Emily Oster

3 min Read Emily Oster

Emily Oster

CDC Early Childhood Guidance on COVID

Emily Oster

3 min Read
Several weeks ago, I wrote a piece in The Atlantic about the irrationality of continuing to require toddlers to mask when older children and adults were not doing so. At the start of that piece, I referred to the CDC guidelines on masking, saying that the agency continued to recommend masking in this group.

That claim was based on a reading of its early-childhood-education guidance, accessible here. Shortly after the piece came out, I was contacted by someone I’d worked with in the past at the CDC who let me know that, in fact, what I wrote wasn’t right. The CDC was no longer suggesting masking for toddlers in areas where it suggested relaxed masking for older individuals (which, at this point, is most of the U.S.).

The confusion comes from the website, which I’ve screenshotted below. The old guidance is what I have crossed out in blue. The red circle is around the new guidance, which suggests the alignment with guidelines for other age groups. The issue, of course, is that on the actual website, there are no blue or red lines, and you can see why this might be confusing.

This discussion was focused on masking. But it’s emblematic of the confusion around many issues in child care and COVID. Parents write to me about still dealing with quarantines for exposure, classroom closures, out-of-state travel quarantines, etc. Despite a lot of loud discussion on masking, I’d venture to say that people’s lives are much more disrupted by not being able to go from Connecticut to New Jersey to see grandma without a seven-day quarantine on the other end.

The CDC guidelines are mostly unhelpful and nonspecific on these issues too. All these things have left the parents of children under 5 feeling abandoned. It’s still totally unclear when we’ll get vaccines for this group, and I hear from so many people who feel the world has just decided to move on without them. This sucks.

I do not have any solutions, but as time has gone on and the CDC has not updated its website, I got curious to see if I could get to the bottom of all this — and to the question of how much it matters for actual practice. So today, we’re going to do two things. First, I’ll report on some information from you, readers, on what your child care is doing. And second, I asked the CDC for some concrete answers.

Your survey responses

A couple of weeks ago, I put out a survey for U.S.-based parents of children under 5 in child care. This wasn’t a random sample! It’s a survey of the readers of this newsletter, about 5,100 of whom wrote in.

I asked three questions: (1) What’s your child care’s masking policy for kids over 2?; (2) What’s the policy with a COVID exposure?; and (3) What’s the policy for travel quarantine? Here are the results:

On masking: About 70% of child-care centers are now not requiring masking in this age group (note that nearly all of these will be “mask optional”). This is consistent with CDC guidance, given the pandemic situation throughout the U.S. at the moment. Twenty percent require masks indoors. It is worth noting that a full 10% of people report that their child-care setting is requiring masking for kids over 2 both inside and outside. This is despite the fact that the CDC guidance has not recommended outdoor masking for almost a year.

On exposures: Half of respondents say that a full quarantine is required after an in-school exposure. Thirty percent have a “test to stay” or “monitor to stay” option, and 18% have no quarantine rules. Several people noted that test-to-stay may be feasible only for children over 2 (although monitor-to-stay is not dependent on age, as it just refers to the practice of not sending your child to school with symptoms).

On travel: Finally, 77% percent of respondents have no travel quarantine restrictions, although 13% still report a quarantine requirement for out-of-state travel (and an additional 10% for international travel only).

What to make of these numbers? I’m not sure. I suspect they may be a little surprising on both sides. The restrictions are highly correlated. If you’re in a child-care setting with mandatory outdoor masking and a seven-day quarantine for visiting grandma, it may be surprising to learn that 70% of settings have no masking and almost 90% have no out-of-state quarantine. On the flip side, I suspect there are people who will be extremely surprised to learn that there are a substantial portion of child-care centers still requiring toddlers to mask outside.

As I’ve written before: to understand each other’s frustration, sometimes it is useful to see the other side.

What guidelines does the CDC actually have?

I asked! I tried to be very specific, and I am tremendously appreciative to have gotten a response from a CDC spokesperson. I’ve printed it in full below.

My questions are in bold.

1. For ECE [early childhood education] programs operating in areas considered low and moderate transmission, where the CDC has suggested optional masking in K-12 environments, can you confirm previous statements indicating that the same masking-optional policy is recommended for ECE environments?  

  • Yes, this is correct.
  • Anyone who chooses to wear a mask should be supported in their decision to do so at any COVID-19 Community Level, including low. At a medium COVID-19 Community Level, people who are immunocompromised or at high risk for severe disease should talk to their health-care provider about the need to wear a mask and take other precautions (for example, avoiding high-risk activities). Since wearing masks or respirators can prevent spread of COVID-19, people who have a household or social contact with someone at high risk for severe disease (for example, a student with a sibling who is at high risk) may also choose to wear a mask when COVID-19 Community Level is medium.
  • At a high COVID-19 Community Level, universal indoor masking in schools and ECE programs is recommended, as it is in the community at large. When the COVID-19 Community Level is high, people at high risk for severe disease should also wear masks or respirators that provide greater protection, such as N95s.
  • As always, masks should not be worn by children under the age of 2 years, or by people with certain disabilities that prevent them from safely wearing a mask.

2. For ECE programs operating in areas considered low and moderate transmission, does the CDC still suggest a 5- (or 10-) day quarantine for any exposure among unvaccinated children? Is this also suggested for unvaccinated children in K-12?   

