Ask any parent what the most difficult part of the COVID-19 pandemic has been for their family and child care is likely to be up there. Not only have millions of American children been learning remotely since March, but the pandemic has decimated the daycare industry, eliminating millions of spots for kids whose parents need a safe place to send them while they work.
Even as state-level restrictions have eased, many parents have been reluctant to send their children back. No one really knows how much children pass COVID-19 among themselves and their providers, and there has been very little scientific data that can help guide parents through these wrenching decisions. Until now.
A study published in Pediatrics, the journal of the American Academy of Pediatrics, has found that sending young children into child care centers that primarily served kids ages 6 and under was not associated with a higher COVID-19 risk among the staff who watched them all day.
That is not the same as saying there was no risk. And researchers didn’t investigate whether those children spread the virus among themselves, or brought it home to their families. But it nonetheless represents a crucial first step in evaluating how safe group child care is during this pandemic, which still has much of the world firmly in its grasp.
“Our study doesn’t fully answer the question of whether to reopen child care or not,” study author Walter Gilliam, of the Yale University Child Study Center in Connecticut, said in a statement. “We don’t have data on children’s risk, and local levels of community spread matter a lot.”
“But our study does offer solid evidence that, under certain conditions, it’s possible to open child care programs without putting staff in harm’s way,” he said.
A notable aspect of the study is its size.
In May and June, Gilliam and his co-researchers surveyed 57,000 child care centers from all 50 states, as well as Washington, D.C., and Puerto Rico, asking whether any staff members had contracted COVID-19 or had been hospitalized. They polled a mix of centers that stayed open and those that closed, either because they chose to or because of local restrictions.
When they compared staff infection rates among the two groups, they did not find evidence that staying open posed additional risk to providers. That suggests that children were not really transmitting COVID-19 to their caretakers.
But there were reported cases of COVID-19 during the survey timeframe. Black, Latino and Native American child care providers reported higher rates of infection in the survey. And in parts of the country with higher rates of community spread at the time, child care workers were more likely to contract COVID-19.
For many parents and child care providers, if the risk is not zero it’s simply not good enough. And the study does have limitations, among them it relied on self-reporting.
But the authors believe it points to a path forward as the pandemic wears on and health officials warn there is likely to be a second wave this winter.
The child care centers that remained open throughout the pandemic were fastidious about infection prevention, sticking closely to measures outlined by groups like the American Academy of Pediatrics, the study found.
More than 90% said they were vigilant about frequent hand washing and wiping down surfaces. Centers carefully screened for symptoms, attempted to “cohort” children when possible (meaning they kept certain kids and staff together throughout the day to avoid unnecessary exposures), and generally had small groups of about eight children in larger centers, and six in home-based daycares.
However, relatively few child care providers that stayed open said they were requiring children ages 2 and up to wear masks. The role mask-wearing may have on COVID-19 spread among toddlers and preschoolers is one issue researchers will need to continue to measure, along with broader questions about potential spread from child to child and among families.
But for now, experts argue the findings are one tentative bright spot in a year that has brought little good news for parents or child care providers.
“This study tells us that as long as there are strong on-site measures to prevent infection, providing care for young children doesn’t seem to add to the provider’s risk of getting sick,” Gilliam said.
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