It's a tradition that traces its roots in America back more than a century.

Little kids — dressed as ghouls and goblins, superheroes and cartoon characters, princesses and pirates — trotting around neighborhoods, ringing doorbells and holding out bags, baskets and buckets eagerly awaiting the sweet treats that will be dropped inside.

Trick-or-treating is an October staple, a night that many kids would likely call a highlight of each year. But this year, with the world in the midst of a pandemic, the Halloween custom might be threatened.

Health experts continue to urge the public to follow safety guidelines like social distancing and wearing masks in public — and not the Halloween kind — to fight the spread of COVID-19. So what does that mean for trick-or-treating, an activity that's pretty high on close-quarters social interaction?

"It's tough," said Dr. Patrick Gavigan, pediatric infectious diseases specialist at Penn State Children's Hospital in Hershey. "There's not going to be a one-size-fits-all situation for every community. There's going to be a lot of different factors and variables depending on the location, specifically with regards to what the community spread of COVID-19 is like there."

Even if children have mostly been asymptomatic compared to older populations when it comes to the virus, they are still at risk.

"It's still important to remember that this can affect children. We have had kids get really sick with it," Gavigan said. "We have to remember that even if they are not sick, they can potentially serve as a transmitter between people who may be at higher risk of having severe outcomes."

According to the U.S. Centers for Disease Control and Prevention, traditional trick-or-treating, where treats are handed to children who go door to door, is a higher risk activity that should be avoided. The same goes for "trunk-or-treat" events where treats are handed out from trunks of cars lined up in large parking lots.

Dr. Debra Powell, chief of the section of infectious disease at Reading Hospital, echoed the CDC’s risk assessment.

“Traditional trick-or-treating is considered higher risk,” she said. “You’re having kids go door to door, possibly going in the house, and getting close to other people. That’s considered higher risk.”

'A different way'

However, that doesn't mean there aren't safe alternatives.

“I think we can do it in a different way,” Powell said.

Gavigan agreed on their being alternatives or safer ways to celebrate the holiday, especially as trick-or-treating is primarily an outside event.

"There are ways inherently that reduce the risk and there are additional ways that you can go about minimizing the chance of transmission and spread while still trick-or-treating," he said. 

The CDC said one-way trick-or-treating can be a moderate risk activity entails people filling individually wrapped goodie bags and giving them out through a grab-and-go model, like placing them on a table at the end of a driveway or yard.

If you decide to prepare goodie bags, the CDC says, make sure to wash your hands for at least 20 seconds with soap and water before doing so.

The CDC also provided some even safer options for celebrating Halloween. It lists the following activities as lower risk:

  • Carving or decorating pumpkins with members of your household and displaying them.
  • Carving or decorating pumpkins outside, at a safe distance, with neighbors or friends.
  • Decorating your house, apartment or living space.
  • Doing a Halloween scavenger hunt where children are given lists of Halloween-themed things to look for while they walk outdoors from house to house admiring Halloween decorations at a distance.
  • Having a virtual Halloween costume contest.
  • Having a Halloween movie night with people you live with.
  • Having a scavenger hunt-style trick-or-treat search with your household members in or around your home rather than going house to house.

“Outdoor activities with a small amount of people wearing masks, I consider those pretty safe,” Powell said. “Any indoor activity I would tell people not to do, especially if they are going to be in close proximity to other people who are not part of their household.”

Other activities that, like one-way trick-or-treating, fall into the moderate risk category include:

  • Having a small group, outdoor, open-air costume parade where people are distanced more than 6 feet apart.
  • Attending a costume party held outdoors where protective masks are used and people can remain more than 6 feet apart.
  • Going to an open-air, one-way, walk-through haunted forest where appropriate mask use is enforced and people can remain more than 6 feet apart.
  • Visiting pumpkin patches or orchards where people use hand sanitizer before touching pumpkins or picking apples, wearing masks is encouraged or enforced and people are able to maintain social distancing.
  • Having an outdoor Halloween movie night with local family friends with people spaced at least 6 feet apart.

The CDC recommends people avoid attending crowded, indoor Halloween parties, going to indoor haunted houses or going on hayrides with people who aren't members of their family.

The CDC also reminds revelers that a costume mask is not a substitute for a cloth mask, and a costume mask should not be used unless it is made of two or more layers of breathable fabric that covers the mouth and nose and doesn’t leave gaps around the face.

“The CDC is also recommending that people don’t wear a cloth mask underneath a costume mask because it may obstruct their being able to breathe,” Powell said. “They do not recommend wearing two masks, but to use a Halloween-themed cloth mask instead.”

If screaming will likely occur at an event, greater distancing is advised. The greater the distance, the lower the risk of spreading a respiratory virus.

"Even when you're outside, it's important to remember to physically distance as much as possible, especially during Halloween when kids are running around, yelling and screaming," Gavigan said. "That certainly may make spread a little bit easier."

Holiday season opens

Powell said an increase in the number of cases is always a concern, even more so as this month marks the start of many celebrations through the rest of the year.

She recommends people avoid larger group events with people who are not within their household and to do very limited extended family gatherings.

“Any time you add extra people to that group, you have an increased risk of exposure and possibly people getting infected,” she said.

Looking ahead Powell suggests people put a virtual spin on holiday celebrations such as having virtual dinners rather than people from different households gathering together in one place, especially in the case of people traveling from different states.

No matter what the event may be, it is important everyone continue to follow the same safety precautions that have been in place since the start of the pandemic.

“We still need to socially distance, wear a mask and wash your hands,” Powell said. “No matter what we’re doing, you don’t want to be in close proximity to people without a mask on. Larger group settings such as indoor events, we don’t really want any of those activities to happen. I think there are safer ways for you to celebrate Halloween and the fall experiences.”

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