  • Quarantine recommendations have not changed.
  • Recommendations for close contacts to quarantine, wear a well-fitting mask, and get tested vary depending on vaccination status and prior COVID-19 infection history. They are not affected by the COVID-19 Community Level. People who have come into close contact with someone with COVID-19 should follow the recommendations outlined on the COVID-19 Quarantine and Isolation webpage. This includes in K-12 schools and ECE settings.
  • It is safest for children not yet eligible for COVID-19 vaccination who cannot wear a mask, or who may have difficulty consistently wearing a well-fitting mask, to quarantine for a full 10 days. For more information, see Isolation and Quarantine in Early Care and Education Programs.

3. Do the CDC guidelines indicate that unvaccinated children under 5 should quarantine away from school after visiting a neighboring state?  

  • CDC’s Domestic Travel website indicates travelers who are not up to date with their COVID-19 vaccines should self-quarantine for a full 5 days after travel. This recommendation is currently under review given the COVID-19 community level recommendations and will be updated soon. In the meantime, when making decisions about implementing prevention strategies, ECE programs should consider the educational needs and social and emotional well-being of children and the importance of children’s access to learning and care.

4. The CDC guidelines for these programs were updated on January 28 to add a banner at the top indicating that guidance should be aligned with the community and that the overall page would be updated soon. Many people find this confusing, given that it is followed by guidelines that do not echo the overall population. Do you have a timeline for when this will be fully updated? Has the CDC considered removing the outdated materials or otherwise communicating its new guidance to early childhood programs? 

  • Recommendations for K-12 schools and ECE programs now align with the new COVID-19 Community Levels. CDC is currently updating guidance for K-12 schools and ECE programs to provide additional context for these settings. CDC hopes to release this guidance along with an accompanying FAQ page in the coming weeks.
  • Page banners give us the opportunity to communicate changes in a timely manner while CDC works on updating specific pages to be consistent with updates that affect multiple pages.

I did follow up after this last question to ask something that’s on the mind of many parents, which is how they can communicate this information to their child-care settings or local health departments. The response was “CDC regularly communicates information about guidance updates to health departments and we strongly encourage all settings, including ECE settings, to consult with their local health officials.

I tried reaching out to some local health officials to see about this communication. In at least one case, they indicated their impression that the CDC had not updated their guidance, suggesting some missing communication step.

I also contacted Head Start, where masking is still required according to their website, to understand why it differed from the CDC guidelines. They told me: “Following CDC’s update, the Office of Head Start (OHS) notified programs on Monday, February 28 that it will not be evaluating compliance with the requirement during monitoring visits. OHS is reviewing the new CDC recommendations and will issue updated guidance.”

Interpretations and final thoughts

I am very grateful to the CDC for its response, and I hope this is (a little) helpful. For me, there are three big takeaways.

First: For those who wanted clarity on masking that they could communicate, it’s there.

Second: Quarantines remain a huge and intractable problem. Most child-care centers are still requiring quarantines for exposure, and that is consistent with CDC policy. But it’s also unsustainable, especially since we’ve seen nothing specific on when vaccines might become available. There is a huge need — by the CDC or local public health departments — to try to figure out a solution here. Whether that is test-to-stay, monitor-to-stay, or simply treating these exposures like other illness exposures, I am not sure. But something must be done. Please.

Finally: The last part of the discussion here makes clear to me that the CDC communication infrastructure is, at best, incomplete. I recognize that there are many moving parts, but the fact that the website is still extremely confusing months after the guidelines changed is a problem, even if there are multiple web pages that need updating. This is reflective of some of the overall communication issues the CDC has faced in the past two years. In the upcoming CDC re-evaluation, this seems a top priority to me, and I suspect I am not alone.

Covid-19 rapid antigen tests arranged in a pattern on a yellow background.

Feb 20 2023

12 min read

COVID-19: Where to Go from Here

A long-term view of the virus

Emily Oster
Covid-19 rapid antigen tests arranged in a pattern on a yellow background.

Oct 20 2022

9 min read

Should You Get the Bivalent Booster?

The latest on the risks and benefits of COVID vaccines boosters for older adults, pregnant people, and kids

Emily Oster
A line graph with pink, yellow, and blue dots representing life's ups and downs.

Aug 16 2022

3 min read

Wins, Woes, and Doing It Again

We have our first story from a dad! And it’s a good one. 10/10 —Girl Dad with Confidence Growing by Read more

Emily Oster
Covid-19 rapid antigen tests arranged in a pattern on a yellow background.

Aug 15 2022

8 min read

Updated CDC Guidelines for School and Child Care

NO QUARANTINES!!!

Emily Oster

Instagram

left right
SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear. 

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear.

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.
...

Happy Father’s Day to the Fathers and Father figures in our ParentData community! 

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛

Happy Father’s Day to the Fathers and Father figures in our ParentData community!

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛
...

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster
...

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy
...

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common. 

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common.

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity
...

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster
...

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor
...

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
...

The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you. 

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths. 

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths

The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you.

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths.

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths
...

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected. 

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected.

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips
...

We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻

We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻 ...

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings
...

Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone. 

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle

Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone.

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle
...

Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
...