Be my Covid-19 oddsmaker (Toronto)
June 28, 2020 11:08 AM   Subscribe

I'm trying to make some decisions around behaviors during the pandemic. Notably: I'm trying to decide whether to send my kid back to daycare. My personal approach to risk (both my emotional response, and my rational decision-making) is helped a lot my knowing the odds. I realize there are a lot of unknown factors, but I'd love to try and get some ballpark sense of the odds of a number of things happening.

My *guess* is that the odds of anything very bad happening as a result of our kid going to daycare are lower than the regular background risk we all lived with every day pre-pandemic. (Like - we are all more likely to be killed/harmed by some other random thing than killed/harmed by Covid). I'm interested if that is true. For me - that's a really important and useful threshold in decision-making.

I realize a lot around all this is very unknown, but I'm hoping there's a way to get ranges?

Here are some things I'd love to think about:

a) What are, roughly, the odds that our kid would come into contact with someone with Covid while in daycare?
b) What are the odds that our kid would get the virus?
c) What are the odds that our kid would get very sick from it?
d) What are the odds that my partner or I would get the virus?
e) What are the odds that my partner or I would get very sick from it?
f) What are the odds that we would have to do a two-week quarantine?
g) Is there some other eventuality/risk we should be thinking about?

Some probably relevant facts:
- We are in Toronto's little Portugal neighbourhood (M6J 3K9)
- Our kid is 5. I am 52. My wife is 44.
- Our daycare is doing closed groups of 8 kids, two teachers. Handwashing. Temp checking. It is indoors a fair amount of the time.

Note that: In most of my day-to-day decisions about Covid, I think at least as much about my responsibility to society than about my own personal risk. But in this case, I'm inclined to focus more on risks to my family and myself. I'm happy to hear opinions about this.
posted by ManInSuit to Science & Nature (18 answers total) 2 users marked this as a favorite
 
(also happy for any partial answers that might point me in directions to figure this out...)
posted by ManInSuit at 11:26 AM on June 28


I work in childcare in Ohio. I think the risk is minimal given the health regulations we had to follow pre-covid. Now we've added the temperature checks and limited the number of children per classroom. I work in the infant room, but anything something goes into someone's mouth (probably not a problem with preschoolers) it gets set aside to be sanitized. Our preschoolers' cots get sanitized everyday and they're not allowed to have anything soft (blanket, etc). Tables are wiped down with bleach water multiple times a day. All plates, cups and utensils are disposable. All toys are sanitized during naptime and after the kids have left. My owner is mandating staff wear masks. Staffs' temperatures are taken upon arriving at work and after their lunch break.

Personally I'm in a higher risk group and I live with my high risk father. I feel comfortable with the precautions I'm taking at work as well as those I'm taking while in public.

I can't give you odds, only my experience. Hope this helps put your mind a bit at ease.
posted by kathrynm at 11:27 AM on June 28 [2 favorites]


I don't think it's possible to calculate these odds. For example, scientists still don't know enough about the virus to understand how likely it is that kids get sick, even though there are some indications that very young children might be less likely to be infected.
posted by pinochiette at 11:36 AM on June 28 [6 favorites]


Without knowing the contact profiles of all 8 kids and both teachers, I don't think you can.
posted by scruss at 11:58 AM on June 28 [2 favorites]


Additionally if you do see any odds ratios out in scientific literature remember that these are odds for a population group, not an individual.
posted by raccoon409 at 12:03 PM on June 28


NPR had an article about this a few days ago that might help.
posted by umwhat at 12:17 PM on June 28 [1 favorite]


I am an equity and derivative trader who essentially calculates and makes decisions on probabilities all day long. I have no basis, no facts other than what I have read and heard or other than I am a trader and a betting man, but here is my gut: (all disclaimers apply)

a) 20% 1 in 5
b) 20% 1 in 5
c) 5% 1 in 20
d) 25% 1 in 4
e) 8.33% 1 in 12
f) 20% 1 in 5 bc those are the odds I set for coming in contact.
g) Not sure. Everyone has their own risk profile and everyone has their own pain or inconvenience or sickness threshold.

