It is safe to assume that no one at the CDC has ever had a toddler. If they had, they would know their new guidance for daycare centers and preschools is insane. Not just from a scientific perspective but from a feasibility perspective. The new recommendations may also make you wonder why CDC guidance is getting more restrictive in light of increasing levels of vaccination and waning cases.
The new CDC guidance calls for mask-wearing for children aged two and older:
Everyone 2 years and older should wear a mask covering their mouth and nose when around people who do not live in their household, except when eating or sleeping.
Anyone who thinks two-, three-, and four-year-olds are going to tolerate this has never met one. In a stunning statement, it goes on to say:
…even after childcare providers and staff are vaccinated, there will be a need to continue prevention measures for the foreseeable future, including wearing masks, physical distancing and other important prevention strategies outlined in this guidance document.
This recommendation is in opposition to everything we are learning about the effectiveness of vaccines. In seven large-scale trials, not a single person who received the vaccination has suffered from severe illness or death. From USA Today:
All seven COVID-19 vaccines that have completed large efficacy trials — Pfizer, Moderna, Johnson & Johnson, Novavax, AstraZeneca, Sputnik V and Sinovac — appear to be 100% effective for serious complications. Not one vaccinated person has gotten sick enough to require hospitalization. Not a single vaccinated person has died of COVID-19.
Additionally, Moderna and Pfizer had 94.1% and 95% effectiveness respectively against mild illness. The Johnson and Johnson vaccine demonstrated 72% effectiveness against the same in the United States. These are the three brands currently being distributed under an Emergency Use Authorization (EUA) from the FDA.
Israel’s real-world experience displays similar results. The country has vaccinated 45% of its population. Through March 6th, 14 days after the second dose of the Pfizer vaccine, they found:
- 97% effectiveness against symptomatic COVID-19, hospitalizations, severe and critical disease, and deaths.
- 94% effective against asymptomatic SARS-CoV-2 infection.
- The risk of death was too small to be calculated seven days after the second dose.
We also know the risk stratification for severe illness and death with COVID-19, according to the CDC. It is significantly correlated with advanced age, which would not be the bulk of the population providing daycare and preschool services. Additionally, I would assume that President Biden would not mislead a child. At a recent town hall, he told 8-year-old Layla, who was worried about catching COVID and dying or giving it to her parents:
First of all, kids don’t get COVID very often. It’s unusual for that to happen. Children aren’t the people most likely to get COVID….You’re the safest group of people in the world, number one. Number two you’re not likely to be exposed and spread it to mommy and daddy. And it’s not likely mommy and daddy are able to spread it to you either.
Questions for a town hall are scripted, and their answers are too. Biden articulated an accurate summary of all of the research to date on young children and COVID-19. It is also consistent with comments made by Dr. Anthony Fauci during congressional testimony in November of 2020.
After a year of living with COVID-19 and increasing vaccination, it is high time for the CDC to make balanced risk-based assessments. Given the exceptionally low risk of a severe outcome in a daycare or pre-school setting, should we be more concerned with young children’s social and emotional development? Toddlers learn social cues and language by seeing people’s facial expressions and watching them articulate words. Our children’s education has suffered broadly over the last twelve months, and as a society, we should be looking to mitigate further losses as quickly as possible.
Unless the CDC has information about COVID-19 it has not shared with the public, this guidance is difficult to understand. In light of everything they have shared, it is cautious in the extreme for healthy children and childcare providers. Teaching handwashing, hygiene, and taking extra care with cleaning and disinfection all make sense. With warmer weather, opening windows and increasing ventilation, or spending more time outdoors are all reasonable guidelines. Keeping toddlers’ faces covered is not.