Nothing To Sneeze At: On Daycare & Disease

Or, Daycare: the cause of as well as the solution to life's problems

A wondrous kaleidoscope of germs just waiting on every little pair of hands. (photo by Alexander Grey)

Sometimes I think back to 2019, the first year of my son’s life, when I was so in love, but also so hungry for time to sit and work and hear myself think again. Here in Berlin, all children are entitled to free childcare from the age of one, so I felt confident in envisioning the future in store; five solid writing sessions, lined up neatly on my day planner, one week after another, after another. And I remember thinking, Wow, I’m going to get so much done.

And then I laugh and laugh and laugh. Not in a joyful kind of way. More like a, “Oh, you poor dumb bunny. You had no idea,” sort of way.

It’s nearly two and a half years that Arlo’s been in daycare now. I’m trying to remember if he’s ever had two weeks in a row where he’s been there the full week. Probably? Certainly, even a single week where he’s gone the full five days seems like a triumph.

There are a few reasons for this.

The first is that there are so many public holidays here. Some of them are political, like German Unity Day, and May Day. Lots of them are religious. Germany is a very Christian country, and Berlin properly shuts down for the weeks around Christmas and Easter. And there’s loads of other days I, as a feral American, had never heard of, like the two “Himmelfahrt” days, which I’m told are the days Jesus and Mary go to heaven. I still never remember when those are, but they’re public holidays all the same, along with loads of others that catch me out every year.

Then there are the days the daycares close for their own reasons. There is fierce competition to get free spots here, so initially, when we couldn’t find one, we enrolled Arlo with a ‘Tagesmutter’ or ‘Day Mother’. This is a one or two woman operation that looks after five or ten babies, usually in an apartment rather than a full school-like facility. They’re still regulated by the state and everything, and it’s actually a good way to gently introduce babies to being away from their parents. But if you only have one lady to rely on, and she gets sick, or she has a doctor’s appointment, or she wants to go on vacation, there is no backup; daycare is closed for that day, or week, or weeks. And even now that we’ve made it into the big daycare, with dozens of adults on staff, they sometimes close in the middle of the week for trainings and things like that.

And of course, there were the entire months that the German government shut the daycares. At first, they closed them altogether. Then they closed them, but only for kids of parents who weren’t on a list of approved jobs. So if you were a doctor, or journalist, or in IT, or food service, or one of hundreds of other specific jobs, your kid got childcare as normal. If you wrote weird books and blogs, like my husband and I, your kid got nothing. And you couldn’t take your kid anywhere, because everything that wasn’t a grocery store or chemist was closed, and playdates in other flats were verboten. And we don’t have a car, or any family in this country. So there was nothing to do but take my son to the playground, day after day. And that is why, despite being born in Berlin, and rarely setting a foot outside of it, my son speaks very little German, and instead speaks extremely good English with an American accent.

But there is a more enduring reason for losing whole days of childcare, and that is having my child come home sick from said care. And holy crap, is there a lot of that. Let me run you through the school year thus far:

• In late September, there was the mystery gastrointestinal malady that made Arlo puke for days. Just as he was recovering, I started puking for days.

• A couple days after I’d recover from that, he came down with what I believe was RSV, because he was absolutely miserable for a solid week, whereas I experienced what only felt like a mild cold. The disparity in our symptoms puzzled me, until I read a headline about the virus, which described a dynamic just like that.

• We had three weeks where we could actually enjoy the beautiful fall here. And then another round of colds. That was relatively mild, and only threw us off for a handful of days.

• We had another good run of days, like a week and a half, and then: the mega-flu. I mean, holy crap. Arlo was knocked out, and my husband and I were just brutalised. I think I may have developed bronchitis on top of the flu itself. It was like someone pumped my lungs full of a kind of edamame jelly; just this unending flow of green slime choking me if I tried to do anything as foolish as talk, walk, or lay down. Even now, going on two weeks since I first joined Arlo in this latest plague and pyjama purgatory, I am not ‘well’. I’m able to sit at my desk, and hold half a thought in my head, which is miles ahead of where I was a few days ago. But I’m still a slime factory. You wouldn’t like to run into me in public.

I asked one of the guys who works at my son’s daycare and he said yep, this is what it’s like every fall and winter; the kids go to school, swap germs, get sick. Yet this year must be unusually bad. It feels like it on a personal level, and the headlines from around the world are full of stories about how a roster of viruses and bacteria are just burning through our children this year, and putting immense pressure on our already battle-weary health care systems. Doctors in Germany say the paediatric intensive care here is “close to collapse.” Hospitals across America are apparently “bursting at the seams”, with some even building overflow areas for their paediatric wings out in their parking lots. One children’s hospital in Northern Ireland has just announced they’re putting off all routine procedures because of the pressure from all the bacterial and viral infections right now. The list goes on.

I remember reading precisely these kinds of news stories about the adult wings of the world’s hospitals around this time in 2020. And you know what they did then? And again in 2021? They closed all the schools and daycares. So you might think that, now that it’s the infants and children themselves who are pouring into the hospitals, they would rush to close the schools and daycares again. But I very much doubt it. And anyhow, I hope they won’t. Because that’s what got us into this mess.

Here’s the thing; kids are gross. They are. The littlest and cutest ones most of all. I mean, with the exception of mine of course. When mine got that stomach virus, and suddenly started vomiting in my room, I instinctively reached out a hand to catch whatever was about to fly out, to try to spare my bedding. So my son can literally puke into my hand and it’s not a problem for me. But when we’re in a sandpit, and someone else’s grubby child starts toddling over to steal our shovels, with great ropes of snot trailing out either nostril, I want to gag.

