Preschooler parents face the toughest choice as offices reopen

Back in March, Rita Hamad decided to pull her 3-year-old daughter out of a Bay Area preschool just as California started shutting down.

Hamad, 38, a social epidemiologist at the University of California, San Francisco, and her husband, another faculty member, juggled work and child care while stuck inside — like so many other American parents. “Thankfully, we can both work from home and our work hours are flexible,” Hamad said. “But that meant we were spending a lot of time in the evenings and on weekends working to make up for those lost hours.”


More than 5 million working families with children under the age of 5 paid for some form of child care before the coronavirus pandemic struck. Now, with many U.S. businesses calling employees back to the office, parents like Hamad with preschool-age kids face a difficult choice.

According to a recent survey, about 60% of families who typically pay for daycare said they were somewhat or very uncomfortable sending their children to child-care centers. But with work-from-home options narrowing for many parents, placing their children — and themselves — at potentially greater risk is fast becoming a real possibility.


While families mull this difficult decision, the U.S. child-care industry is in trouble. Back in April, almost half of the 5,000 child-care providers surveyed by the National Association for the Education of Young Children were closed. By mid-June, more than 80% of child-care centers said they were open, but enrollment was down by an average of 67%.

The $3 trillion bailout passed by Congress in March allocated $3.5 billion to support child-care providers, an industry that before the pandemic employed more than 1.1 million people, according to the U.S. Bureau of Labor Statistics.

Advocates for child care-providers are pushing for $50 billion in additional aid. About 40% of respondents in June said they would close permanently if they didn’t receive more public assistance. Only 18% said that they could survive more than a year with less than 80% of their pre-coronavirus enrollment and no public assistance.

Almost half of America’s licensed child-care slots — accounting for more than four million children — could disappear because of the pandemic, according to an April analysis. Many child-care providers operated on razor-thin margins before the pandemic. State requirements that they restrict enrollment to maintain smaller group sizes to avoid virus transmission will leave money on the table they can ill afford to sacrifice.

“One month of not getting the enrollment you expected can have a devastating impact,” said Simon Workman, director of Early Childhood Policy at the Center for American Progress.

Bright Horizons, which also works with employers to provide worker child care, typically operates almost 700 centers in the U.S. Right now, there are only 250 open, according to Chief Executive Officer Stephen Kramer. He said the company has implemented safety measures, including reduced class sizes and adults wearing masks, and plans to reopen all its centers by September.

Such safety precautions — physically separating children, personal protective equipment and sanitization — require money that many providers say they don’t have. With states limiting enrollment sizes, it means less revenue coming in while paying for new safety measures. Some 70% of providers contend they are spending more every month — ranging from an additional $3,136 at large child-care centers to $500 or more at smaller family centers.Some states have already distributed grants provided under the first federal bailout, money that was aimed at funding care for the children of essential workers, such as nurses and other health care professionals, while helping providers weather the pandemic. Alabama is offering grants to child-care providers that agree to reopen by Aug. 17, while Nebraska is giving priority to those that say they will reopen within 30 days, among other prerequisites. New York City is offering $65 million in grants to preschools and daycare centers that reopen by the end of this month.

But even if more aid comes from Congress in a second bailout currently being negotiated, it may not be enough — especially since the pandemic is expected to extend into 2021.


“The cost of child care under these conditions is probably going to be two or three times as much as you would expect under normal conditions, simply because you’re going to have fewer children in the program and fewer children per adult,” said Walter Gilliam, president of the board for Child Care Aware of America, a nonprofit that advocates for high quality, affordable child care and provides resources for families and providers. The group is calling for a $50 billion child-care bailout.

But for parents, safety likely comes before money. Children age four and below make up 1.4% of all confirmed U.S. coronavirus infections, according to the U.S. Centers for Disease Control and Prevention, equaling more than 30,000 of known cases. Multiple studies have found that children typically have more mild symptoms from the virus than adults.

“Children might still have fever, cough, shortness of breath, sore throat, runny nose, muscle aches and headaches similar to adults, but not as many of them might have symptoms or they might be more mild,” said Anna Sick-Samuels, assistant professor of pediatric infectious diseases at Johns Hopkins School of Medicine, in an interview last month.

That does not mean, however, that children are immune or can’t pass the virus on to parents or child-care providers. The risk of transmission between children and adults is not yet known in the commercial child-care setting, Sick-Samuels said at the time.

Marcy Whitebook, founding director of the Center for the Study of Child Care Employment at the University of California, Berkeley, said providers are also weighing the risk of infection of their staff against the needs of families. With no national pandemic strategy, and different rules in different states, the decision on how to provide child care is being left up to individuals, she said.

Gilliam, a professor of child psychiatry and psychology at Yale University’s Child Study Center, said the struggle to reopen child care services safely — while critical to the economy so parents can work — is a conundrum, because the employees who provide child care will also be at risk. “When we neglect child-care providers, we neglect children,” he said.


The CDC issued guidelines for child-care programs that have remained open, but it is the states that control child-care providers. Texas rolled back its guidelines for child-care providers then re-instituted them in late June. As of July 9, more than 8% of the centers that were open had reported an infection, with more than 1,600 total cases at child-care centers across the state. The number of cases has since risen to 2,300.

In Norwell, Massachusetts, Lisa Commesso must follow a 32-page document issued by the state describing minimum safety requirements for her home child-care business, where she supervised as many as 10 children before shutdowns ensued. She plans to reopen in September, but worries about the social and emotional effects this new style of care will have on children.

Many of the best practices in childhood education conflict with keeping the coronavirus at bay. Sharing toys and meals, for instance, is no longer possible. Commesso said she must forgo “circle time” under state guidelines, part of requirements that she keep children as socially distanced as possible. “There’s just so many factors,” she said.

Social distancing “doesn’t make for a very developmentally stimulating or enhancing environment” for preschool children, said Alice Kuo, a professor of internal medicine and pediatrics at the David Geffen School of Medicine at the University of California, Los Angeles.

Gilliam of Yale agreed: “In many cases, we’re asking (child-care workers) to do the exact opposite of what we’ve been trying to teach them to do for many years.”

“Most people really struggle to find child care that is affordable and meets their needs.”


And as Gilliam noted, parents willing to return their charges to preschool will face an additional obstacle: paying more money. Increased costs could be passed onto consumers, and more than half of parents are expecting child care costs to be higher than before the pandemic.

Even before the pandemic, access to child care was a financial burden for many Americans. More than half of families who use child care services spend more than $10,000 per year on it, according to a survey, and almost three-quarters spend at least 10% of their income on the service.

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“Most people really struggle to find child care that is affordable and meets their needs, which leaves them kind of scrambling to put together a patchwork of care,” said Workman of the Center for American Progress.

Some retailers have announced temporary child care benefits for employees. Amazon in early June said it would subsidize 10 days of child or adult care through — a provider of on-demand child-care services — for its 650,000 employees. Target is offering free back-up child and elder care for employees through August, giving them access to Bright Horizons at one of its centers or in-home services, according to a Target spokesperson.

For Hamad, the decision to send her child back to preschool when it reopened June 15 was “filled with angst.” The facility is keeping the children in small groups, following local guidelines and having the kids wash their hands constantly, she said.

“They’re having her wear a mask or a face shield, which I thought at first seemed pretty cruel, but then the kids seemed to love it,” Hamad said. “They’re just, ‘hey, I’m just like mom and dad.’”


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