For ME, I think the chances of kiddo getting it and getting very sick from it are low, less than 5%. The chances of getting very sick from kiddo are also low, but the chance that there is exposure and the authorities require a quarantine are much higher. If I needed to have my child in daycare for work purposes or any purpose, I would send them now. I would not have sent them say a month or two ago. I am not a huge risk taker, but I think taking risk is inherent in most of what we do.

I am not sure I would care as much about the percentage or odds or probability of getting a quarantine order because if you do not send kiddo, you are essentially in a pretty quarantined situation anyway. How is a quarantine order much different than your current situation. If it was not much different, it seems another reason to take the risk.

The problem with taking this risk versus financial risk is that if you lose to the odds and get real sick, that is something you have to be able to live with meaning can you live with having sent kiddo back to daycare and kiddo gets real sick. Will you be kicking yourself and beating yourself up over the decision or can you rationally accept that you lost to the odds?

Personally, I am very good about living with any outcome if I assessed the odds and made a decision based on sound reasoning. My gf is the opposite. No matter the sound reasoning, if she losses to the odds, she is upset.

I think with health, and especially with a child's health, decision making is tough. We let our kids play outside in the woods doing dumb kid things and accepted that there would be injuries and bug bites and crying. Some parents try to avoid that.

I think one can assess the odds and make ration decisions based on those odds, but with a child's well being, emotion almost always creeps in. You and your wife need to be in lockstep about the decision bc god forbid one is not down with the decision and then something goes wrong, not only is physical health an issue, but your relationship health might be too.
posted by AugustWest at 12:24 PM on June 28 [7 favorites]


I have no official statistics for you, but I can tell you that daycares are a literal petri dish, and if you didn't end up exposed to COVID at the bare minimum in this situation I would be shocked. I would say there is a very good chance that you and your family will end up sick here. It's remarkable the viruses I caught when I was working in childcare. I got hand foot and mouth disease. Hand foot and mouth! As an adult! It's also worth considering that temperature checks don't mean jack shit when you consider how much asymptomatic transmission drives the spread. You basically need to count on the daycare providers and all of the families with kids there to take serious steps to prevent the virus from entering the facility, and if the past few months have taught us anything, it's that a small but substantial minority will behave however they want with no regard for public health, posing a direct threat to everyone around them. And, heck, every single family could take every precaution possible and *still* there's a good chance that COVID will enter the facility.

I know this is anecdotal, but I really think you're underestimating the risk here.
posted by Amy93 at 12:36 PM on June 28 [6 favorites]


I can't look up those numbers for you right now, but here is a doctor doing the math for himself for a plane flight.

The other thing I've read is that you should also be calculating the odds that staying home is bad for your kiddo. Depression, maybe less physical activity, etc.
posted by slidell at 12:38 PM on June 28 [2 favorites]


I found this article very helpful in making the same decision. It's written by the same women who wrote expecting better. I have a 3 year old son, and from what you've said, we must live in the same neighbourhood.

Here's what I thought about in deciding. I think this current situation for my family is not tenable until there is a vaccine. So if I know I am going to send my son back at some point, what is the difference between now and September? I also know that the testing being done in Toronto seems to be adequate, due to the low overall positive results, fairly quick results, and relatively quick contact tracing per the city of Toronto dashboard.

My son is returning to daycare tomorrow. It was a hard decision and the worst part is the judgement we have received for making it. Good luck with your choice.
posted by ice-cream forever at 12:59 PM on June 28 [3 favorites]


I'm a fairly advanced poker player, so I calculate odds based on incomplete information all the time, and each time with real-money implications. I would love to use that practice to give you concrete estimates, but as others have mentioned, too much information is missing to do so, in my opinion.

I think I may have something additional to add, though. I think that in addition to the gaps in information related to specific elements of covid-19 transmission, there are also very real gaps in morbidity and mortality reporting, and Ontario might be a particularly bad offender in terms of radically under-reporting the numbers of people getting sick there.

They have not released any information about excess mortality in the province, which is the only reliable way to validate if any of the figures that have been released are accurate. Most other places have. Quebec, for instance, has an excess mortality rate of 30% over an average of the past year, while New York City has an excess mortality rate of 217%. It's possible, even probable, that at least some of those excess deaths compared to other years are due to other causes, but some work has been done on that front as well, and the proportion of deaths from other causes seems to be lower than some had anticipated.

