This fall has been a blur of runny noses, body aches and lost paychecks for Jacob Terry.
His 18-month-old daughter came home from day care with Respiratory Syncytial Virus a few weeks ago. Now he's got it, too, while trying to juggle child care responsibilities with his job as a marketing freelancer.
"My daughter's at home, she's sick, I'm sick," said Terry, 39, who lives near Los Angeles. "If I don't work, I don't eat. I'm medicating myself and staying up all night to catch up. It's one big mess."
A new round of viral infections - flu, RSV, covid-19 and the common cold - is colliding with staffing shortages at schools and day cares to create unprecedented challenges for parents and teachers. More than 100,000 Americans missed work last month because of child-care problems, an all-time high that's even greater than during the height of the pandemic, according to new data from the Bureau of Labor Statistics.
Those absences are rippling across the economy and straining families and businesses, just as many thought they'd turned a corner.
"We have sick kids at the same time we have a child-care crisis - you put the two together and there just isn't any wiggle room," said Diane Swonk, chief economist at KPMG. "People are falling through the cracks. It means missed paychecks, disruptions at home, and staffing shortages that erode productivity growth and increase costs at a time when we're already worried about those things."
Nearly three years into the coronavirus pandemic, families, businesses and health-care facilities say they're under renewed pressure. Children's hospitals nationwide are at capacity, in large part because of RSV and other respiratory viruses. Workplaces are reporting unfilled shifts and lost revenue as employees call out for extended periods of time. And parents are, once again, caught in an impossible position, balancing sick children, school closures and workplace demands.
There are signs that those pressures are taking a toll on the economy. Worker productivity - a measure of goods and services an employee can produce in an hour - posted the sharpest plunge on record in the first half of this year, according to federal data.
"When you have so many workers out unexpectedly, it's a quiet drag on productivity," said Sarah House, senior economist at Wells Fargo. "Child care has always been an impediment for working parents, but the problems with inconsistent child care that we've seen more recently - your child is sick or has to quarantine, or day care is closed - is making it really difficult for working parents to weave back into the labor force."
The country's child-care system is still reeling from the departure of thousands of educators and staffers who left during the pandemic for higher-paying work. Although the overall job market has more than made up for early 2020 losses, the child-care sector remains a major exception. Public schools are still short nearly 300,000 workers, while day cares are down 88,000 employees from pre-pandemic levels.
"We still haven't dealt with some of the major problems from early in the pandemic, especially when it comes to child care," said Elizabeth Palley, a professor at Adelphi University who focuses on education, health and child-care policy. "The median child-care worker is paid less than $12 an hour, which means you can make more working at McDonald's. A lot of people have left the industry and new ones are not coming in."
That shortfall is putting increased burden on the educators who remain. In interviews, many teachers said they felt they had little choice but to keep working while sick. Dozens of schools - including in Kentucky, Ohio and Tennessee - have gone so far as to cancel classes in recent days because so many students and teachers are sick.
Kathryn Vaughn, an art teacher in Covington, Tenn., works at a rural elementary school that's so understaffed that she's kept teaching - with a mask - even with RSV and walking pneumonia. Roughly 15 percent of the school's teachers are out sick on any given day, with RSV, covid or flu, she said. Substitute teachers - who are paid $65 a day - are increasingly tough to find. That means more classes are being combined and support staff, including secretaries, are filling in for teachers. Five nearby school districts, she said, have recently closed for days at a time because of illness and staffing shortages.
"It feels like we've made absolutely no progress," Vaughn, 42, said. "We don't have enough teachers. Access to health care is still an issue - a lot of students here don't have pediatricians they see regularly. Hospitals all over the state are shutting down."
Infectious-disease specialists say a confluence of factors, including weakened immune systems from covid-19, could be contributing to the recent spike in viral illnesses. It's also possible that "pandemic babies" who were protected from respiratory pathogens because of social distancing and other preventive measures are now getting sick. And although many schools encouraged, even required, masks last fall, that is no longer the case, making it easier for a variety of viruses to spread.
In Lincoln, Neb., Lindsey Dick had just started a new job as a case manager for a workforce services company in mid-October when her 3-year-old son came down with RSV. Dick, 37, didn't have paid time off yet, so she took unpaid leave for a day. Her husband watched their son the rest of the week while working his tech-support job from home.
"It was just quite a lot for all of us," she said. "I could only miss one day and even that felt stressful."
Low-income families - especially those less likely to receive paid sick leave and employer-provided health insurance - have been hit disproportionately hard. While 96 percent of the country's highest paid workers received paid sick leave last year, only 40 percent of the lowest earners did, according to federal data.
In Sevier County, Tenn., neither Drew Moore nor his wife, Raven, receive paid leave. Their children, ages 2 and 4, have been sick for weeks, which means they've both had to cut back at work, cutting into their annual household income of about $30,000. Moore said he's lost out on thousands of dollars' worth of landscaping projects this fall, while his wife has had to forego lucrative weekend shifts at the steakhouse where she works.
The timing is especially bad: Business tends to be busiest in the fall, when tourists flood nearby Great Smoky Mountains National Park, Moore said. He recently had to pass up a two-day job cleaning a koi fish pond, which would've brought in about $1,000, his biggest job in months.
"Fall is the time to make money around here; it's what gets us through the rest of the year," said Moore, 36. "But of course it's also right when the kids' sickness kicks off. I'm really scared it's going to screw us up financially."
Back in Los Angeles, Terry, the freelancer who's been caring for his daughter, estimates he's lost at least two weeks' worth of work because of RSV-related child-care disruptions. He and his wife, who works two jobs as an aesthetician, have been eating into their savings to make ends meet.
“It’s been difficult for all of us,” he said. “We thought things were finally going back to normal, but it’s just one snowball after another.”