(CNN) Parents are experiencing whiplash. After two years of pandemic restrictions, several states -- including California, Oregon, Illinois, Delaware, New Jersey, Connecticut and New York -- have announced they will end indoor mask mandates. In some cases, that includes easing mask requirements in schools.
Against this backdrop, the US Food and Drug Administration has said that it will delay authorization for the Covid-19 vaccine for children under 5. And while coronavirus cases are declining, they remain at a high level in much of the country.
What should parents know about Covid-19 safety for their kids? Are activities such as playdates, dance classes and moviegoing OK to resume? If masks become optional at school, does that mean your children should take them off? What about children who are worried about the coronavirus and aren't ready to stop certain precautions? And what's the advice for parents of kids under age 5?
For this updated parents' guide, I spoke with CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of "Lifelines: A Doctor's Journey in the Fight for Public Health" and the mother of two young children.
CNN: It feels like there has been a sudden change over the last couple of weeks. Have circumstances really changed that much when it comes to Covid-19 safety for children?
Dr. Leana Wen: I do think there's been a marked change, although I would say that the change began in November when vaccines were first authorized for 5- to 11-year-olds. Children who got their shots as soon as they became available became fully vaccinated in time for the winter holidays. The hope was that they and their families could have a fairly normal Christmas, New Year's and other winter celebrations.
The problem was that the Omicron variant emerged just before the holidays. In many parts of the United States, it surged quickly and overwhelmed hospitals. There was no time for kids to enjoy the normalcy that vaccination promised to bring. When Omicron first arrived, we also didn't know how well the vaccines protect against it.
Now, we know that the vaccines work well to protect against severe illness due to Omicron. Cases are also declining rapidly in most communities. That's why many elected leaders, including many who have been very cautious about mitigation measures, have announced easing of restrictions. I think they are right to do so, because things have changed a lot in a short span of time.
CNN: Does that mean it's safe for parents to organize indoor playdates and take their kids to the movies now? What about indoor dance, soccer, choir, swimming and other extracurriculars that some families have been putting off?
Wen: This is an important question to consider. Just because restrictions are being lifted doesn't mean that suddenly everything's safe. Covid-19 infection levels are still quite high in many communities that are ending mitigation measures. Government-required measures are ending, but that doesn't mean that individuals should make every risky choice. There are many things we could do that are risky, but that we don't always choose to do.
Nearly everything we do has some level of risk when it comes to contracting Covid-19. The question every family should ask is this: How much do we want to keep avoiding the coronavirus? And what's the price we're willing to pay to do so?
Many families will decide that they have already done everything they can and are willing to do. If every member of their household is vaccinated and boosted when eligible, it would be reasonable to decide that they won't restrict their children's activities anymore. For a vaccinated child, the chance of severe illness from Covid-19 is very low. Many parents would not want their kids to forgo any more activities, and would want to resume indoor playdates, movies and all extracurriculars.
Others will still want to be cautious. They may be concerned about the possibility of long-term symptoms from Covid-19 infection. Perhaps they live with someone who is immunocompromised or otherwise vulnerable. They might decide on a case-by-case basis to reduce risk where possible while trying to keep cumulative risk low.
For example, they might keep playdates outdoors unless the other kids are all vaccinated, too. They might allow their kids to go to the movies but require that they wear a high-quality mask (N95, KN95, KF94) the entire time. They might ask their kids to choose the one or two sports or extracurriculars that they enjoy the most and cut out the less valued activities.
The point is that families will make different choices based on their medical circumstances, risk tolerance and value of returning to normalcy. In a sense, this isn't different from many other decisions families make, using criteria that are unique to their individual situation.
CNN: If masks become optional at school, should kids wear them or take them off?
Wen: That again is up to each family's medical circumstance and how much they want to keep avoiding Covid-19. I'd ask one more question: How much does being maskless mean to them? A younger child or one with learning disabilities might benefit more from mask-optional policies. A kid may also not want to mask because their friends also aren't masking. All of these are reasons to consider, keeping in mind that masks do reduce coronavirus transmission -- especially a high-quality mask.
CNN: What about kids under age 5 -- should they keep masking in school? What about their older siblings?
Wen: All families, including those with young, unvaccinated children, should decide how important it is to them to keep avoiding Covid-19. Covid-19 infections aren't always mild, especially if the child is unvaccinated, and there is still the potential risk of long-term symptoms. Those who want to keep preventing the coronavirus infection should keep masking, and that includes kids under 5 and their older siblings. There will be a lot of families that will no longer prioritize preventing Covid-19 infection -- such as families that may have just contracted and recovered from the coronavirus. In those circumstances, it would be reasonable to resume pre-pandemic activities and to forgo masks in some cases.
CNN: There are a lot of kids who may not be ready to shed pandemic restrictions. What's your advice to them and their parents?
Wen: First, begin with empathy and reassure your child that these are very normal feelings. I think we can all understand how, after two years of living with so many precautions, it's hard to peel them back.
Second, go slow and ease into activities that are the most enjoyable. Maybe your child isn't ready for an indoor, maskless birthday party with 50 people. What about getting together with two close friends for a dinner or sleepover?
Third, focus on the positives. If your child has missed a sport or activity, how will it feel to go back to doing something they really love? If you haven't been able to travel, how fun will it be to go somewhere they've always wanted to visit? If you were too busy before the pandemic, consider this opportunity to not add every activity back into your schedule. And continue checking in as a family as you all adjust to this transition period together.