The trouble is, as germ-laden as other people’s children are, mine needs to mix with them. During and after pregnancy, I read many a book and article emphasising how important this is. Learning how to socialise with peers is crucial for a child’s early mental development. And it’s crucial for developing their immune systems, too. I mean, social connection is important for children of all ages, and even for supposed adults like myself. But it’s like vitally important for little ones, who have to build their social frameworks and immune systems basically from scratch when they are born. And denying them the opportunity to mix together can have all kinds of knock-on effects.

I’ll give you a terrible example. Did you see the headlines this past spring, about a ‘mysterious increase’ in little children contracting severe hepatitis? We’re talking three year olds needing liver transplants, and no one could work out why. None of the children tested positive for any of the five standard forms of hepatitis (A, B, C, D, E). The only thing researchers could find in common was that many tested positive for a kind of adenovirus that normally just gives kids a cold. But,

UK health officials believe young children, who were not exposed to common viruses during the Covid pandemic because of reduced social mixing, are now being infected when they have no previous protection. (BBC)

Now, correlation is not causation. Every article I’ve seen on this says that they’re not completely sure if it’s the adenovirus that’s causing the liver problems, or just something that these kids all have as a separate issue. But that is the strongest possibility anyone can come up with; kids weren’t exposed to normal germs in a normal fashion, and now when they are belatedly being exposed, their bodies are not prepared. In other words, by forcing little ones to stay home and ‘stay safe’ for so long, we have created an ‘immune deficit’ in what should probably otherwise have been healthy children. Which is the kind of thing that was widely predicted from the very beginning of the lockdowns, but not deemed a priority.

This terrifying organ-failure example may be an outlier. But now we have the headlines about a strep wave crashing across schools in the UK at a completely uncharacteristic time of year, killing children, and apparently leading to scarlet fever at three times the pre-pandemic rate in some places. And we have the high levels of hospitalisation for RSV around the world. And so on. Officials kept closing everywhere young children could possibly go to play and learn with each other, and forbidding that they gather in private. And now the little ones who have lived through this whole period, like mine, are having to catch up on three flu seasons’ worth of germs in one. And that is a lot for a little body to take.

And it’s hard for those of us who have to ferry them through it; in two chief ways.

The first is in terms of family. I am, as I have been since his birth, acutely grateful that my son is a hearty, robust little guy. It has been hard enough seeing him so poorly so much of the time these last few months, and hearing his terrible coughing in the night. I can only imagine how much harder it would be if he was less healthy to begin with, or if his symptoms had required medical intervention. My heart goes out to the many families who suddenly find themselves filling the hospitals, when they should be flocking to the Christmas markets.

The second is in terms of work. If you add up all the days and nights I’ve spent looking after my sick child, plus all the days I was genuinely too ill to function, then subtract those from the total number of work days that the daycare was actually open, you get… a pretty wimpy figure. Fistfuls of days, snatched here and there. Enough time to restock our kitchen shelves, clear my desk, get just a little momentum going on my work again, and then… another virus or holiday stop it in its tracks.

This is the part of the discussion around mothers, careers, and childcare that I don’t seem to hear being addressed. I keep coming across articles and activists suggesting that if we give families access to affordable childcare, there is no limit to the amount of time and energy mothers can clock in at their jobs. And look, I 100% believe that affordable, high-quality childcare should be a top priority for any state that is genuinely interested in the welfare of its citizens and economy. But I have free, quasi-regular daycare for my son, and it’s a pleasant surprise when I can actually send him in the full week. ‘Daycare’ is not just an item you collect, like a golden coin, and go, “Great, that’s all sorted,” and move onto the next level of your game. It’s more like a weather event, that can be forecast, but with probably only 75% accuracy at best.

Now that I am into the third year of the ‘kid coming home sick from daycare’ phenomenon, I realise what an intractable issue it is, and how pervasive it must be, even in non-pandemic years. It seems to me that this must be a huge component of the motherhood penalty, and I wonder that isn’t talked about more. Maybe because it’s hard to imagine how to solve it. I mean, you can’t solve it. If you have a kid, they get sick, because they have to, and someone has to stay home with them. There’s nothing you can do about that, and no one to blame for it. There’s not a discrete policy improvement to point to, like maternity leave, that will fix it. Certainly, more daycare won’t resolve it.

Adequate paid sick leave and care leave days would go a long way to help though. It would certainly be worth considering in my own delightful homeland, where there is no national sick leave policy, and thus around 24% of workers have no sick leave at all. Here in Germany, you’re entitled to paid sick leave for up to six weeks at a time, with a doctor’s note. And many employees can take paid time off to look after their sick children, if they have a doctor’s note. If their employment contract excludes that benefit, their insurance provider will apparently cover it. Since neither my husband or I have ‘real’ jobs, we can’t use these great benefits, and just loose out on work time and income. Which is hard on the household. But, on the other hand, we don’t have to get permission from anyone to stay home, and can avoid taking our sick child to sit for hours in a waiting room full of other sick children unless he really needs to go (the heath care here is good; the waiting times are not).

But again, sick leave does not change the fact that you will have to put work aside to deal with sickness. That has a real impact on how much and how well a parent can show up to their work. And we could do a better job of building all this into our expectations of what our lives as parents are going to look like. I can’t be the only one who was surprised by it. I don’t know what I could have don’t differently, even if I’d been better prepared. At the very least, perhaps I wouldn’t have let it frustrate me as much if I’d known it was coming. Certainly, we need to give this a much bigger place in our conversations around how on earth anyone is supposed to maintain anything like a healthy, functional home life and work life. And we need to actively shoehorn it into every stinking brainstorm and think piece about how to make the modern workplace more suitable for women and families. Yes - daycare. But also yes - children are gross. Let us all try to plan accordingly.