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Is it safe to return to day care? 7 experts weigh in

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Parenting is hard. Parenting while monitoring children cooped up at home is even harder. According to a Stanford study, 42% of the U.S. labor force are working full-time from home, and 26% are required to leave their homes for work.

When businesses began closing their doors, most day-care centers had to follow. But now that many states are reopening, working parents, especially mothers who took on the majority of childcare work during the lockdown, may have the option to get the support they need. While young children are not exactly reliable when it comes to following social distancing and safety recommendations, the reality is that parents need outside help.

As the American Association of Pediatrics likes to remind us, kids are not just little adults. While scientists have learned a lot about how COVID-19 spreads among adults, more research must be done before we fully understand what the virus means for children. The available research suggests that young children are less likely to get infected and spread the virus. One large study, however, recently revealed that children over 10 years old are equally as effective at infection and spreading the virus as adults are.

So what to do with the approximately 10 million children in the U.S. under the age of 5 who attend day care each year?

To help parents understand their options, Fortune asked public health and medical experts around the country to weigh in. There is no absolute right or wrong answer, but here’s where the professionals agree: There will always be some risk involved.

Their responses have been edited for length and clarity.

Dr. Robert Johnson, dean of the Rutgers New Jersey Medical School: “I think the biggest issue that parents need to be concerned about is the program itself. They need to make sure that the day care’s activities are intentional and keep kids socially distanced. Kids naturally run to each other and hug each other and all those types of things. The staff should be reminding kids to wash their hands often and making sure they’re doing it properly. Parents should also make sure their day care has a plan of action for kids who come in with symptoms. I have lots of reservations about congregating kids, but many parents have to get back to work, and so we’ll have to do the best we can.”

Dr. Norman Beatty, professor at the University of Florida College of Medicine: “More research is definitely needed to confirm these findings, but we have to remember the risk is still not zero for our children. The two most important questions to ask yourself:
1. How at risk is my household?
2. Does the childcare facility have an established plan in place to protect children and staff from the spread of COVID-19?

“This should help you make a decision whether or not you may feel comfortable sending your child to day care.”

Dr. Hugh Mighty, dean of Howard University’s College of Medicine: “For children, especially those in the pre-K through early school ages, we should understand the risks. The data now suggests that these children do have risks of becoming infected and passing the virus on to others. There is also some early evidence that in a small number of children there may be some longer-lasting impacts, even to asymptomatic children themselves. Ideally, social distancing and masks would be great, but highly impractical for this age group.

“The decision to return to day care should be driven by knowledge of the risk both to the child as well as to anyone in a household. This should be balanced by the need to meet essential family challenges. For example, for hourly workers who must maintain their jobs in order to take care of the family, it may be an acceptable risk and indeed a necessity. Many day-care centers and schools will make decisions based on the local environment and public health guidelines.”

Nicolette Louissaint, executive director of Healthcare Ready in Washington, D.C.: “The age of the child matters as we are learning more about COVID. We should be considering whatever we know about preventing COVID-19 infection in pediatric populations, the ability to allow for sufficient physical distancing, disinfection and sanitation measures in the facility, as well as whatever symptom monitoring and testing plans are in place for day-care staff. Those sorts of bits of information are very critical for parents to continue to learn, as well as a plan for how long they would like to keep their child in day care.

“I think this is the type of conversation that we should continue to have in the weeks and months to come as we have more information and plans are made. We are still learning a lot about this virus and the ways in which we can protect ourselves and our children. And so we need to make sure we’re continuing to learn more and continuing to ask these questions, as there may be more information or better recommendations available at a later date.”

Dr. Lindsay Thompson, medical director of the Pediatric Research Hub at the University of Florida: “The majority of children without underlying illnesses don’t get severely sick from COVID-19, which is reassuring, and they benefit from the educational and socialization of day-care settings.

“Some day-care centers have even remained open throughout the COVID-19 pandemic, and so far, anecdotally, they have remained the safe, nurturing second home for young children that they have always been. However, every day-care center needs to have strict policies like keeping children home with any signs of infection, and every location needs to stay in close contact with local health departments to best understand what the area rates of COVID are.

“I recommend asking for their procedures ahead of time. These should include frequent deep cleanings of all areas in the facility, the adoption of a small group or cohort of children that go through the day together, limiting exposures. These “pods” lend themselves to staggered drop-offs and pickup times. Ideally, not only do we want to reduce the chance of a child getting sick, but we want to limit cases in the whole community, so following these guidelines carefully can limit community spread significantly.

“Staying home, if possible, is the safest for COVID, but the risks need to be weighed against the developmental needs of the child and the realities of work for the parents. Every family situation also needs to be considered. If an elderly grandparent lives with the family, the family needs to consider that the child could bring the virus home.”

Dr. Stephanie Miles-Richardson, associate dean of the Morehouse School of Medicine: “Because everyone is at risk for getting COVID-19 if they are exposed to the virus, the question posed is really regarding the risk-benefit analysis of x—with x being day care, the public parks, laundry, etc. Thus, the question is actually: What is my risk-benefit analysis of x? Individuals must compare the risk of the action (e.g., sending my kids to day care) to the potential benefits of the action (e.g., having childcare so I can go to work). The reason that there are no straightforward answers to the questions is because analyzing the risk is dependent on human factors including personal circumstances and options.

“Regardless of the outcome of the personal risk-benefit analysis, the three W’s can help to reduce the risk of exposure to the coronavirus that causes COVID-19: Wear a face covering; wash your hands; and watch your distance.”

Dr. James H. Diaz, program director in the LSU School of Public Health: “The CDC advises parents to make sure the day care adheres to their recommendations, such as maintaining an adequate ratio of staff to children to ensure safety. Childcare programs that remain open during the COVID-19 pandemic should address these additional considerations:

“Care programs should also plan ahead and have a roster of substitute caregivers who can fill in if your staff members get sick or have to stay home to care for sick family members.

“When feasible, staff members and older children should wear face coverings within the facility. Cloth face coverings should not be put on babies and children under age 2 because of the danger of suffocation.”

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