"I had a parent tell me to f*** off last week," Cori Berg said. She directs the Hope Day School, a church-affiliated early childhood program in Dallas.

The unhappy mother took her two children out of Berg's center after each of their classrooms were closed for quarantines, saying she'd hire a nanny. Wanting to return, she emailed, called and finally showed up in the middle of the day. Just as Berg had warned her, her spots were taken.

The mother, according to Berg, threw a fit before coming back and apologizing. "She was like a toddler; she was jumping up and down."

The people who take care of and educate children under 5 years old – both parents and providers – are in a special kind of hell right now. These children are too young to be vaccinated, and it's difficult for them to wear masks consistently. Many child care directors, like Berg, are still following 10- or 14-day quarantines, closing entire classrooms after a single positive test, which has caused nonstop disruptions given the current record numbers of COVID-19 cases. Recently, Berg's infant room had "double decker" quarantines: closed for two weeks, back for one day, closed for another two weeks.

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Meanwhile, caregivers told NPR they can't get a hold of enough rapid tests, and they're struggling to apply the Centers for Disease Control and Prevention's safety guidance. Center directors say they have few substitutes to cover for those out sick, and early childhood educators typically don't have union protection. Providers say they are spending out of pocket on equipment like masks and gloves.

Parents, meanwhile, are losing their tempers, losing sleep and losing jobs when the child care they pay for is canceled, over and over. About 1 in 6 parents told pollsters they had experienced either a school or a day care shutdown in the past few weeks, in a national poll from Axios and Ipsos released Jan. 11.

Child care centers are struggling with repeated quarantines

The child care crisis in the United States predates the pandemic. The average annual public spending on early childhood care across rich countries is $14,436 per child. In the U.S., it's $500. Child care is scarce, expensive for most families, and of varying quality, and providers earn an average of around $25,000 a year, even with specialized training and degrees.

Still, as hard as things have been, advocates, parents and early childhood educators like Berg told NPR that January 2022 has been the worst month of the pandemic.

The latest job numbers show child care workers leaving the workforce, even as other sectors are hiring. The federal incentives for employers to offer paid leave ran out in September. And while the American Rescue Plan provided $24 billion in stabilization grants to child care programs in 2021, the Build Back Better plan, with its $400 billion in federal child care and preschool funding, is stalled in Congress.

"This is the worst it has ever been," Berg said. "It is so fractious between parents and centers. Last week in particular, every single director I know got really beat up."

Berg spoke to NPR while she was quarantining at home after being exposed to COVID-19 at work. (She has since returned to the classroom.)

"I've got [a] sore throat, fever, chills."

But she wasn't sure she actually had COVID – she couldn't find a rapid test, and the earliest PCR test appointment she could find was four days later.

"I'm almost more worried that I don't have it and people are going to be mad at me that I've been out these days," she said.

Before this quarantine, Berg had taken only about two sick days in her nine years at the school.

Berg has already downsized from eight classes to four since the start of the pandemic because of a lack of available staff. As of Tuesday, she had 12 cases reported among children, and two of her four classrooms shut down for quarantine.

Like Berg, Kasia Kaim-Gonçalves, who runs an early childhood program in Brooklyn, N.Y., also said the omicron wave marked the hardest time of the pandemic.

"Not only did I get sick – my whole family was sick – but also with such high positivity rates half the children are out at a given time."

In January, she has resorted to requiring rapid tests every day for the roughly half of her children who have yet to contract COVID.

"It's very stressful for families, it's very stressful for us," she said.

Both of her employees quit recently.

"One said that she didn't feel safe coming in, and that was really difficult for her and for me."

Working parents can't always afford to keep a sick child home

Gladys Jones is an in-home day care provider in Staten Island, N.Y. She serves families on public subsidies, who are living paycheck to paycheck. Some are in shelters. They can't afford to miss work, so sometimes sick children show up at Jones' house. One recent morning a toddler girl started vomiting – it turned out her sister had been exposed to COVID on the school bus.

"Her mother didn't come get her until the evening. We cleaned her up, made her comfortable, but in the meantime we're all exposed," Jones said.

Bernadette Ngoh also cares for children in her home, in West Haven, Conn. She said some of her parents are front-line workers who have been reluctant to get their children tested for COVID when they show symptoms.

