The Impact of School Closure for COVID-19 on the US Healthcare Workforce and the Net Mortality Effects

Jude Bayham; Eli P Fenichel

Covid-19's global spread is triggering a range of public health responses. School closures are some of the highest-profile social distancing measures employed to slow the spread of an infectious disease. Japan recently instituted a nationwide school closure, which drew a swift response from families scrambling to make alternative childcare arrangements. South Korea, Italy, and some US school districts have closed schools. School closures prevent contacts among children and reduce cases. But, there is a downside to closing schools, even if the only goal is saving lives during an epidemic. Closing schools can inadvertently cause child care shortages that strain the healthcare system. Lempel et al. estimated that the child care obligations associated with school closure could reduce key medical personnel by 6-19%. 1 Here, we use the recent years (2018-2020) of the US Current Population Survey to estimate the school closure induced child care obligations for the US healthcare labor force. Approximately 29% of US households with a healthcare worker have at least one school-aged child age 3-12, who requires child care. Child care obligations are especially high and relatively inflexible in households where a parent is a nurse or medical assistant. Understanding these tradeoffs are important in planning the public health response to COVID-19, because if the survival of infected patients is sufficiently sensitive to declines in the healthcare labor force, then school closures could increase deaths.