Annie Shea Weckesser was in a Target parking lot in Sand City, Calif., waiting for groceries to be loaded into the trunk of her car when her 8-year-old daughter started crying. Weckesser, a mother of three, knew her eldest had to use the bathroom but asked if she could possibly hold it, since they were just 20 minutes from their destination in Pebble Beach. “Her face was red and she was crying hard,” she recalled. “There was no way she was going to be able to hold it.”
There were no masks in the car, so darting inside to use the store’s restroom wasn’t an option, since masks were required inside buildings in her Northern California county, and the parking lot didn’t offer a lot of real estate for an outdoor potty session. Weckesser grabbed one of her 22-month-old’s diapers and shooed the 8-year-old out of the car. As Weckesser watched out for cars and her mother-in-law held up a sweatshirt for privacy, the girl relieved herself into the diaper.
“After that, she was perfectly happy,” said Weckesser, who disposed of the diaper and hit the road.
Many parents are finding creative ways to avoid public restrooms during the novel coronavirus pandemic, either from fear of infection or because many public restrooms and highway stops are closed. Still, experts say that with the right supplies and careful hygiene, restrooms can be a reasonable risk to take this summer.
Public bathrooms have always brought up an ick factor — especially in parents with young kids who touch everything and put things in their mouths. But in pandemic times, there are even more worries: a study came out last month confirming that infectious coronavirus is present in feces — something that was suspected but not known before.
It’s still not clear how much infectious material is in the feces of a person with Covid-19, and how long aerosolized bits can hang around in the air after someone flushes, said Dr. Yvonne Maldonado, M.D., a professor of pediatric infectious disease at Stanford University.
Since many public restrooms are small, poorly ventilated spaces with a high volume of traffic, they feel like a place where people could potentially be exposed to viral material. But Dr. Moldanado said that the overall risk of a public bathroom is probably not as high as people imagine it to be. It’s not about the contact in an area, it’s more about the amount of time a person has had contact there.
“Most people aren’t sitting in public bathrooms for hours and hours,” she said. “And frankly, if you look at the data on transmission, some of the most important transmission occurs in the home, because there are lots of high-repetitive touch areas over time.” In a public bathroom an infected person is just touching surfaces once, rather than over and over.
She adds that while scientists don’t yet know the risk of using a bathroom that an infected person has been in for a few minutes, there are still common-sense actions that parents can take. “The best way to deal with surfaces is with disinfectant wipes and hand washing: wipe down door handles and toilet seats,” she said, adding that the coronavirus is pretty easy to inactivate with disinfectant. People, including kids, should also wear masks inside any building and keep distance from others as much as possible in a bathroom; respiratory droplets still are a much bigger source of transmission than surfaces.
Dr. Tanya Altmann, M.D., a pediatrician, spokeswoman for the American Academy of Pediatrics and mother of three based in Calabasas, Calif., said she had a motto for her small children in questionable public restrooms: “Don’t touch anything, Mommy will do it all for you.” She advises that parents do all the touching of surfaces in a public restroom, with a barrier on their hand (either a wipe, gloves or paper towel).
That means parents open the door, lay out a toilet seat cover, lift a child onto the toilet, help them wipe, flush and open the door. While your child’s bottom isn’t a way for the virus to enter the body, any barrier to commonly touched surfaces is recommended, Altmann said. Not just for coronavirus, but for general hygiene also.
When done, parents and children should wash their hands thoroughly and avoid the hand-drying machines, which can blast dead skin cells and other materials into the air. Opening the door with a paper towel couldn’t hurt either. As kids get older, Altmann said, they can learn to safely avoid touching surfaces in the restroom on their own.
For changing infants and babies in diapers, Altmann advises parents to bring a plastic garbage bag to spread out over a changing table, creating a clean mat. Having necessary supplies on hand — sanitizing wipes and gloves — means you don’t have to go hunting around and touching surfaces while changing a diaper. And when the change is done, the garbage bag can be rolled up with the diaper, wipes and gloves, and thrown away. Another option is to do diaper changes outside, on the grass or in the back of the car.
But don’t just tell kids to hold it. Holding a bladder or bowel movement until you reach a safe place may not be healthy, said Dr. Richard Jackson, M.D., a pediatrician and professor emeritus at the University of California, Los Angeles, Fielding School of Public Health.
“Mother Nature intended us to get rid of waste, and it doesn’t take much time to get backed up,” he said, adding that holding waste can lead to problems like voiding dysfunction. Of course, sometimes kids have to hold it for a while, but “Don’t hold it until it hurts” he said.
Dr. Jackson suggests bringing along a travel toilet when traveling with younger kids. That’s what Raina Kumra, a mother of two in Santa Monica, did on a recent road trip to Orange County. Her 6-year-old son was happy to urinate on a tree outside, but her 4-year-old daughter refused to do any nature stops — so Kumra bought a camping toilet to store in the car. “It’s just a bucket with a toilet seat on top — it’s genius,” she said. Armed with this, baby wipes and disposable liners, she feels ready to take her family on more road trips this summer.
Outdoor pees have always been popular for little kids, especially boys. But public health experts said to be wary of outdoor defecation, especially in areas like campgrounds where there may be other people walking in the same areas. “Make sure that you’re following the rules of that campground. If the rules are to use the bathrooms, be considerate and follow the guidelines,” said Dr. Altmann. “Do whatever you would want other people to do.”
“It would not be a good idea to disperse feces around a place where there are a lot of people running around,” said Dr. Jackson. “You don’t know if a 3-year-old is going to be running in the area a few minutes later. If you’re going to have to use the facilities, use gloves and masks.”
On hikes or camping trips where there is no public restroom, carry out solid waste or dig a hole eight inches deep and far away from the trail or water.
Still, Dr. Altmann said, the benefits of getting out into sunshine and fresh air outweigh the risks of public bathrooms. Being outside is important for mental health as well as physical well-being. “It’s more important than ever to get out into nature,” he said.