It's spooky season, and Halloween is just around the corner. As scary as so much of 2020 has been, the fun and theatrics of the costumed, sugar-laden holiday may come as a relief. However, we are still in the middle of a pandemic, and that means Halloween will need to look a little different this year, with some traditions being riskier than others.

Beth Thielen, M.D., Ph.D. is a physician-scientist focusing on adult and pediatric infectious diseases, much like COVID-19. She works as an assistant professor at the University of Minnesota Medical School and an adult and pediatric infectious diseases physician with M Health Fairview. She is committed to "ensuring that Minnesotans of all backgrounds have access to evidence-based, patient-centered infectious diseases care." Thielen joined The Current's Jill Riley for this week's Wellness Wednesday to discuss how parents and community members can stay safe while celebrating Halloween during this pandemic.

Listen to the interview above, and read a transcript of the complete conversation below. Every Wednesday morningat 8:30 CDT, Morning Show host Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends atnCall to Mind, MPR's initiative to foster new conversations about mental health.

For this year, we're talking about Halloween safety. And I've got a special guest on the line: Dr. Beth Thielen, an assistant professor in the University of Minnesota Medical School and an adult and pediatric infectious diseases physician with M Health Fairview. And we're gonna talk about how parents and community members can stay safe while celebrating Halloween during a pandemic. Dr. Thielen, thank you for joining me!

Yeah, thanks Jill, for having me.

Yeah, Halloween certainly is going to look different this year. It's almost hard to believe that, you know, thinking back to March, that this would still be the situation in October. And you know, Dr. Thielen, I have a four-year-old who absolutely loves Halloween. And so, you know, we're thinking about how Halloween is going to look different this year. Why should traditional Halloween activities...why is that a concern for Minnesotans?

There's just a number of activities, I think, that many of us associate with the traditional Halloween, and unfortunately there's just quite a bit of overlap between activities that we know are a risk for spreading SARS-CoV-2, the virus that causes COVID-19. And so, you know, thinking about trick-or-treating as sort of the classic event that we do. And, you know, traditional trick-or-treating, you're having contact face-to-face with lots of people, and, you know, kids are reaching into candy buckets, touching common objects that, you know, spread the virus. Here is Minnesota, it's starting to be cold weather, and so people are gonna be indoors more. And so, we do know that being indoors in close proximity to people, particularly in spaces that aren't particularly well-ventilated, can be a risk for transmitting the virus. People are screaming, and, you know, the act of shouting kind of aerosolizes droplets that then can transmit the virus. And so, there's just a lot of these activities that we know are particularly risky for spreading SARS-CoV-2.

Yeah, so when it comes to the traditional trick-or-treating or, you know, the, like, screaming inside of a haunted house. But what about outdoor activities? You know, I was thinking about some of the hayrides. I mean, even with it being fall and people wanting to go to an apple orchard, I mean, the hayrides, or any kind of maybe outdoor events that are being planned?

Those are definitely safer activities in general to be outdoors. We generally encourage people to be outdoors as much as possible. I think still that some of the similar principles, though, we should be thinking about. So, trying to limit within a group of household members or sort of a smaller number of people. Definitely in places like apple orchards where you can maybe maintain that physical distancing a bit better are safer than things like hayrides, where you may be clustered. Even though you're outdoors, you may be in close proximity to people who are outside your household, and so that might be a risk as well. Certainly, we have seen cases of transmission, even in outdoor concerts where people were unmasked. And so, I think the same, you know, things you can do to be safer are still wearing masks if you're gonna be in close proximity to people, but preferably keeping that physical distance to at least six feet between yourself and members outside your household are still good ideas.

Well Dr. Thielen, on the subject of masks, I mean, I think of masks when I think of people dressing up for Halloween. So, how do costume masks compare to the cloth masks that we've been wearing during this pandemic?

Yeah, so I think it probably depends a little bit on exactly what you're talking about, but when I think of masks, I think of, you know, something that covers up the whole face but leaves holes around the nose and mouth so that you can breathe through them more easily. And that's sort of exactly the opposite of what we're aiming to do for preventing the spread of SARS-CoV-2. So, ideally, we want something that's gonna cover both the nose and the mouth and prevent you from coughing or breathing out those droplets that can potentially spread the virus. And so, you know, I think, certainly leave it up to people's creative ideas about how that can be accomplished, but I think generally speaking what experts are advising this year is that maybe instead of the traditional costume mask, you opt for something like a decorative face covering that, you know, covers the nose and mouth and that is maybe appropriate for the holiday season.

Well, Dr. Thielen, people are going to be getting creative this year for Halloween. You know, for parents listening right now, for me, like, I have four-year-old son, what are some safe alternatives to traditional trick-or-treating?

