When can child care resume?

I used to work for hours in a row without interruptions. Now, there is an astronaut-themed Lego set on my desk that seems to move a little bit each day. As I write this, my 7-year-old is sitting next to me, deconstructing pencils instead of doing his schoolwork. In listening to an interview I had recorded, I heard a young voice in the background and then heard myself say, “I’ll help you in a second. I’m still on the phone.”

>> Emily SohnThe New York Times
Published : 16 May 2020, 11:15 AM
Updated : 16 May 2020, 11:15 AM

As the pandemic stretches on, many parents have wondered: When will it be possible to resume child care?

Not all parents had a choice to stop using child care in the first place. Essential workers have relied on family members, day care centers and other strategies from the beginning of the pandemic, even in the midst of stay-at-home orders and widespread facility closures. Now parents who have been working from home with schools and day cares closed are asking: Is it safe to get help from grandparents, nannies, babysitters or day cares that are starting to reopen?

Experts say there are no easy answers, but there are ways for parents to think about levels of acceptable risk, while factoring in both health and financial considerations.

“Everyone is going to be making different decisions that are unique to their family and their community,” said Dr Frank Esper, a pediatric infectious disease specialist at Cleveland Clinic Children’s Hospital. “It’s not a one-size-fits-all decision.”

Although children have been less severely affected than adults by COVID-19, they can still get sick. They also can spread the virus, even if they never cough or sneeze. Many people are asymptomatic, which has raised concerns that children could play a significant role in the pandemic as silent vectors. To lower that risk, some schools and day cares around the country have been closed or operating at limited capacity for weeks.

Since the pandemic began, 16 states have mandated closures of child care facilities to all children except those of essential workers. A 17th, Rhode Island, closed child care facilities to everyone. Even in states without regulations, many day cares have chosen to close in response to the pandemic, according to Child Care Aware of America, a nonprofit advocacy group.

But day care restrictions appear poised to loosen alongside other stay-at-home orders. Gov. Jim Justice of West Virginia spoke at an April 24 news conference about testing the state’s day care employees for COVID-19 as part of his strategy to reopen facilities to all children, not just those of essential workers.

“I think we will certainly see on the horizon that some of these states that have closed are going to be slowly ramping back up,” said Dan Wuori, Ph D, director of early learning at the Hunt Institute, an education nonprofit in Cary, North Carolina, which has been maintaining a database of each state’s child care rules.

When it comes to nannies, baby sitters, single-family kid swaps and other child care strategies, the rules are wide-ranging. California’s stay-at-home order says that baby sitters can come into homes to care for the children of people working in “essential sectors.” Many states, including New Jersey and Ohio, allow baby sitters for anyone, while others don’t specifically address the scenario. In Tennessee, caring for a family member, friend or pet is considered an essential activity.

One reason for the disparity is that, unlike licensed facilities that need to follow government-mandated public health rules, baby sitters are generally not regulated, said Rhian Allvin, chief executive of the National Association for the Education of Young Children, a nonprofit in Washington focused on early childhood education.

“As states reopen, the burden of making these decisions goes from the government to individual families,” Allvin said, leaving parents forced to decide between losing their jobs or resuming child care. “It will become as much an economic decision as it is a decision from a public health perspective.”

Where you live is one important variable, Esper said. States, and even cities, are experiencing different levels of infection, and the numbers change every day. Whether or not there is a hot spot in your area can guide decisions about interacting with people outside your household.

Minimising the number of people you interact with is another guiding principle, said Dr David Cennimo, a pediatrician and infectious disease expert at Rutgers University in Newark, New Jersey. He recommends thinking in terms of acceptable and relative risk, while recognizing that “zero risk” is not going to be possible.

A single caregiver would be preferable to an outside facility, Cennimo said. Hiring one person to come every day could reduce the chances that they are working for multiple families and multiplying exposure. “This is obviously a lot of privilege talking,” he said. “But probably bringing one stable person into your house for care duties is less of a risk than putting 20 kids from different households together in a day care.”

Engaging a grandparent to provide child care raises tricky questions because people in older age groups have fared worse from the virus.

If there’s a choice, it’s probably preferable to hire a young caregiver instead of leaving children with grandparents who are in a high-risk age group, Esper said. Even day cares, if well-regulated, might be safer than exposing grandparents, for now.

If grandparents are your best or only option, take precautions, like wearing masks, distancing and lots of sanitising. “When that’s the case, you have to make sure you are doing the best you can to protect older individuals and anyone at severe risk,” he said. “The best thing is to stay distant until this whole thing blows over.”

However, if families live in multigenerational units, Cennimo doesn’t recommend that grandparents lock themselves in their bedrooms away from children. Because the virus can spread well in enclosed spaces, playing outside with caregivers can reduce risks, while offering other mental and physical health benefits.

If a child is sick, nobody outside the household should care for that child, Esper added. If anyone in your household contracts COVID-19, the whole household should isolate from others.

As day care centers reopen, parents should expect them to operate in ways that limit the spread of disease, experts say. CDC guidelines offer plenty of ideas of how that is likely to look: Children will be confined to small groups with a single, consistent teacher. Parents will not be allowed inside. Disinfection and hand washing will happen more often. Temperature checks will happen at the door.

Many of these recommendations are likely to become standards for child care providers, said Javaid Siddiqi, Ph D, president and chief executive of the Hunt Institute. “You’re going to see a host of new regulations, potentially legislation and a ton of policies that are going to come out of this that centres are going to have to adhere to, I think, in perpetuity,” he said. “This is going to be the new normal.”

Don’t plan on any school concerts, parties or other festivities any time soon. And expect periodic closures.

“You can imagine a world where you’ve reopened day cares and schools, and then a kid in the class is identified as having COVID-19, and you’ll probably close that school for a few days and use that time to test all of their close contacts,” Cennimo said.

“I think parents are going to unfortunately have to be ready for the idea that these schools may open and close and open and close.”

Given the uncertainties that still surround the virus, Cennimo recommends that parents make decisions that are right for them, with the knowledge that every choice will have some level of unquantifiable risk. “You gotta do what you gotta do,” he said. “And it’s a mess.”

c.2020 The New York Times Company