Brownstone Journal

Before my youngest daughter turned two, she contracted Hand, Foot, and Mouth Disease at her daycare. Hand, Foot, and Mouth Disease is caused by a Coxsackie virus, is highly infectious, and is transmitted by the fecal-oral route as well as through direct contact. The symptoms start with high fever that lasts for a day or two followed by sores that appear in the mouth and on the body. These sores are painful and cause quite a bit of discomfort, making it difficult for the child to eat.

The result is often a very fussy toddler, which was definitely the case with my daughter. After a few days, the sores begin to heal, but they might take a couple of weeks to disappear.

More importantly, infected individuals may remain contagious weeks later, by secreting virus in their stool. Anyone who has worked at daycare knows - the diapers can pile up pretty fast, and it takes a lot of work to keep everything clean. In reality, it's an impossible task. What's even more important is that daycare workers can also spread the virus, even if they are asymptomatic.

All of this suggests that once the virus gets into a daycare, it's going to spread until all of the susceptible children and adults are infected and recover. There's simply no stopping it.

Mortality from Hand, Foot, and Mouth Disease is almost non-existent. There is so little threat from the virus, that the best strategy of dealing with it is simply to let it run its course.

But that's not what happened in our case. We were informed by the daycare director that our daughter had to stay home for two weeks, until all of her lesions had completely healed, "because she might be contagious." During this time, my wife and I, who both had professional careers, were expected to continue to pay for daycare that we weren't receiving, and would have to make other arrangements for our child that was already on the mend and posed no real threat to anyone.

When we objected to the policy on these grounds, the director informed me that she had contacted the local public health department, and that they had agreed her policy was a sound one.

This had conflicted, not only with what we knew, by also with what our pediatrician had told us, which was that our daughter could go back after she had no fever for twenty-four hours. When we called her to discuss what the public health department had done, she helpfully contacted them to question them further. She told them that she was recommending what the American Academy of Pediatrics recommended, and wanted to know why they were telling the daycare something different.

Still, the health department resisted, insisting they were correct.

Being the stubborn person that I am, I walked over to their offices to talk with the county public health department director herself. She was very amicable, but as stubborn as me, and I could tell after talking with her that she was not about to budge from their decision, despite what our pediatrician and an infectious disease scientist might think, "we overrule physicians all the time," she said.

At the time, I couldn't understand this way of thinking. The facts were on my side. Why would the public health department agree with the daycare director, when her actions were not making anyone safer? As I mentioned before, keeping my daughter home would do nothing, the virus was already in the daycare, and would continue to spread until all the susceptible children and workers had acquired it and recovered, no matter if she stayed home or not. No one would suffer any serious consequences.

We would be out two weeks of daycare for nothing, and I couldn't fathom why.

The reason wouldn't become completely clear until the SARS-CoV-2 pandemic, three years later.

The Safest Space

Sociologist Frank Furedi wrote in his book How Fear Works:

Although risk is historically defined as exposure to the probability of loss, harm or some kind of misfortune, through its current expanded usage it has been reinterpreted as the possibility of such ad...