The thing that I love about being a pediatrician, you know, it's fun to make a game out of just about anything. Taking the attitude of "how do we make this fun and creative?" I think it really lends a positive feeling to the experience. So, you know, we can still do a lot of the things that we would normally do, so carving and decorating pumpkins that you can put out and maybe arrange with some of your neighbors to do an outdoor walkthrough to view the pumpkins at a particular time. Watching a movie, either, you know, some of my neighborhood, we have outdoor movie screenings where people could maintain physical distance and watch a movie together, or alternatively watch on Zoom or one of these other video platforms. Certainly, you know, going to places like pumpkin patches and orchards, as long as there's good handwashing and people are maintaining distance, I think those are very nice things to do this time of year. So, lots of opportunities, it's just an opportunity for you to flex your creative muscles and make it a little bit special this year.

You know, when it comes to COVID-19, and I think about my son, you know, I look at him and go, you know, "he's a really healthy child, let's say he would get COVID-19, you know, hopefully he would be able to fight it off," but we just don't know the long-term effects. I mean, that's another concern, isn't it?

So, I think it's become very clear that children do get infected with the SARS-CoV-2 virus. It does seem that there's a higher likelihood that they may be asymptomatic or minimally symptomatic when they do get infected. There are very few children who become severely ill, but still, as a pediatric infectious disease doctor, I have seen children who have become very severely ill with the virus, so the risk is definitely still there. But I think more of what we're worried about is how children may factor into the transmission within the community. And so, we know for other viruses like influenza that the children can spread the virus to other, you know, family members in the household, parents, grandparents. And so, certainly those are things that I worry about that if children do become infected, they themselves may not become severely ill, but they could unknowingly transmit it to other, more vulnerable close contacts, so that's part of it.

And then I think, you know, you raised a question that I think we're grappling with in the medical community about the long-term consequences. And certainly, we're hearing more and more reports of these sort of "long haulers," these people who have symptoms kind of persisting for weeks or even months. And we don't fully understand why certain people are affected, and don't really have the ability to predict who will be severely effected and have more prolonged illness. And so, I think really, given that uncertainty, I think really the best guidance for people right now is to still do whatever you can to avoid becoming infected.

We are talking about staying safe during this year's Halloween, as Halloween will look very different than other years. It's Halloween in a global pandemic. What are some things that people should really think about?

You know, early on, we were just telling people, "stay home." And I think now we've gotten some additional tools or other ways to kind of think about how people can help keep themselves and their loved ones safe. So certainly, I think wearing a face covering, covering the whole nose and mouth, I can't emphasize that enough. But that is not perfect, and so I think really what we should be thinking about is just a panel of things, multiple behaviors that we can do that help reduce our risk.

So, maintaining those distances, I think, as much as possible, you know, having, when you're going to gather with people who are outside your household, doing that outdoors or in a space where you can be, again, well-ventilated. Limiting the size of gatherings. So, you know, maybe don't have that party with 100 people, maybe limit it to some close friends and family, and do it where you can maintain that distance a bit better. Certainly, when people are feeling ill, I encourage them to stay home to avoid spreading it, even if the symptoms aren't the fevers and the cough that we typically think of being associated with COVID. There can be other symptoms that can be indicative, more mild symptoms, and so I encourage people just to stay home and avoid spreading any virus. You know, it could be influenza, it could be cold viruses. Any number of viruses can be transmitted this time of year and particularly in the winter season so stay home if you're ill.

I do encourage people to, if they have symptoms that are suggestive of COVID, to get tested. I think we're hearing more and more people raising concerns that things will happen as a result of their diagnosis they're not wanting to do but I think it's really important that we identify those cases so that we can take actions to stop transmission and stop it from spreading, the virus, from spreading in the community.

And then, this time of year, a message that actually I give every year is protect yourself from the flu. There's quite a bit of overlap between SARS-CoV-2 and influenza, and we actually do have some really good tools for preventing influenza. And the top among that is get yourself a flu shot. Basically, almost everyone over six months of age can get a flu shot. It's safe. It doesn't totally prevent the risk of infection, but it does substantially reduce the risk of severe disease, hospital stays, emergency room visits, even in children. So definitely get yourself a flu shot.

Hand washing is another big part of what we recommend. Just, it's generally good infection prevention. Just plain soap and water or an alcohol-based hand sanitizer. Use it liberally, particularly if you're handling food, after going to the bathroom, if you need to touch your eyes or mouth or face. So, those are some generally good tips to keep healthy, not just from SARS-CoV-2 but for preventing other infections this time of year.

Well Dr. Thielen, thank you so much for all the tips and all the really good reminders here. And thank you for joining me for Wellness Wednesday.

Thank you so much for having me.

For fun and creative Halloween ideas based on COVID risk levels in your area, check out halloween2020.org. And for more questions and concerns on Halloween or other holidays, visit the CDC's website.