Child welfare agencies across the U.S., often beleaguered in the best of times, are scrambling to confront new challenges that the coronavirus is posing for caseworkers, kids and parents.
For caseworkers, the potential toll is physical and emotional. Child welfare workers in several states, including Michigan, Massachusetts, New York and Washington, have tested positive for COVID-19.
Many agencies, seeking to limit the virus's spread, have cut back on in-person inspections at homes of children considered at risk of abuse and neglect. Parents of children already in foster care are missing out on weekly visits. Slowdowns at family courts are burdening some of those parents with agonizing delays in getting back their children.
"There are real sad consequences for folks who've been making progress toward reunifying," said Boston social worker Adriana Zwick, who represents unionized caseworkers with Massachusetts' Department of Children and Families.
She recounted how one supervisor broke down in tears after learning that a mother on the verge of getting her son back from foster care was told there would be a delay because the food service job she'd been promised was scrapped because of COVID-19.
"She was almost there," Zwick said. "This has really thrown a wrench into things."
For workers, widespread shortages of gloves, masks and other safety gear are raising concerns, said Angelo McClain, CEO of the National Association of Social Workers.
"If a report comes in of a kid in danger, you need to go out and make sure that child is safe — but you need a face mask, gloves, sanitizer," he said.
In New York City, the nation's worst-hit area, child protection staff are instructed mostly to use "virtual visiting," even while investigating potential risks to a child's safety.
The city's Administration for Children's Services has provided staff with questions to ask families to gauge whether any household member may have the virus. If they do, the agency says special medical assistance might be requested if pursuing an investigation.
The CEO of one of New York's biggest youth and family services providers, Michelle Yanche, says some of her 1,200 staffers at Good Shepherd Services have tested positive for COVID-19, and she's bracing for the number to rise.
"We've had to triage," she said. "For the most high-risk families, there's no other alternative than to see them in person."
Because of insufficient supplies, she said her staffers sometimes make urgent visits either with no equipment or gear that's been used.
In Massachusetts, Zwick's department confirmed Thursday that one of its Boston-based employees has tested positive for COVID-19. The union says at least three other workers are presumed infected after becoming seriously ill.
Many child welfare professionals worry the pandemic, by increasing stress on already fragile families, will fuel a rise in child abuse and neglect.
"You have families that don't have stable housing, stable income. Maybe there's a mental health challenge or a substance abuse problem — and now the schools are closed," Zwick said. "That is a recipe for disaster."
Teachers and other school employees normally offer a safeguard by reporting suspicious bruises and other warning signs, said McClain of the social workers association.
"Now you don't have those eyes and ears," he said.
In Fort Worth, Texas, Cook Children's Medical Center recently admitted seven kids under 4 who suffered severe abuse, including two who died the same day.
Dr. Jayme Coffman, who heads the hospital's child abuse prevention center, linked the surge of cases to the heightened stress on many families during the pandemic.
The Houston-based sheriff of Harris County tweeted his concern.
"We cannot let a health pandemic become a child abuse pandemic!" Ed Gonzalez wrote. "The number one reporters of child abuse are teachers, but kids aren't seeing them right now. Neighbors and other family members, PLEASE pay close attention."
Because older people are particularly vulnerable to COVID-19 and relatively few children have died from it, kids have not been a focus of public health efforts.
That's a mistake, according to University of Pennsylvania professor Marci Hamilton, also CEO of CHILD USA, a think tank seeking to prevent child abuse and neglect.
"Already some areas are reporting spikes in abuse," she said. "If caseworkers don't have that protective equipment, it's likely we'll have fewer home visits, and fewer home visits mean more kids at risk."
For many parents whose children are in foster care, and who yearn to get them back, the pandemic has worsened their predicament. Many family courts have postponed non-emergency cases, and many social services required for reunification, such as addiction treatment programs, have been disrupted.
"One thing that jumps out: The system's inability to move forward when courts shut down," said professor Vivek Sankaran, who directs the University of Michigan Law School's Child Advocacy Law Clinic.
"The courts don't have the technology to hold virtual hearings, case files aren't available electronically. There's almost this sense of paralysis," he said.
The disruption of services also can heighten concern about children's safety. Elizabeth Novotny, a social worker in Northern California's Santa Clara County, said a boy was recently reunified with his mother, but now a drug-testing program has been suspended that would have let Novotny verify that the mom was staying off drugs.
"I hope the kid is safe," she said.
Foster care also is facing upheaval, with the U.S. Department of Health and Human Services easing its oversight rules.
Under longstanding law, caseworkers are required to make monthly in-person visits to children in foster care. The agency now says caseworkers instead can do videoconferencing visits.
JooYeun Chang, executive director of Michigan's Children's Services Agency, said caseworkers should make in-person home visits only when "absolutely necessary." Her agency confirmed Thursday that six staffers had tested positive for COVID-19.
As for visits between foster children and their biological families, Chang said they're no longer required to be face to face but can be done through Skype or FaceTime.
These changes have confused many foster parents, said Irene Clements, executive director of the National Foster Parent Association. They're used to accommodating frequent court-ordered visits from their foster child's biological family and now are unsure about their obligations, Clements said.
She said school closures have created severe disruptions for foster parents who still need to leave home to work.
"But it's not just about the foster families," Clements said. "Some of the birth parents are going to suffer the consequences of not being able to reunify because of lack of income. It's nobody's fault, and it's heartbreaking for all of us."