The coronavirus pandemic has been a tumultuous time for a lot of reasons, including how misinformed most of us feel. With public, political, and even scientific opinion changing almost daily, it’s sometimes difficult to figure out what to think. And in the midst of all this confusion, schools, daycare centers, and camps have been opened throughout most countries.
This brings the question – is it safe for your child to return to daycare or to get a babysitter again? Additionally, how should you go about it – what precautions should you take and what can you expect from your daycare provider?
Unfortunately, for most households, the quick answer is that they’ll only be able to provide the type of care they can afford. On a brighter note, most experts seem to believe that with basic precautions and monitoring, parents can safely rely on most types of caregivers, daycare centers, and even camps.
For example, officials from the New Jersey’s state Department of Health shared that since April 1st, when daycare centers reopened, there have been no reported Covid-19 outbreaks of two or more cases.
“That’s more than interesting, it’s absolutely entrancing!” said Dr. William Schaffner, a professor and infectious disease specialist at the Vanderbilt University School of Medicine. “That will encourage us to open the schools. It’s in line with other countries that have not closed their schools, or have only modified their school attendance somewhat.”
This isn’t to say that all the unknowns have been figured out. For one, we still don’t know how susceptible children are to transmitting the disease to one another. Even with many child centers being open for nearly two months now, there still aren’t many studies about that.
Dr. Ashish Jha, the incoming dean of the Brown University School of Public Health finds this to be quite troubling. “The idea that we’re not using every opportunity to study this stuff blinds us when making decisions,” Jha said.
Still, economic circumstances are forcing more and more parents to send their kids to daycare and camps whether it’s safe or not.
Dr. Caitlin Rivers, an epidemiologist and assistant professor at Johns Hopkins Center for Health Security also agrees with Dr. Jha. “We can’t wait for a vaccine; that’s too far off. We can’t wait for a therapy to come online to prevent severe illness.”
So, what are the risks?
The uncertainty is undeniable but the question still needs to be answered – what are the risks for our children?
“Doctors have hospitalized very, very few children with COVID-19,” said Raphael Viscidi, a pediatric virologist at Johns Hopkins University School of Medicine. “That’s been true here and true across the world. When we look at the other objective measure of judging how bad is this — death — it’s extremely rare.”
Of the over 23,000 deaths in New York City as of the end of May, a little more than a dozen were older than 20. Similar thousands-to-one ratios are obvious all across the world as well.
This isn’t to say that children are 100% safe. Recent weeks have also brought us the troubling news that a severe inflammatory syndrome in kids has been associated with Covid-19. The syndrome appears similar to the rare Kawasaki disease and includes symptoms such as fever, abdominal pain, low blood pressure, and more. Still, even that syndrome seems rare so far, plus – there are treatments for it.
How susceptible are children to becoming asymptomatic carriers?
The next – and arguably bigger – question is whether sending kids to daycare is risky for adults? The fact that our kids are safe from suffering and dying from the virus is great but they can still bring it home, right?
Yes, they can, but it might be at a lower rate. Two studies from China have confirmed that the infection rate is “dramatically higher” for adults than it is for children. The first study while the adult infection rate in their test groups was ~20.5%, the rate for children was ~4%. The other household study from Guangzhou, China found similar results.
An Icelandic study of 13,080 people also confirms this as the number of infected children there was exactly zero out of 848.
Of course, as always in science, there has to be at least one study that contradicts all the rest. That study was done in Shenzhen, China and it examined 391 coronavirus cases and their 1,286 close relatives. Of them, the infection rate in children under the age of 10 was 7.6% which is similar to the 6.6% all-ages average for the region. This led the researchers to conclude that “children are at a similar risk of infection to the general population.” Thankfully, so far this study seems to be an outlier.
The conclusion here is that the risk of children getting infected and infecting others after that is relatively low. This isn’t to say that infected children are less infectious, however. To the contrary – a study from Germany has concluded that children have the same “viral load” as adults, meaning that they can be just as effective carriers as them.
“Based on these results, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation,” the authors wrote. “Children may be as infectious as adults.”
Kids are just less likely to become carriers in the first place and that’s what makes daycare centers and sleep-over camps a not so horrible idea. Besides, there’s much more research that needs to be done as well. For example, one recently-started study from the National Institutes of Health is attempting to figure out what percentage of infected children are symptomatic.
How should parents weigh the risks?
Every parent’s situation is different so there isn’t a single blanket advice that can be given to everybody. From budget differences, through the type of area you live in, to your family’s members and risk factors, every parent will have to make the decision of returning their children to daycare on their own.
Still, if you’re uncertain, here’s a quick list of the main things you should consider:
- How many people have contracted Covid-19 in your region?
- Do you live with or frequently visit elderly relatives or family members within the main health risk groups?
- What are the social costs of keeping your child in isolation? If you have multiple children who get along or one child who tends to be more of an introvert, isolation will be easier. However, if you have a child that requires frequent social contacts, isolation can be too costly. There are plenty of studies that have concluded that prolonged isolation can lead to increased risks of depression and anxiety in kids as well as adults.
- Do you have frequent social contacts at your workplace? If you work from home than getting Covid-19 from your child will mostly be a risk you bear alone. However, if you yourself have frequent social contacts, your child’s daycare can become a major risk for the community through you as a secondary transmitter. Sadly, it’s precisely essential workers who have to keep working with other people that need daycare or babysitter services the most.
- How important is for your child to go to kindergarten or daycare? Is your child at risk of missing out on important development skills if she/he stays home?
Which child care option is the safest?
Say you don’t have a choice and you have to get your child some form of daycare. Say that the financial differences between the several main options are irrelevant – which should you choose?
Most experts agree that it isn’t the type of the child care that matters as much as its quality. In other words, all types of daycare, kindergarden, school, day camps, sleep-in camps, and babysitting can be relatively safe if the instructors there follow the CDC safety guidelines. On the other hand, all types can be risky for you and your child if safety guidelines are not followed.
If there’s one type of daycare that should probably be singled out as too risk it’s any daycare for infants and toddlers. That’s simply because these children are too young to be taught not to put things in their mouths. Additionally, they also require much more physical contact due to the constant bottle feeding, diapering, etc.
In short, it’s best to keep infants and toddlers at home but you can let older children to daycare or school if the circumstances in your state are favorable and the care provided follows all safety guidelines.