This morning, my husband and I sent our 4-year-old son to school a little bit sick. His fever, which peaked at nearly 103 degrees a few days ago, had not returned, and his spryness had been fully restored. These factors were evidence enough of a recovery for my husband, who, like me, had been battling the same virus over the past few days and was eager to both get some rest and catch up on some work. I really wanted to agree with him, but I couldn’t get past our son’s teary, sunken eyes and snotty nose. Ultimately, I was paralyzed by indecision and deferred to my husband, who made our son’s lunch, got him dressed, and took him to school.
Was I complicit in an ultimately selfish calculation in sending my son to school, overvaluing the benefits to me and my husband as parents and undervaluing the potential negative effects to our son and his classmates and teachers? Or, as my husband insisted, was our son really fine?
According to a new NPR story about the often confounding process of deciding whether a slightly sick child should go to school, my husband was probably right. Reporter Katherine Hobson looks into the science behind this decision and discovers that sending an on-the-mend, but still not quite 100-percent, kid to school can be morally sound.
“The science really tells us that most disease is spread before the child gets sick,” pediatrician and pediatric emergency medicine physician Andrew Hashikawa told Hobson. He explained that, in a good many cases, keeping a child home is useful insofar as it helps the child recover, and not because it prevents others from catching whatever bug the child has. He points to the American Academy of Pediatrics’ guidelines for child care illness exclusions, which are surprisingly chill. The long list of conditions that they don’t see as being cause for keeping a child home includes: common colds; runny noses; watery, yellow or white discharge or crusting eye discharge without a fever; fever without any signs or symptoms of illness; pink eye; and a rash unaccompanied by a fever or behavioral changes. After reading this list, I will be sleeping better tonight.
Unfortunately, as Hashikawa points out, many child care centers have far more restrictive exclusion policies than those recommended by the AAP and don’t allow children to come to or stay at school when they’re a little sick. This is hard for dual-income households, the number of which have more than doubled in recent decades, as there is no parent for whom the decision to stay home isn’t a complicated one. Unfortunately, most families resolve this modern-day predicament by resorting to the old world order: Moms are 10 times more likely than dads to skip work to care for an ill child. This happens because men and women both still see moms as the primary caretaker—even when moms work. Such a dynamic was at play this morning in our house; I felt both more responsible for our son and more worried that his preschool teachers would think I was a bad parent for sending him in snotty, subprime condition.
The decision whether or not to send a sick kid to school is even harder for the 52 percent of workers who aren’t guaranteed paid time off to take care of a family member. (Four in ten private sector workers, and nearly 80 percent of low-wage workers, don’t have paid sick days to take care of themselves, either.) For many of these parents, the decision to miss work and tend to a sick kid isn’t just a matter of potentially disappointing co-workers or superiors, but also of not being able to pay their rent at the end of the month. These parents are, unfortunately, incentivized both to go to work sick and to send their kids to school sick. According to the National Partnership for Women and Families, 23 percent of workers report having lost a job or being threatened with job loss for taking time off for a personal or family illness, and parents without paid sick days are twice as likely as parents with paid sick days to send a sick child to school or child care.
The absence of a universal paid sick leave policy affects us all. A paper published last year by National Bureau of Economic Research found that the flu rate “decreases significantly” when employees have access to paid sick days. A better world would be one in which keeping a sick child home is always an option, and taking a slightly sick one to school is never a source of guilt.