Our decision on daycare this fall
My wife and I are nervous about sending our son to daycare, specifically because of COVID-19. Our concerns are (1) him getting infected; and (2) spreading it to us and others. Unless we shelter in place with no outside contact ever, we realize that there is no way to make the risk of infection equal to zero.
Our son’s pediatrician, and other doctors, have made recommendations, and yet, we weren’t able to make a decision. Despite having all the facts and guidance, our emotional sides were complicating our decision making. We needed a narrative to help us feel better. In this post, I talk through some of the research we conducted to stress test some of the guidance and recommendations that helped us decide to send our son to daycare this fall.
Disclaimer
I’m just Tim the Dad. I’m not a medical professional. I’m sharing my thought process in the spirit of contributing to the broader dialogue concerning COVID-19 and our children.
Our plan
The daycare that we’ve chosen for our son opens this month. We were initially planning to wait until our newborn daughter turned a little older before sending him in. But, we figure that most of the kids there will already have vaccinations for all of the really bad stuff. Additionally, the daycare we’ve chosen is going beyond the federal guidance for child care facilities, making us feel a lot better about his risk for COVID-19 or other general sicknesses.
We’re going to continue to do our part and practice social distancing, mask wearing, and good social hygiene. Hopefully we’re helping limit the spread of COVID-19, which, in theory, should help mitigate spread to daycares, too.
Building our narrative with data
From what we can tell, children are (1) less susceptible to infection, and (2) less likely to be a vector. Observational data concerning states’ daycare appear to align with those claims.
Nationally
Across the country, it seems like the rate at which children’s share of cases is slowing, see Appendix Table 2 in AAP’s weekly presentation. Earlier on in the pandemic, children’s share was increasing at about half a percentage point per week. During the past month, the week-over-week increase has dropped to 0.2 percentage points (as of the August 27, 2020 publication).
One thing that does concern me is that children’s share has been rising steadily. My intuition tells me that COVID-19 was particularly effective at spreading amongst the older demographic initially, but, as the states and local jurisdictions took social distancing measures, there was a sort of reversion to the mean, i.e., we reduced spread amongst older populations, and therefore, any increase in children would necessarily mean an increase in children share.
My fear is that my intuition is at least partially incorrect, and rather, children’s share is rising as a function of returning to schools and daycares reopening. That makes sense logically, and at the same time, isn’t necessarily mutually exclusive with the belief that children are less vulnerable to infection and less likely to be a vector.
In that same presentation, in Appendix Table 3, it appears that children’s share of total cases is less than the children's share of overall population within each state or city. That implies to me that children are less susceptible than the general population.
Locally in NYC
New York City (NYC) releases a ton of data as well as tools to inspect the data. This has made it easier for me to compare against the World Health Organization’s (WHO) criteria to change COVID-19 measures, particularly whether “[t]here is indication that the epidemic is controlled.” For example, WHO recommends (among other things):
Testing: “Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, assuming that surveillance for suspected cases is comprehensive,” where comprehensive means “in the order of 1/1000 population/week.”
Deaths: “Decline in the number of deaths among confirmed and probable cases at least for the last 3 weeks.”
Using the graphics here, I see that (a) the number of tests is greater than 1/1000th the NYC population, and (b) that the positivity rate is well below 5%. I’m also looking at the data by zip code here, and it looks like my neighborhood meets that testing criteria, too. I’m specifically looking at the last table called “Recent Testing by ZIP Code,” and then selecting the “Table” view.
Also, according to the same American Academy of Pediatrics’ presentation, the net increase in children cases is amongst the lowest in the country here in NYC (see Figure 5). It’s hard to tell, however, whether this rate of increase is below, above, or at the same rate of increase across the city as a whole.
Other states
I started to scan, compile, and analyze the interwebs for data in other locations. Eventually, I came across this post from Emily Oyster, which is far better than anything I could have put together myself. And she’s got a ton of useful information on her broader site, like this framework to help parents think about grandparents and daycare.
Closing thoughts
My intent is not to convince readers to do anything, but rather, to share how I’m thinking about daycare. It’s probably worth reiterating that I’m just Tim the Dad. I’m not a medical professional. I’m sharing my thought process in the spirit of contributing to the broader dialogue concerning COVID-19 and our children.
