Families, day cares feel strain of new COVID-19 health rules

.... As more families make the jump back to group day care this fall in an attempt to restart lives and careers, many parents, pediatricians and care operators are finding that new, pandemic-driven rules offer a much-needed layer of safety but also seem incompatible with the germy reality of childhood.

They stem largely from coronavirus guidelines issued by the Centers for Disease Control and Prevention lowering the fever threshold, disqualifying even a single bout of diarrhea or vomiting and making sniffles suspect in group settings.

But the guidelines don’t take into account that young children are prone to catching the common viral infections that help build up their immune systems, or that seasonal allergies, crying, even teething and normal playground exertion can prompt a COVID-19-like symptom.

And the price parents and kids pay for such symptoms — which could easily signal either a happy, healthy toddler, or a lurking case of the disease that has now killed more than 230,000 people in the U.S. — is now a dayslong disruption. ...uilt over neglecting work.

Medical experts acknowledge the lines are blurry for kids with symptoms.

The CDC notes on its website that young children commonly have up to eight respiratory illnesses or colds each year as a matter of course. In its guidelines for K-12 schools, the CDC warns that excluding children for longer than “existing” policies over COVID-19 symptoms alone could cause unnecessary absences.

The American Academy of Pediatrics’ latest child care guidelines released in October initially didn’t include congestion, runny nose, vomiting or diarrhea on its symptoms checklist. Following questions from The Associated Press, the pediatricians’ group updated its recommendations on Friday to include those symptoms in alignment with the CDC, calling it an oversight. ...

Dr. Elaine Donoghue, who helped write the pediatricians’ child care guidelines, said any symptom must be taken seriously if it looks even vaguely like COVID-19. While young children are prone to minor infections, they now in theory face less exposure to those milder illnesses due to pandemic-related social distancing, and that means the calculus behind assessing symptoms changes.

“We should not be expecting certainty during a pandemic,” Donoghue said. “This is an uncertain time.”