Krista Lyn Harrison

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The importance of childcare across a pandemic

In reviewing my weekly letters from the two years of the pandemic, I see an ongoing thread about the importance of childcare.

An article written by a friend about the history of the child care movement includes the story of when federally-funded childcare was expanded during WWII so that women could enter the workforce. Early in the pandemic, I was entirely frustrated that the school/childcare issue is being left out of the conversation about re-opening the economy.

In week 8 of the pandemic I was waiting for news about when childcare can resume. Our daycare says we can't all come back until the 10-person group restriction is lifted (e.g. the end of shelter-in-place) and they will be prioritizing only those who need to be on-site to do their jobs starting in June 2020. Apparently as faculty I can claim I'm "essential"....but that's pretty debatable in my mind. It's really hard to make a decision from pragmatic, moral, and public health-minded perspectives. I didn’t want people recommending solutions about the work/childcare situation - I’m resourceful and smart, I’ve thought of most of the options. I just wanted to be told that whatever I'm doing or not doing is acceptable. So for any of you feeling similarly right: you're doing great, whatever you're doing. You don't have to do anything different. Radical acceptance.

In week 10, a colleague sent this article predicting the collapse of the child care industry because it’s not publicly financed. With some googling I learned 33.4 million families, 2/5 of all families, have kids under age 18, and 91% of those families had one parent employed in 2019. I’d like to see more advocacy for public investment to help reinvent schools and daycare for pandemic circumstances, in order to have a workforce again. Improved ventilation and filters to reduce transmission, free rapid PCR tests every week to reduce spread of otherwise undetected cases.

In week 11, we had the experience that when Sam and I stayed inside our mental bubble of focusing on just our household we could remain in balance – but when we start hearing about what other people are doing (friends getting access to childcare again or what coworkers are accomplishing) it was harder to keep emotional equilibrium. This tells you about the intensity of stress we were under.

In week 17, Theo went back to school, and it took us a month or two to re-adjust.

In week 27, we started talking about the mental health crisis that is pandemic parenting amid all these other crises.

In week 35 we started to see data on the unequal effects of the pandemic on scientists – having a dependent age 0-5 was associated with a 17% decrease in research time in April 2020….a gap that I assume got worse with time as we lost resilience.

In week 48 the UCSF K Scholars women’s support group talked about the differential experience of women junior clinician-investigator faculty because of gender imbalances in home caregiving. Some of the members also recently published a study of the impact of pandemic parenting on physician moms, with 41% of respondents reporting moderate to severe anxiety. Both UCSF and NIH have mechanisms for caregivers (of kids or older adults) to request additional funding support for research - but you have to have enough bandwidth to apply, and there’s no guarantee that everyone in need will receive it. In additionally, UCSF has been implementing family-friendly policies and examining gender-based salary inequities - they are improvements but still inadequate.

In week 57, the continued (depressing) news about the impact of the pandemic on women researchers – which is, of course, many times worse for researchers who are women of color from communities that are more intensely impacted by covid.

Though conversations about childcare shortages have abated in the first half of 2022, I suspect in August and September we will hear again about staffing shortages in schools and especially in childcare centers and preschools. Clinician, physician parents - especially moms of young kids - are particularly burnt out after 2+ years of juggling unpredictable child care, higher volume of clinical demand, and higher acuity of needs in each clinical interaction. At least, this is particularly intense among the geriatricians, primary care providers, and home care clinicians I know. In June, the NYT posted a survey to help people self-identify their degree of parental burnout, as well as an opinion piece about the current state of parental burnout.

We’ve been privileged that the classrooms that Theo’s been in at our childcare center didn’t have COVID exposures until this spring, after public health systems and recommendations ended, like easy access to PCR tests and masking indoors and on planes. We’re preparing for Theo to start kindergarten at the local public school in August, yet so far the school doesn’t have information to share on the official start date, the length of the school day, or the availability or price of after care. I’m blocking off my work calendar 8-9am for potential school dropoff, and from 2pm onward, to cover my bases during this time of uncertainty - things that are possible for me as a researcher but would be impossible if I were a clinician. Of course, I’m assuming aftercare will work out and I won’t be trying to cram 8-10 hours of work into 5 hours. This is my quiet way to make the challenge more transparent and to avoid meetings scheduled at times that make life more challenging for parents.

In the meantime, I’m using my weekend afternoons to grab naps when I can.