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Are you protecting your child’s caregiver? Or putting them at risk?

Since the outbreak of COVID-19, we’ve seen an outpouring of altruistic human responses. Communities have been supporting the sick and quarantined in beautiful ways. But I have also witnessed terribly misguided behavior, often from the same people, ignoring the health and well being of those employed in their homes.

Many of the families in my children’s Jewish day school have people working in their homes to assist with childcare. In early March, with a confirmed case of COVID-19 in my children’s school, my children were placed on precautionary quarantine. Parents, however, were not placed in quarantine, and we all struggled to balance the burden of our quarantined children with our other obligations.

And the communications the school sent us about parameters of quarantine were clear in their broad strokes, but vague in important detail. “Generally, workers in the home should be prohibited,” read a note from the school. “If the worker is essential for assistance with others in the home — child care or elder care — they must be aware of the situation and should take appropriate precautions.”

But many wondered: What is essential? Each family was left on its own to decide, and a number of families decided that their child care was “essential.”

Gov. Andrew Cuomo’s executive order was similarly vague. Among the list of “essential services” exempt from his PAUSE (stay at home) regulations were “childcare services.” Here again, each family is left to decide the degree to which their nanny is “essential.”

Certainly, there are cases where care is essential. If all of a child’s primary caregivers are healthcare workers, I think we can all agree that someone else needs to take care of the kids while they work the front lines of this pandemic. But there is also a large grey zone where inconvenience can be cast as need.

And this grey zone could cost someone their life. As of Monday afternoon, there were more than 71,000 confirmed cases in New York City. Models suggest that we only know of one in ten cases, and that there are more than 630,000 people who are positive and not yet diagnosed.

In asking someone to travel across the city every day, to take public transportation, or to enter a quarantined home, what are we saying about the value of their safety? Their life? The safety of their families?

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There are moral consequences to our actions that cannot be ignored. Poorly worded public health policy should not serve as an excuse to endanger the lives of the people who work in our homes, the people who live in their communities, the hospital system and society at large. In light of all we know, I am dismayed by the decision many in my community have made to ask their childcare workers to come to their homes.

A thought experiment: If your employer asked you to come to work every day this week, or to share a cubicle with someone in precautionary quarantine, what would your reaction be? How hard would it be for you to push back on the request?

Poverty is a strong determinant of negative health outcomes. This situation helps to illustrate why: Poor families are more likely to live in close quarters. They’re more likely to share bathrooms. They’re more likely to have preexisting conditions that put them at risk and less likely to seek medical care when they become ill.

This virus will be more deadly for those who are in lower economic strata. Data is already demonstrating the strong correlation between income and the ability to stay home. Wealthier people are able to stay at home and reduce their exposure while lower-income workers are forced to move around. Although the data is just beginning to surface, it is very likely that low-income neighborhoods will be hit the hardest.

In asking caregivers to travel during this time, we are responsible for reinforcing this cycle.

This is a public health crisis that calls attention to the intensity of our interconnectedness. It is critical to be thinking about not only our own families’ health, but the public’s health, not only the trees but the forest where we all live and breathe.

Modeling by the Imperial College London indicates that unless the United States flattens the curve, upward of two million lives could be lost. At this point, we all know that to slow the rate of transmission, social distancing is necessary. Every choice to stay home can have an exponential effect. And very few people should be asked to leave their homes.

If at all possible, we need to give our children’s caregivers paid leave before asking them to put themselves and their families at risk. It is the individual responsibility of each of us to accept a great deal of inconvenience and financial loss before we endanger another person and another community.

Most of what I have witnessed surfacing in the face of this crisis has been resourceful, generous and brave people. But this virus is resourceful as well; it is making its way quickly into every home, along each line of social connection. In that way, it is inviting us to broaden our compassion, and examine our privilege.

We now have an army of children at home from school; thousands of families need to make decisions about the people they employ to care for their children. In the absence of clear policy guidelines, the burden of protecting those who work for us falls squarely on our shoulders.

Stephanie Pell, JD, MPH, lives in New York with her spouse and three children.


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