Health rules strain day cares
SEATTLE — Joelle Wheatley hit her pandemic-parenting rock bottom after her son was sent home from day care for a second time, with the sniffles, due to stricter health guidelines in a symptomsensitive COVID-19 world.
It was supposed to be Jacob’s first day back after a stressful10-dayhomequarantine for another mild symptom that turned out to be harmless. Frustrated, desperate — there were no other care options, and she needed to focus on work — and certain that the 2-yearold’s runny nose and cough were also benign, the Seattlemomdefied the day care’s orders and brought him back the next day anyway.
“Iwas just sosurehehad a cold, and that sounds so irresponsible,” saidWheatley, 43, who works at an early education nonprofit. “But I honestly was just in such a low place.”
As more families make the jump back to group day care this fall in an attempt to restart lives and careers, many parents, pediatricians and care operators are finding that new, pandemic-driven rules offer a much-needed layer of safety but also seem incompatible with the germy reality of childhood.
They stem largely from coronavirus guidelines issued by the Centers forDisease Control and Prevention lowering the fever threshold, disqualifying
even a single bout of diarrhea or vomiting and making sniffles suspect in group settings.
But the guidelines don’t take into account that young children are prone to catching thecommonviral infections that help build up their immune systems, or that seasonal allergies, crying, even teething and normal playground exertion can prompt a COVID-19-like symptom.
And the price parents and kids pay for such symptoms — which could easily signal either ahappy, healthy toddler, or a lurking case of the disease that has now killed more than 230,000 people in the U.S. — is nowa dayslong disruption.
That’s a realityWheatley knows all too well: Jacob was turned away again on Day 2 and she then had to scramble to get him a coronavirus test and an appointment with a doctor who wrote a note confirming the boy was virus-free. It took two days to get Jacob back to preschool, causing her anxiety about his health and guilt over neglecting work.
Medical experts acknowledge the lines are blurry for kids with symptoms.
The CDC notes on its website that young chil
dren commonly have up to eight respiratory illnesses or colds each year asamatter of course. In its guidelines for K-12 schools, the CDC warns that excluding children for longer than “existing“policies overCOVID-19 symptoms alone could cause unnecessary absences.
The American Academy of Pediatrics’ latest child care guidelines released in October initially didn’t include congestion, runny nose, vomiting or diarrhea on its symptoms checklist. Following questions from the Associated Press, the pediatricians’ group updated its recommendations on Friday to include those symptoms in alignment with the CDC, calling it an oversight.
Dr. Elaine Donoghue, who helpedwrite the pediatricians’ child care guidelines, said any symptom must be takenseriously if it looks even vaguely like COVID-19. While young children are prone to minor infections, they now in theory face less exposure to those milder illnesses due to pandemic-related social distancing, and thatmeans the calculus behind assessing symptoms changes.
“We should not be expecting certainty during a pandemic,” Donoghue said. “This is an uncertain
time.”
Considered essential in many states, day cares are one of the fewservices that have remained open through the pandemic that’s now stretched nine months and counting in the U.S. Numerous programs have permanently closed, though there are signs families are trickling back to preschool.
According to theU.S. Bureau of Labor Statistics, the number of people working in child care has recovered steadily in recent months. But while the 853,000 workers reported in September marks a 28 percent jump from April, it’s still below the more than 1 million in the field a year ago.
In October, the Child Care Aware of America advocacy group released a national survey conducted by Yale researchers in May and June of more than 57,000 child care employees — including those who were and were not actively working at the time — and found no link to known positive coronavirus infections or hospitalizations among the workforce. The study’s authors say this suggests that when done under such strict guidelines, child care can be safe fromwidespread transmission during the pandemic.