Back in March, Rita Hamad decided to pull her three-year-old daughter out of a Bay Area preschool just as California started shutting down.

Hamad, 38, a social epidemiologist at the University of California, San Francisco, and her husband, another faculty member, juggled work and child care while stuck inside—like so many other American parents. “Thankfully, we can both work from home and our work hours are flexible,” Hamad said. “But that meant we were spending a lot of time in the evenings and on weekends working to make up for those lost hours.”

More than five million working families with children under the age of five paid for some form of child care before the coronavirus pandemic struck. Now, with many U.S. businesses calling employees back to the office, parents like Hamad with preschool-age kids face a difficult choice.

According to a recent survey, about 60% of families who typically pay for daycare said they were somewhat or very uncomfortable sending their children to child-care centers. But with work-from-home options narrowing for many parents, placing their children—and themselves—at potentially greater risk is fast becoming a real possibility.

While families mull this difficult decision, the U.S. child-care industry is in trouble. Back in April, almost half of the 5,000 child-care providers surveyed by the National Association for the Education of Young Children were closed. By mid-June, more than 80% of child-care centers said they were open, but enrollment was down by an average of 67%.

The $3 trillion bailout passed by Congress in March allocated $3.5 billion to support child-care providers, an industry that before the pandemic employed more than 1.1 million people, according to the U.S. Bureau of Labor Statistics.

Advocates for child care-providers are pushing for $50 billion in additional aid. About 40% of respondents in June said they would close permanently if they didn’t receive more public assistance. Only 18% said that they could survive more than a year with less than 80% of their pre-coronavirus enrollment and no public assistance.

Almost half of America’s licensed child-care slots—accounting for more than four million children—could disappear because of the pandemic, according to an April analysis. Many child-care providers operated on razor-thin margins before the pandemic. State requirements that they restrict enrollment to maintain smaller group sizes to avoid virus transmission will leave money on the table they can ill afford to sacrifice.

“One month of not getting the enrollment you expected can have a devastating impact,” said Simon Workman, director of Early Childhood Policy at the Center for American Progress.

Bright Horizons, a child-care provider which works with employers, said it typically operates about 1,100 centers globally with almost 700 in the U.S. As of March 31, when the pandemic was first taking hold in North America, only 250 remained open worldwide, the company said. Chief Executive Officer Stephen Kramer said it has since implemented safety measures including reduced class sizes and masks for adults.

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