Child-care experts say they are increasingly concerned America’s child-care system, fragile even before the coronavirus pandemic, is in danger of collapse without substantial help from Congress.

The issue affects not just the nearly 12 million children under age 5 and their families who rely on providers for care, but also is a factor in how quickly the U.S. economy can recover from the crisis. Although we hear much more about this concern in regard to the reopening of K-12 schools, the same basic problem holds true for working parents who have young children: If they have to stay home to take care of their kids, they can’t return, or give full attention, to their jobs.

Between March and April, 336,000 child-care workers lost their jobs, and thousands of child-care centers and family child-care homes are in danger of closing permanently, according to Hanna Melnick, who co-leads the early childhood learning team at the nonprofit Learning Policy Institute, a California-based think tank co-founded by Linda Darling-Hammond. Melnick wrote in a blog on the institute’s website that closures of these programs “could lead to the loss of as many as 450,000 child care slots,” which would make it difficult for parents to return to work.

The National Association for the Education of Young Children and the Early Care and Education Consortium recently joined advocacy organizations calling for some $50 billion in emergency stimulus funding to keep the child-care industry from collapsing.

That is the amount Sen. Patty Murray (D-Wash.) is pushing for Congress to provide for child-care stabilization grants just to get programs beyond the crisis and to help them prepare for smaller, safer classes when they reopen. Murray was key in securing some $3.5 billion for child care nationwide to assist low-income families in the $4 trillion economic stimulus package, known as the Cares Act, that Congress passed in March.

On Wednesday, she and other lawmakers, including Rep. Rosa L. DeLauro (D-Conn.), chair of the House Appropriations subcommittee on labor, health and human services, and education, and related agencies, and Rep. Robert C. “Bobby” Scott (D-Va.), chair of the House Education and Labor Committee, introduced legislation that would create a $50 billion Child Care Stabilization Fund.

“I am worried that the child-care system is at risk of collapsing,” said Murray, who is the ranking Democrat of both the Senate Health, Education, Labor & Pensions Committee and the Appropriations subcommittee on labor, health and human services, and education, and related agencies.

“They need federal support to make sure they stay alive,” she said. “We know a lot of providers had to shut down though a number stayed open to provide care for the children of essential workers. The tuition they relied on has been depleted. Many of them are telling me they are not going to be able stay open because they can’t pay rent and pay teachers."

“It’s one of those hidden crises people don’t want to talk about because they don’t want to make it sound like a problem,” she said.

Melnick wrote that the child-care system has long been in a fragile state.

“Despite increases to public funding, more than half of child care and early learning costs in our nation are paid by families, and many programs that serve children on public subsidies also rely on private tuition,” she wrote.

“In a recent survey, 61 percent of parents reported that their child care provider had closed due to covid-19. Most parents have stopped paying tuition during the closure,” she said. “There is little room for providers to make up for that lost revenue, since they operate on thin margins and the vast majority of funds go to payroll and rent. Cutting wages isn’t a viable option, given that child care workers are paid an average of just $10.72 an hour — which is less than what 98 percent” of what other U.S. workers earn.

Here is the guidance published by the Centers for Disease Control and Prevention on how child-care programs can safely reopen during the pandemic:

INTERIM GUIDANCE FOR CHILD CARE PROGRAMS

The gradual scale up of activities towards pre-covid-19 operating practices at childcare programs is crucial to helping parents and guardians return to work. Many states have closed schools for the academic year and, with summer quickly approaching, an increasing number of working parents may need to rely on these programs. CDC’s Interim Guidance for Administrators of US K-12 Schools and Child Care Programs and supplemental Guidance for Child Care Programs provide recommendations for operating childcare programs in low, moderate, and significant mitigation communities, In communities that are deemed significant mitigation areas by state and local authorities, childcare programs should be closed. However, childcare programs can choose to remain open to serve children of essential workers, such as healthcare workers. All decisions about following these recommendations should be made locally, in collaboration with local health officials who can help determine levels of covid-19 community transmission and the capacities of the local public health system and healthcare systems. CDC is releasing this interim guidance, laid out in a series of three steps, to inform a gradual scale up of operations. The scope and nature of community mitigation suggested decreases from Step 1 to Step 3. Some amount of community mitigation is necessary across all steps until a vaccine or therapeutic drug becomes widely available.

