Child Care During the COVID-19 Pandemic: A Bad Situation Made Worse.

Abstract

* Abbreviation: COVID-19 — : coronavirus disease 2019 Pediatricians have long recognized that social determinants (the circumstances in which children live, learn, and play) influence the health and well-being of children and their families.1 The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of this broader scope of health care, which encompasses more than simply addressing a child’s medical conditions. Although the vast majority of COVID-19 cases in children have been mild, the secondary effects on the health of children have been profound. Downstream effects of the virus on a family’s social circumstances, including increased food insecurity, housing instability, school closures, and lack of child care, have exacerbated preexisting socioeconomic and racial disparities.2 Although it has often been overlooked, the need for safe and enriching child care that allows parents to be able to work, particularly for the most vulnerable children in our society, has become more acute over the last several months and requires urgent action. The pandemic has brought to light the lack of safe, reliable, and affordable child care options. Even before the closure of many facilities, child care was plagued by long waitlists, ballooning costs, and safety concerns. Child care costs for preschool-aged children can rival college tuition,3 making high-quality child care nearly inaccessible for many families, especially those experiencing material hardships. With recent school closures due to … Address correspondence to Nikita Kalluri, MD, Boston Medical Center, 801 Albany St, Boston, MA 02119. E-mail: nikita.kalluri{at}childrens.harvard.edu