July 20, 2020

To whom it may concern,

This letter is to convey my medical opinion about the travel of Lennon and Beckett Slavin, twins
both age 9.

Lennon and Beckett both reside in rural Washington State with their biological mother (on full
disability), grandfather (age 75) and grandmother (age 73). All 3 adults act as Lennon’s and
Beckett’s primary care givers. The children will be visiting their biological father in St.
Petersburg, Florida. In order to comply with this mandated visit, the children will be transported
by car and airplane from Seattle, WA to Tampa, FL by way of a stop in Texas. The children will
be exposed to 5 airport environments (round trip) and 3 different airplanes in the course of this
travel.

The first concern is the risk of travel itself. The Centers for Disease Control recommend against
air travel as a form of travel at present and considers air travel one of the most at risk activities
for COVID-19 exposure. Although testing for the virus is available, the results are not provided
rapidly enough to halt movement of affected persons and further spread of the virus. Masks,
gloves and handwashing can be effective if adhered to rigorously but it is well recognized that it
is essentially impossible to maintain compliance in children (and most adults), particularly given
the very lengthy flights and airport times. Airline security, boarding and seating as well as use of
restrooms are unavoidable contact-transmission points. Social distancing is the most effective
form of protection from disease but cannot be achieved in commercial airline travel. Airlines
have not developed means to prevent the spread of the virus; even mask- wearing does not
effectively block airborne transmission. Therefore, in order to adhere to CDC recommendations,
all persons including children should avoid air travel.

The second concern is that the children would be traveling into an area with the highest national
numbers of COVID-19 spread in the last 2 weeks. Most recently the state of Florida had
reached the mark of 15,000 positive cases in one day, the highest of any state in the US since
the onset of COVID-19. Particularly, the Tampa Bay region (St. Petersburg included) is one of
Florida’s hardest hit areas with a high case load. Hospitals are overwhelmed, many of which
have had to divert non-COVID related emergencies to hospitals outside of Tampa Bay. Travel of
these children from Washington state to Tampa Bay, Florida at this time is seemingly quite
irresponsible since they would be travelling from an area much less affected with COVID-19 to a
current epicenter of virus infection.

The third concern is how would the children be treated should they contract COVID-19. Three of
the children’s primary care givers (mother, grandfather, grandmother) would be a great distance
away. Also as I mentioned many hospitals in the Tampa Bay region are overwhelmed with
patient numbers. In fact, the children’s grandfather is a retired vice chairman of the Department
of Pediatrics at the University of South Florida and Professor of Pediatrics at Johns Hopkins-All
Children’s Hospital. He has extensive training in microbiology and both basic and clinical
immunology. In consultation with colleagues, he has been advised strongly to avoid all but

DEPARTMENT OF PEDIATRICS • DIVISION OF ALLERGY, IMMUNOLOGY AND RHEUMATOLOGY

Children’s Research Institute • 601 Fourth Street South, CRI 4008 •St. Petersburg FL 33701-4899
(727) 553-1258 • FAX (727) 553-1295
emergency travel. If the children developed a non-COVID related emergency, it could be more
difficult for them to access care given the current state of Florida.

The fourth and last concern is that what is now well recognized is that children often become
asymptomatic carriers of COVID-19, spreading the disease to their parents and grandparents.
Given the ages and co-morbidities of these care providers, the outcomes could be disastrous if
Lennon or Beckett spread COVID-19 to them when they retun home from this travel.

In summary, there exist no effective means to avoid or mitigate the exposure risk to the children
in the course of their travel from a state with rising cases of COVID-19 to a state that is at the
epicenter of the COVID-19 pandemic and as such it places them and their caregivers at high
risk that is avoidable.The mother supports the right of the father to have his children visit but
given the current situation asks that in the interest of the health of all relevant parties and the
rampant increases in cases in Florida that it be canceled and revisited at some future date.

Regards,

Jennifer Leiding, MD
Associate Professor
Division of Allergy and Immunology
Directo, Multi-disciplinary Immunology Service
USF Department of Pediatrics
Children’s Research Institute
601 – 4th Street South, CRI 4008
St. Petersburg, FL 33701
jleiding@usf.edu

DEPARTMENT OF PEDIATRICS • DIVISION OF ALLERGY, IMMUNOLOGY AND RHEUMATOLOGY

Children’s Research Institute • 601 Fourth Street South, CRI 4008 •St. Petersburg FL 33701-4899
(727) 553-1258 • FAX (727) 553-1295