When the coronavirus first swept across the country, many day care centers closed to protect children, staff and their families. But many states are now starting to reopen and, with that, some day care centers are opening up to families again, too.
The coronavirus hasn’t gone away, though. The virus and the disease it causes, COVID-19, continue to spread in practically every state, and parents understandably have questions about the safety of sending their children back to day care.
“I talk about this with families every day,” says Danielle Fisher, M.D., F.A.A.P., pediatrician and vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California.
Maybe you need to go back to the office or have (understandably) hit your breaking point with working from home while juggling child care. Or maybe you just want a break after months of being home with your baby. And of course, for parents who are essential workers, continuing to send their children to day care may not be a choice. Whatever your situation, here's what parents need to know about the reopening of day care centers.
Some day care facilities stayed open during the initial wave of the pandemic to try to help first responders, with guidance from state authorities and the Centers for Disease Control and Prevention (CDC). But regulations that dictate when children of non-essential workers can attend day care and when day care centers can reopen are largely determined by individual state governments, Dr. Fisher says.
However, the CDC has issued guidance for child care providers and families. The guidance recommends that:
But ultimately, state and local authorities dictate the plan for reopening day care in your area. (Check your state’s public health department website for more information.)
The CDC has very long, very specific guidelines in place for day care centers to follow. The measures that are actually put into place at your day care will be largely dictated by state and local guidance, as well as the center’s individual policy. However, much of that will be based on the recommendations issued by the CDC, which call for:
“A lot of the precautions are similar to what child care centers would take in response to influenza; norovirus; hand, foot and mouth disease; rotavirus and RSV outbreaks,” says Trish Garcia, M.D., pediatric hospitalist at Connecticut Children’s Medical Center. “Parents should keep in mind that child care centers are used to dealing with outbreaks of viruses. While COVID might spread more easily than the other viruses, it still spreads through the same methods as RSV and influenza, so child care facilities know what to do. This isn't a huge unknown to them.”
The most important thing families can do is to keep children at home if a child is sick, even with a slight fever or cold symptoms, Dr. Garcia says. “Child care centers have always been very strict about attendance and illness and they are going to be even more vigilant now,” she says.
For essential workers, sending your children to day care during the pandemic has likely not been a matter of choice. But for non-essential workers who are debating whether or not to send their children back to day care, there is no one-size-fits-all answer.
“It depends on necessity,” says Ashanti Woods, M.D., a pediatrician at Baltimore's Mercy Medical Center. “With many families having one or both parents working from home, moms and dads in some cases need the kids to be engaged and watched by the day care staff. Also, some families simply want their child to get the social interaction that comes along with attending day care. Ultimately, it will be a family decision whether returning to day care is the best move.”
Dr. Fisher recommends considering your personal situation. “It’s important to ask, ‘If we send our child back to day care and they get sick, what are our capabilities to care for them?’” she says. It’s also important to determine how well your family is able to quarantine for 14 days if your child is exposed to the virus at day care.
Older and immunocompromised family members should also be factored in, Dr. Fisher says. If one or more of the people in your household falls into that category, it’s important to figure out in advance what you would do to protect them if your child becomes sick.
Weighing what is happening with the spread of the virus in your area also needs to be considered. “If you see a big surge in cases in your area, that would make me nervous,” Dr. Fisher says. “If they stay stable, that’s probably okay. Do a risk assessment.”
If your child or a day care center caregiver became sick at the facility, the CDC recommends that they be isolated from others and sent home as soon as possible. From there, the day care building should be cleaned and disinfected after the sick person has gone home.
If it is your child who is sick, the CDC recommends doing your best to isolate her from the rest of the household. However, that can be tough with small children, Dr. Fisher points out. After your child has recovered, when they can return to day care depends on individual policy.
“Each center should have a written policy about this and what conditions are needed to return to day care, for example, how long a child needs to be fever- or symptom-free,” Dr. Garcia says. “Additionally, the center should have a policy about testing and what is required and this should be made available to parents — for example, some centers might require that a sick child be tested for COVID-19.”
If a day care worker becomes sick, it’s important to consider the contact they’ve had with your child, Dr. Fisher says. If your child’s main caregiver became sick, your child will likely need to be quarantined. But if there were degrees of separation, such as a household member of your child’s care provider became ill, “the provider should quarantine themselves, but not the child,” Fisher says. “If it’s not direct caregiver contact, it’s not necessary,” she adds.
If your child is a baby, the best thing you can do is to try to follow COVID-19 prevention strategies to keep them healthy outside of day care, like practicing social distancing and washing their hands and toys regularly, Dr. Fisher says.
If your child is a little older, Dr. Garcia recommends encouraging frequent hand washing, teaching her the importance of covering her nose and mouth when she sneezes or coughs and practicing those skills at home. Talking about wearing a face mask (if she's older than 2), and practicing using it at home can also help, Dr. Woods says.
It’s a good idea to let your child know that their caregivers will likely be wearing masks. “Masks are scary, especially for toddlers,” Dr. Fisher says. “You need to tell children that adults and older children wear masks to help prevent the spread of germs."
Finally, ask how you can support your child’s facility. “They may be in need of donations — disinfectants, masks, etc. — or other assistance,” Dr. Garcia says.
Ultimately, the decision to send your child back to day care isn’t an easy one. But experts say that weighing your family’s risk and considering what is happening in your area can help you make the right decision for you.
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