Scaling Up Operations

• In all Steps:

“Establish and maintain communication with local and State authorities to determine current mitigation levels in your community.

Protect and support staff, children, and their family members who are at higher risk for severe illness.

“Provide staff from higher transmission areas (earlier Step areas) telework and other options as feasible to eliminate travel to childcare programs in lower transmission (later Step) areas and vice versa.

“Encourage any other community groups or organizations that use the childcare facilities also follow this guidance.

• Step 1: Restrict to children of essential workers.

• Step 2: Expand to all children with enhanced social distancing measures.

• Step 3: Remain open for all children with social distancing measures.

Safety Actions

• Teach and reinforce washing hands and covering coughs and sneezes among children and staff

• Teach and reinforce use of cloth face coverings among all staff Face coverings are most essential at times when social distancing is not possible Staff should be frequently reminded not to touch the face covering and to wash their hands frequently. Information should be provided to all staff on proper use, removal, and washing of cloth face coverings.

• Have adequate supplies to support healthy hygiene behaviors, including soap, hand sanitizer with at least 60 percent alcohol (for staff and older children who can safely use hand sanitizer), paper towels, and tissues.

Intensify cleaning, disinfection, and ventilation (Steps 1—3).

Clean, sanitize, and disinfect frequently touched surfaces (for example, playground equipment, door handles, sink handles, drinking fountains) multiple times per day and shared objects between use.

• Avoid use of items (for example, soft or plush toys) that are not easily cleaned, sanitized, or disinfected

• Ensure safe and correct application of disinfectants and keep products away from children.

• Ensure that ventilation systems operate properly and increase circulation of outdoor air as much as possible such as by opening windows and doors. Do not open windows and doors if doing so poses a safety or health risk (for example, allowing pollens in or exacerbating asthma symptoms) to children using the facility.

Take steps to ensure that all water systems and features (for example, drinking fountains or decorative fountains) are safe to use after a prolonged facility shutdown to minimize the risk of Legionnaires’ disease and other diseases associated with water.

Promote social distancing.

• Steps 1 and 2

“Ensure that classes include the same group of children each day and that the same childcare providers remain with the same group each day, if possible»Restrict mixing between groups»Cancel all field trips, inter-group events, and extracurricular activities (Step 1),

“Limit gatherings, events, and extracurricular activities to those that can maintain social distancing, support proper hand hygiene, and restrict attendance of those from higher transmission areas (Step 2; Note: restricting attendance from those in Step 1 areas)

“Restrict nonessential visitors, volunteers, and activities involving other groups at the same time»Space out seating and bedding (head-to-toe positioning) to 6 feet apart if possible.

“Close communal use spaces, such as game rooms or dining halls, if possible; if this is not possible, stagger use and disinfect in between uses.

“If a cafeteria or group dining room is typically used, serve meals in classrooms instead Put each child’s meal on a plate, to limit the use of shared serving utensils and ensure the safety of children with food allergies.

“Stagger arrival and drop-off times or put in place other protocols to limit direct contact with parents as much as possible.

• Step 3

“Consider keeping classes together to include the same group of children each day, and consider keeping the same childcare providers with the same group each day

“Allow minimal mixing between groups Limit gatherings, events, and extracurricular activities to those that can maintain social distancing, support proper hand hygiene, and restrict attendance of those from higher transmission areas (Step 1 or 2 areas)

“Continue to space out seating and bedding (head-to-toe positioning) to 6 feet apart, if possible

“Consider keeping communal use spaces closed, such as game rooms, playgrounds, or dining halls, if possible; if this is not possible, stagger use and disinfect in between uses

“Consider continuing to plate each child’s meal, to limit the use of shared serving utensils and ensure the safety of children with food allergies.

