already transitioned to distance learning. Get into the habit of having your child complete their daily school assignments each day.
  • Schedule harder tasks, such as classwork, to be completed earlier in the day when your child is more refreshed and rested. Save easier tasks for later in the day.
  • Allow for natural breaks or recess throughout the day. This time can be spent relaxing, listening to music, reading for fun, engaging in a hobby or exercising. During this time, be attentive to your child’s mood. When they are overly stressed or anxious, you might schedule in additional fun breaks.
  • Allow opportunities for your child to help around the house and do simple chores. This can be as simple as setting the table, folding laundry, or walking the family dog. Giving a child a simple task or job to do can help build up their sense of empowerment.
  • Encourage hobbies and other creative outlets. Your once busy child now has the gift of time to engage in creative outlets such as drawing, painting, cooking, designing, writing a short story or play, or building a fort. Hobbies are a great way to foster creativity and imagination all while giving a child something to do to break up their day.
  • Set aside time for outdoor activities, following social distancing guidelines. This is a great opportunity to go for a short family hike, bike ride or walk around the neighborhood. The goal is to remain active and physical while upholding good social distancing practices.
  • Engage in mindfulness and stress-relieving activities. Many meditation and mindfulness apps are offering free downloads or reduced subscription dues for many effective mediation, guided imagery, and stress reduction exercises or activities your child can do. CHOC offers online guided imagery.
  • Allow screen time as needed. It’s inevitable that your child will want to connect with friends online or spend some time in front of a screen. Screen time is a great way to reward your child for completing their tasks such as chores and schoolwork. As always, monitor and ensure safety measures are in place to allow for safe screen time.
  • Schedule time to connect with friends via technology. This can include video conferencing, text or social media. Social connections are important for children to continue to achieve their developmental goals. You can use video chats, for example, to have a virtual play date while children do the same activity such as creating the same craft together.
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What to expect at CHOC outpatient offices during COVID-19

As CHOC Children’s and other healthcare facilities adapt to the fluid environment created by the COVID-19 pandemic, and national, state and local recommendations and guidelines changing frequently, you may notice some changes the next time you visit the doctor’s office. We appreciate your patience and understanding as we adjust our practices to ensure a safe environment for our patients, families, staff and community.

You are going to be asked more questions.

Your history of potential COVID-19 exposure, travel history and recent symptoms are clues to your family’s risk. We are screening on the phone and prior to entry into our clinical areas.

We will ask you to limit the number of people with your child.

For the safety of our patients, families, physicians and staff, we are limiting the number of people who can accompany a patient. Please check choc.org/visiting for the latest visitor guidelines by location.

Our phone lines are busy.

We anticipate our phone lines being busier than normal. Thank you, in advance, for your patience with our staff, who remain dedicated to providing the best customer service. If you have questions about your child’s health and COVID-19, call our 24/7 nurse line at 1-844-GET-CHOC.

You may be asked to see your doctor virtually.

Many appointments can be done through telehealth, which means you can interact with a provider from the comfort and safety of your home. Depending on your child’s health needs, you may be asked to see your doctor using a computer or mobile device. When you schedule a telehealth appointment, you will receive a link by email or text message, which will connect with a CHOC provider at your appointment time.

Appointment times might change.

Your appointment may be moved to a different location, date or time. Appointments that can be safely delayed may be rescheduled  to accommodate surging demand. We will continue to do our best to accommodate our patients and appreciate your patience and flexibility.

You may see a different provider.

We will relocate some providers to different locations to ensure adequate staffing and to protect providers who may be at risk. If your child’s provider is not available, you will be given the option of seeing a different provider or rescheduling for a future date if possible. We thank you for being flexible with our providers.

No one will come to work sick.

This has always been our policy, but we will be extra cautious in the current climate. Please be aware that there may be occasions when we will need to make last-minute cancellations or location/provider changes due to staffing issues.

Our cleaning procedures are rigorous.

We will continue to thoroughly sanitize our offices to the most rigorous standards. Clinical areas will be cleaned multiple times per day, in addition to the medical grade sanitization we have always provided.

This is a rapidly evolving situation and our efforts to provide you with the safest and most effective care will not stop. Please stay tuned to choc.org/visiting for the latest information about visiting our locations.

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20-second songs to sing while you wash your hands

How long do you have to wash your hands? At least 20 seconds each time. This equates to the time it takes to sing “Happy birthday” twice. But if you’re looking for a refresh on your hand-washing set let,  Kevin Budd, a CHOC Children’s music therapist, has compiled this list of 20-second snippets of your favorite songs, to sing while you wash your hands. (And you can get more hand-washing tips from a CHOC Children’s pediatrician here.)

Just the Way You Are – Bruno Mars
When I see your face
There’s not a thing that I would change
’cause you’re amazing
Just the way you are
And when you smile
The whole world stops and stares for a while
‘Cause you’re amazing
Just the way you are

Mr. Brightside – The Killers
Jealousy, turning saints into the sea
Swimming through sick lullabies
Choking on your alibis
But it’s just the price I pay
Destiny is calling me
Open up my eager eyes
‘Cause I’m Mr. Brightside

Love on Top – Beyoncé
Baby it’s you
You’re the one I love
You’re the one I need
You’re the only one I see
Come on baby it’s you
You’re the one that gives your all
You’re the one I can always call
When I need to make everything stop
Finally you put my love on top

Stressed Out – Twenty One Pilots
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out

Can’t Hold Us – Macklemore
Can we go back? This is the moment
Tonight is the night; we’ll fight till it’s over
So we put our hands up
Like the ceiling can’t hold us
Like the ceiling can’t hold us X2

Some Nights – fun.
Some nights, I stay up cashing in my bad luck
Some nights, I call it a draw
Some nights, I wish that my lips could build a castle
Some nights, I wish they’d just fall off
But I still wake up, I still see your ghost
Oh Lord, I’m still not sure, what I stand for oh
What do I stand for? What do I stand for?
Most nights, I don’t know anymore

Truth Hurts – Lizzo
Why men great ‘til they gotta be great
Don’t text me; tell it straight to my face
Best friend sat me down in the salon chair
Shampoo press, get you out of my hair
Fresh photos with the bomb lighting
New man on the Minnesota Vikings
Truth hurts, needed something more exciting
Bom bom bi dom bi dum bum bay

Whatever it Takes – Imagine Dragons
Whatever it takes
‘Cause I love the adrenaline in my veins
I do whatever it takes
‘Cause I love how it feels when I break the chains
Whatever it takes
You take me to the top I’m ready for
Whatever it takes
‘Cause I love the adrenaline in my veins
I do what it takes

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