The Child-Care Crisis Is Even Worse for Health-Care Workers

Medical professionals need to be at work more urgently than ever, but their child care has essentially evaporated. Eager (but fragile) networks of volunteers have stepped in to help.

Getty / The Atlantic

When Ellen Lubbers first decided to try to help the doctors and nurses of Ohio State University’s Wexner Medical Center line up child care for their kids, whose schools had suddenly closed as a result of the coronavirus pandemic, she didn’t realize just how much help they actually needed.

On March 14, Lubbers, a 30-year-old third-year OSU medical student, saw a small commotion sparked by a tweet from one of her classmates: Because clinical rotations had been canceled, the classmate had offered her services as a babysitter to any doctor or nurse. Other students immediately jumped in with similar offers, and Lubbers wondered if one central, shareable document might be more helpful than a disjointed smattering of tweets.

Lubbers set up a Google Doc, where, with permission, she listed the contact information of other interested students. “I sent the link to one person, a clinician who’s a mom,” Lubbers told me. “I said, ‘If you think this would be helpful to anybody, please share it.’” Within hours, some of the first students who had signed up were sending panicked emails to Lubbers: They had been swamped, already, with more requests from health-care workers than they could handle.

As COVID-19 cases multiply all over the United States, the influx of new hospital patients has put a strain on medical centers’ resources—of both the material variety and the human. In New York State, where it’s estimated that nearly half of America’s confirmed coronavirus cases are located, hospital staffs are spread so thin that Governor Andrew Cuomo and New York City Mayor Bill de Blasio have called on retired doctors and nurses to form a “medical reserve” force. Many if not most primary-care physicians and hospital staffers are at work much more than usual, and some are even living apart from their families to protect them from exposure. Meanwhile, the infrastructure that usually provides care for their kids (schools and day cares) have mostly closed. As a result, many health-care workers are facing an impossible choice between caring for victims of a pandemic and caring for their own children at home. Other people whose job or education has been put on hold by the pandemic have rushed to fill the vacuum and help these parents get the assistance they need—but even that presents a number of challenges.

After Lubbers’s Google Doc proved to be an unsustainable system, she created an online form, where health-care workers who needed help and students willing to babysit could enter info about themselves into a database—where they lived, what hours they needed assistance or were available, what kind of assistance they needed or could provide. Lubbers included “petsitting” and “errands” as categories of available aid, but “really, people just needed child care,” she said. “Of the 90-some requests we fielded, there were, like, three for other services.”

The form went online on the afternoon of March 15, and it, too, was inundated by the next morning. Lubbers and another medical student got to work matching health-care workers with willing students; Lubbers said she was emailing, calling, and texting people for the next 13 hours straight. Making her job harder was the fact that a lot of health-care personnel needed child care right that minute: “A lot of in-home day cares were electively closing at that point,” she told me, “and it was really frustrating for providers that some of their normal babysitters and normal nannies were not willing anymore to watch their kids, because they’re kids of doctors who are going to go to a hospital,” and thus their household was at greater risk of contracting COVID-19. The form was closed a few days later, when the OSU medical center stepped in and offered to help match students with employees using the app Juggle. But before it closed, about 100 students had signed up to provide help, 91 parents had signed up to receive it, and 61 matches been arranged.

OSU’s grassroots effort isn’t the only one of its kind; similar ad hoc babysitting networks have sprung up at Dartmouth, Johns Hopkins, and the University of Minnesota, among other places. As of Monday, the group that has grown out of the University of Minnesota—known as MN CovidSitters—had approximately 300 volunteers, many (but not all) of whom are med-school or nursing students. MN CovidSitters, like OSU’s network, also offers pet care and errand-running, but has primarily been tasked with coordinating child care; unlike OSU’s network, in which parents and their sitters or helpers can negotiate pay individually, MN CovidSitters provides all services for free. The group is looking to expand to meet the needs of health-care workers statewide, and recently partnered with Clinician Nexus, an app often used by medical schools to manage students’ clinical rotations, to match families with volunteers. It has also begun accepting volunteer applications from any university students currently located in Minnesota, as long as they submit to a background check and are fully up-to-date on immunizations; applicants who are CPR-certified are strongly preferred.

Lubbers and student organizers from MN CovidSitters told me that the response from doctors has been positive overall. “We’ve gotten many letters of gratitude from our professors and mentors,”  said Sara Lederman, a 30-year-old second-year medical student and one of MN CovidSitters’ founders. Lubbers noted that having their kids cared for by a health-care student seemed to put a lot of health-care workers’ minds at ease. “There are a lot of doors you have to go through to become a medical student or nursing student,” she said, “and they knew a medical [or nursing] student would be vaccinated and have had a background check.”

Lederman also acknowledged, however, that there are risks to this kind of solution—risks that may have hindered some schools from getting similar efforts off the ground (or so she’d heard). “I think there’s a lot of concern around infection and around liability issues,” she said.

Indeed, one challenge inherent to any kind of child care at this moment is that it necessarily involves people coming and going into other people’s homes—which directly contradicts the best practices of social distancing. And when the kids who need looking after live with a health-care worker, one of the homes in the equation is automatically at a higher risk of coronavirus exposure.

Lubbers and her OSU classmates adopted a one-to-one student-to-family system to minimize exposure, but it quickly became clear that students’ available time was insufficient to meet families’ child-care needs. MN CovidSitters, by contrast, has been using what it calls a “pod model,” whereby three or four students are assigned to one family and encouraged to limit their exposure to anyone else—an approach that trades minimizing exposure for maximizing coverage. Last week, during spring break, Jacob Walling, a 23-year-old first-year University of Minnesota medical student, was able to spend some 19 hours over the course of two days caring for a pair of school-age kids whose single mom is a health-care worker. This week, class is back in session, and “I still have four hours of lectures to go through today online,” he told me on Monday—so other students will take over for him, and he’ll resume child-care duties next week.

Both approaches meet the goal of providing child care to workers who desperately need it, but neither perfectly meets health-care workers’ needs while also perfectly complying with social-distancing guidelines. There may not be a system that can do both.

These networks don’t address all of health workers’ needs. Some also need help caring for their elderly parents or relatives—who are part of a population that’s both especially vulnerable to COVID-19 and whose care often requires specific training. Jade Cohen, 28, a second-year medical student and MN CovidSitters’ volunteer-coordination director, told me that the group had recently put a notice on its intake form telling families that the student volunteers weren’t qualified to care for elderly patients. (There are some resources available to help meet this need., for instance, is offering free three-month premium memberships for medical workers.)

But these improvised care networks are far better than nothing, and they are threatened by the possibility of full lockdown protocols, and the coronavirus itself. The state of Ohio has been under a stay-at-home order since March 23, but it includes an exception for “taking care of others”; the governor of Minnesota announced today that a similar order (with a similar exception) will take effect at midnight on Friday. Still, organizers like Sara Lederman are thinking ahead to the possibility of stricter orders. “As soon as they say ‘You cannot leave your house ever, not even to support health-care workers,’ we will respect that,” Lederman told me. And then health-care workers with children will be utterly without support.

Organizers also have to think ahead to what would happen if and when the disease spreads further. “We have each volunteer track their hours and contact with each family so that we can easily trace where they have been in any window of possible infection,” Lederman told me. If someone in a “pod” starts having symptoms of or tests positive for COVID-19, “we automatically pause the service, and we ask that whoever was in contact with that family self-quarantines for 14 days.”

The networks that have sprung up to care for the families of caregivers are poignant expressions of community members’ commitments to one another—but they’re also fragile. They’re just as susceptible to disease, and just as much at the mercy of the unknown future, as the humans who built them.