The implication of this is that in Ontario, there is no way to validate that the numbers being published are real, and there's a significant chance that covid-19 rates are much higher than the government is letting on. As well, consider that other than meat packing plants and long-term-care facilities, big cities tend to be hardest hit by the disease. I think there's still a significant cause for concern in Toronto.

With that context, the other thing that is starting to become a little clearer is that covid-19 transmission is greatly elevated by being indoors - this is why even home-sequestered family groups can see the disease cut through the family while those people in the park in Parkdale and protesters in the US seem to be relatively little affected.

These two trends would make me very reluctant to send a kid to daycare in Toronto. However, if they have an appropriate outside facility, and pledge to keep the kids in that area for much or most of the day, that would mitigate my fears a lot. As well, there is the basic question of whether the daycare staff is going to be able to sustain the careful practices they mean to keep as time passes. It's so easy to lapse into complacency and old practices, I would want to have a very high level of confidence that this staff can overcome that, all day, every day.
posted by mikel at 2:03 PM on June 28 [3 favorites]


Thanks! This is all amazing.

I love the points that AugustWest raises! But the numbers in their reply seem much, much higher than I would estimate. I'm curious what others think.

The facts in the article that umwhat link to seem to me to suggest *much* lower numbers than what AugustWest suggests.

- if I understand right: it sounds like - there were YMCA daycares running in New York City at the peak of the pandemic there and even there- they report that no site reported more than one covid case (which means, if I undertand right, there was literally no spread, because spread would mean one person had it and one person caught it)

- "In a separate, unscientific survey of child care centers, Brown University economist Emily Oster found that, as of Tuesday afternoon, among 916 centers serving more than 20,000 children, just over 1% of staff and 0.16% of children were confirmed infected with the coronavirus." That is 0.16% who had it. Presumably some percentage of those caught it elsewhere.

- ""There are almost no recorded cases of child-to-adult transmission of COVID-19," says Elliot Haspel, an education policy expert "

- And: Numbers in Toronto are *miniscule* compared to NYC in April, or compared to a lot of places in the past couple months.

These facts suggest to me, that even if the numbers are, say, 20 times worse than the articles suggest:

- The chance of my kid getting Covid in daycare (here in Toronto where numbers are low) are *much less* than the 5% that AugustWest suggests.

-The chance of me getting Covid from my kid are *much less* than the 25% that AugustWest suggests.

Am I missing something?
posted by ManInSuit at 2:27 PM on June 28 [1 favorite]


Am I missing something?

Timing.

And like the rest of us, information.

But I think what you're missing most in your analysis is timing.

So in NYC at the height of the crisis, during stay at home orders, the results will be different because a) it's a snapshot and b) people were behaving a particular way, which may or may not continue. In some ways I think daycare centre infection rates were more likely when all the kids were coming from essential workers, because the families were inherently in high-risk environments.

HOWEVER, all those people may have been being really, really careful, and also not visiting other people, and from my observation of my Toronto-Scarborough neighbourhood, people are now being fairly higher risk in their habits (although still not, for example, going on March Break.)

I particularly worry about daycares because as reopening becomes the 'new normal,' I suspect people will start going to work with a cough again...unlike April and May when everyone was considering that unthinkable. But that's not really a risk I can quantify for you.

It looks to me like you've made your decision and you're cherry-picking a bit because you didn't mention:

Cases in Quebec schools (not catastrophic but not zero)

Covid outbreaks at Toronto daycare during the emergency-only phase.

But I think, if you need childcare, then you may end up just accepting the risks. I'm not sure what your alternative is?
posted by warriorqueen at 3:41 PM on June 28


Risk is cumulative. At a certain point, that number rises to 100%. You have *no idea* what the other families are doing. Is one of the kids there because their parents are nurses actively in contact with COVID patients? That changes rather dramatically the risk profile. Without that information, you can not make an informed decision except to know that at some point this year your kid will be exposed at daycare. 8 families + 2 teachers + whatever cross over there is in the school building = you are effectively being exposed to all of Toronto over a course of months. It's the same old math about how many sexual partners you have and how quickly that means you've effectively slept with a set population indirectly.