“Consider limiting nonessential visitors, volunteers, and activities involving other groups. Restrict attendance of those from higher transmission areas (Step 1 or 2 areas).

“Consider staggering arrival and drop-off times or putting in place other protocols to limit close contact with parents or caregivers as much as possible

• Limit sharing (Steps 1—3)

“Keep each child’s belongings separated and in individually labeled storage containers, cubbies, or areas and taken home each day and cleaned, if possible.

“Ensure adequate supplies to minimize sharing of high-touch materials to the extent possible (art supplies, equipment etc assigned to a single child) or limit use of supplies and equipment by one group of children at a time and clean and disinfect between use»If food is offered at any event, have pre-packaged boxes or bags for each attendee instead of a buffet or family-style meal»Avoid sharing of foods and utensils.

“Avoid sharing electronic devices, toys, books, other games, and learning aids.

“Prevent risk of transmitting covid-19 by avoiding immediate contact (such as shaking or holding hands, hugging, or kissing).

• Train all staff (Steps 1—3)

“Train all staff in the above safety actions Consider conducting the training virtually, or, if in-person, ensure social distancing is maintained.

Monitoring and Preparing

Check for signs and symptoms(Steps 1—3)

• Screen children upon arrival, if possible Establish routine, daily health checks on arrival, such as temperature screening of both staff and children. Options for daily health check screenings for children are provided in CDC’s supplemental Guidance for Child Care Programs that Remain Open and in CDC’s General Business FAQs for screening staff.

• Implement health checks (e g temperature checks and symptom screening) screenings safely and respectfully, and with measures in place to ensure confidentiality as well as in accordance with any applicable privacy laws or regulations. Confidentiality should be maintained.

• Employers and childcare directors may use examples of screening methods in CDC’s supplemental Guidance for Child Care Programs that Remain Open as a guide.

• Encourage staff to stay home if they are sick and encourage parents to keep sick children home.

Plan for when a staff member, child, or visitor becomes sick (Steps 1—3)

• Identify an area to separate anyone who exhibits covid-like symptoms during hours of operation, and ensure that children are not left without adult supervision.

• Establish procedures for safely transporting anyone sick to their home or to a healthcare facility, as appropriate.

• Notify local health officials, staff, and families immediately of any possible case of covid-19 while maintaining confidentiality consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state privacy laws

• Close off areas used by any sick person and do not use them until they have been cleaned. Wait 24 hours before you clean or disinfect to reduce risk to individuals cleaning. If it is not possible to wait 24 hours, wait as long as possible. Ensure safe and correct application of disinfectants, and keep disinfectant products away from children.

• Advise sick staff members or children not to return until they have met CDC criteria to discontinue home isolation.

• Inform those who have had close contact to a person diagnosed with covid-19 to stay home and self-monitor for symptoms, and to follow CDC guidance if symptoms develop. If a person does not have symptoms follow appropriate CDC guidance for home isolation.

Maintain healthy operations (Steps 1—3)

• Implement flexible sick leave policies and practices, if feasible.

• Monitor absenteeism to identify any trends in employee or child absences due to illness. This might indicate spread of covid-19 or other illness. Have a roster of trained back-up staff in order to maintain sufficient staffing levels.

• Designate a staff person to be responsible for responding to covid-19 concerns. Employees should know who this person is and how to contact them.

• Create a communication system for staff and families for self-reporting of symptoms and notification of exposures and closures.

Support coping and resilience among employees and children.

Steps 1—3

• It is very important to check State and local health department notices daily about spread of covid-19 in the area and adjust operations accordingly.

• Where a community is deemed a significant mitigation community, childcare programs should close, except for those caring for the children of essential workers, such as the children of health care workers.

• In the event a person diagnosed with covid-19 is determined to have been in the building and poses a risk to the community, programs may consider closing for a few days for cleaning and disinfection.