"Some parents explain to me, 'If I take my child to test and then it comes back positive, then I cannot go to work, because this child cannot go to day care. What will I do with my rent, with my bills?' "

She has told families that she will not charge them if they keep a sick child out for a week, even though she can't really afford to do that.

"It was so, so expensive [for me] – but if more than one child might get sick, then the whole program will be closed."

Parents and children are dealing with unpredictable disruptions

"We got the email at 9:30 p.m ... there's been an exposure. And now we're done with having child care for our 4-year-old for the rest of the week," said Elliot Haspel. He's a father of two in Richmond, Va., and this is his second daycare shutdown in as many months. He also happens to be an early childhood care advocate, and author of the book Crawling Behind: America's Child Care Crisis and How to Fix It.

"My experience is privileged – I can work from home; my wife works part time, she can work from home," he said. "It's just the constant – it's like a quakestorm of disruption, and it's so unpredictable, which is not great for young kids, either, by the way, who thrive on predictability and reliability. That's certainly not great for the mental health of parents."

Early childhood educators don't know what health guidance to follow

In December, the CDC endorsed "test to stay" policies to keep K-12 students in school despite COVID exposures, using rapid tests. The agency also cut its recommended isolation periods for people infected with the coronavirus from 10 days to five, without requiring a test to return to activities. With worker shortages across the economy, employers are summoning people, including working parents, back to work faster than before. And those parents need child care.

But child care centers, full of unvaccinated children, aren't sure exactly how to apply the new rules. That leads to tension between parents and providers.

"It's crazy because we don't know which guidelines to follow," said Kasia Kaim-Gonçalves in Brooklyn.

On Monday, New York state issued new guidance, recommending a shortened five-day isolation period for children in child care, in some cases. Before that, Kaim-Gonçalves had been requiring 10 days, and families had been lobbying her to change the rules.

"People send me articles like, 'Look, I've read this. Look, CDC changed the rules to decrease the quarantine. Can't we do that?' "

In Texas, Cori Berg said some parents who don't like her day care's policies have gone one step further, calling the state's health department and its child care licensing agency to demand changes.

Back in March 2021, Texas Gov. Greg Abbott issued an executive order lifting all state-imposed COVID operating limits on businesses. So it's now up to "little mom and pops" like her to enforce health guidance all by themselves, Berg said.

"Everybody threw us under the bus."

The market can't solve the child care problem

To child care advocates like Haspel, in Richmond, the omicron wave is an acute disaster on top of the long-term problem of child care supply.

"Child care staffing is still 10% below its pre-pandemic levels," he said, "and pre-pandemic was not robust ... There is so little public money in the child care sector that programs cannot offer competitive wages at a time when many other industries have been able to raise their benefits and their wages."

The child care industry has bled workers for the past three months – 3,700 in December alone – at a time when other sectors are hiring.

"You can get paid more to go work at Walmart than you can to take care of a child for eight hours a day. We can't compete," said Berg, who starts her assistant teachers at $12.50 an hour.

"We can't take in any more children. Parents are upset with us, but they can't leave to go find another center that meets their needs because they can't get in somewhere."

In September, a study of American child care put it this way: "The existing child care system in the United States, which relies on private financing ... fails to adequately serve many families. This is not just happenstance – sound economic principles explain why relying on private money to provide child care is bound to come up short."

Those words didn't come from a progressive child advocacy group, but from the U.S. Department of the Treasury. The report explains that high-quality care and education for small children requires low child-staff ratios, specialized training and experience, and clean, healthy facilities. Being human-capital intensive, it is inherently expensive.

President Biden's Build Back Better bill includes funding for states to expand infant and toddler care, a universal preschool program for 3- and 4-year-olds, payments directly to parents to lower the out-of-pocket cost of care, plus a child tax credit for all parents. But that legislation has so far failed to get the required votes.

Recently, Sen. Richard Blumenthal, D-Conn., spoke in favor of breaking out the $400 billion child care section of the legislation into a separate bill. By some reports, Sen. Joe Manchin, D-W.Va., one of the two Democrats whose vote on the full package has been most elusive, backs at least the pre-K part of the proposal.

"What we're seeing now is sort of a taste of what is to come on a more permanent basis if we don't put public money into the child care sector," warned Haspel. "The U.S. Treasury Department is very clear. It's a market failure – and it's not a pandemic artifact. It's not going away."

He said unless the Senate can agree to pass a new plan, this is the new "terrible" normal.

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