So, those are your odds. The actual odds you might be calculating are how quickly that will happen.
posted by stoneweaver at 3:58 PM on June 28


I'm an essential worker. I likely had Covid already. My child is in daycare two days a week and has been for most of the pandemic in Chicago. She's in a classroom of less than ten and is about two.

We haven't had a problem. There was an incident where one of the teachers tested positive in a different classroom. The whole daycare closed for deep cleaning for the day, all teachers were tested. None of the other classrooms had cases. There was no signs of the kids having it. The other staff member in the room tested postive as well. They closed for another day and the weekend. Things went on fairly normally aside from the disruption from cleaning. Both teachers recovered and returned to work. None of the kids showed symptoms or tested positive that I'm aware of. Essentially the protections worked as intended.

I can tell you my toddler has been way healthier in a daycare setting now than precovid.
posted by AlexiaSky at 4:42 PM on June 28 [2 favorites]


warriorqueen- thanks for pointing out that I may be cherry-picking information. That is super-helpful! I am leaning toward sending our kid, it's true. But I am also at the point where I'm interested in information that disconfirms my assumptions.

Those links are helpful!!

- Looking at the Quebec schools data: From my googling around, it seems like those are the only cases so far. So there are 44 kids in Quebec schools known to have the disease (and, again, we don't know whether they got it in school or elsewhere). According to this article, there around 100,000 kids in school in Quebec. The article you like to also re-states "kids who get the coronavirus have very mild symptoms." This still suggests to me that, say, AugustWest's estimates that my kid has a 20% chance of getting the virus seem very high, and a 20% chance of him getting very sick also seems very high. (even accounting for the facts that cases are under-reported, and it's just been a few weeks)

- The Toronto story seems more troublesome. There were only six daycares open, and one has a serious outbreak. Those are bad odds. I'd be interested to know more about what happened there: It seems out of keeping with what I've read about elsewhere. But the fact that it's so close to home makes it feel harder to ignore. I'd like to know more about that case.


Thanks!!!
posted by ManInSuit at 10:28 AM on June 29


For anyone visiting this ask, interested in personal covid-related odds: This site: https://19andme.covid19.mathematica.org/ has a calculator. It is US-Only, so not so useful to me, and does not address my question. But maybe useful as a starting point.
posted by ManInSuit at 11:31 AM on June 29 [1 favorite]


For anyone checking this still: I ran the questions here past a friend of mine who is a scientist who has been following Covid news and studies somewhat obsessively. He is a biologist, and cautions "the opinions I am expressing are not 'professional' opinions but my own personal thoughts based on how I interpret what I see in the literature. I am not a ID doctor or an epidemiologist or a virologist. Those are the expertise I look for in deciding what information to follow."

Here are his comments, slightly edited:

==================

Death reporting in Canada is very good. There is a lot of transparency in Ontario.

there are fields in science where there is low tolerance for guesstimating (enzymology) and ones where all they they do is guesstimate (astrophysics), Biology and medicine have a pretty low tolerance for guesstimating most of the time, so I think people with really knowledge of these issues would be reluctant to weigh in.

My guesstimates would be something like: (im listing what I would imagine upper bound probabilities are so that to get maximum likelihood you multiply those)

a) What are, roughly, the odds that our kid would come into contact with someone with Covid while in daycare? less than 0.1%
b) What are the odds that our kid would get the virus? (less than 10%, if he is exposed)
c) What are the odds that our kid would get very sick from it? (less than 0.1%, if he gets the virus)
d) What are the odds that my partner or I would get the virus? (less than 10%, if kid gets the virus)
e) What are the odds that my partner or I would get very sick from it? (depends how you define "very" but in your age group ~5-10% as a guesstimate, if you get the virus)
f) What are the odds that we would have to do a two-week quarantine? (super hard to estimate that but I'd say 1-5%)
g) Is there some other eventuality/risk we should be thinking about? our understanding is evolving all the time, we could learn that this thing has higher or lower risk (for example because of sequlea) so it will show our current risk calculus to have been incorrect.
posted by ManInSuit at 11:21 AM on July 1


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