COVID-19 and Child Care: According to the latest research

Sending offspring back to day care provides a welcome rest for parents caring for young children, but many are hesitant for fear of exposing their children and themselves to the new coronavirus. I will.

Find out how the coronavirus affects children, how safe the program is for children and their families, and which steps are most effective in mitigating the virus and its illness, the spread of COVID-19. The question remains.

But seven months after the national child care centers were closed due to the first wave of the pandemic, the study provides some answers. Here’s what we know at this point:

What risks does COVID-19 pose to young children?

Children can be infected with the new coronavirus, but the consequences are generally not as serious as adults.

More than 741,000 children in the United States have been tested positive for the coronavirus since the outbreak of the pandemic, according to recently updated data from the American Academy of Pediatrics. As of October, about 100 children and teens had died of the disease. This is a small part of the country’s total death toll, currently over 221,000. As with adults, children with certain underlying illnesses such as obesity, severe genetic or neurological disorders, diabetes, asthma, and other chronic lung disorders may be at increased risk of serious complications. ..

Children and teens may also develop what doctors call multiple organ inflammatory syndrome, or MIS-C. Symptoms of infants and preschoolers are similar to Kawasaki disease. Kawasaki disease is a rare disease of unknown cause that usually affects people under the age of 5 and can cause inflammation of blood vessels. According to the Centers for Disease Control and Prevention, MIS-C caused at least 20 deaths.

Can infants spread the virus?

Throughout the pandemic, children infected with the coronavirus often show asymptomatic or mild symptoms, and there remains a persistent concern that they may be silent spreaders.

A small study published in the Journal of Pediatrics in August found that some children had high levels of the virus in their respiratory tract during the first three days of infection, even though the symptoms were negligible. I will. In another recent study at JAMA Pediatrics, children under the age of 5 with mild or moderate cases of COVID-19 had similar or higher viral load in the upper respiratory tract compared to older children and adults. It is reported that there was a quantity.

However, experts say that the amount of virus in infants does not necessarily mean they are the primary source of infection, and there is a lack of data on the risk of infection.

“There is clear evidence that children can increase viral load, but epidemiologically, this was feared a few months ago as a’superspreader’,” said John Oholo, an infectious disease specialist at the Mayo Clinic. There is little evidence that it will lead to the situation, “I wrote in an email in Rochester, Minnesota.

In a telephone interview, Ohoro said infants may have different immune systems, and smaller lungs may make it difficult to exhale infectious particles. In any case, “very small children are not as efficient at transmitting the virus as older children and adults,” he said.

Is it safe for infants to raise their children?

The results of studies examining the impact of child care programs on the expansion of the US community are mixed.

In September, the CDC released a small study of contact tracing data collected from April-July from three child care centers in Salt Lake City, with perhaps 12 children becoming the new coronavirus at the facility. I found that I was infected and continued to infect my family. .. The infection was also associated with two children who confirmed asymptomatic cases. Outbreaks at the two centers have been traced back to staff exposed to the coronavirus throughout the family, but the cause of the outbreak at the third facility has not been identified. According to the report, all programs had various safety measures at the time.

However, a recent study by Yale University researchers who surveyed more than 57,000 child-rearing workers in May and June reassured experts that risk mitigation efforts would be effective in such an environment. Showed evidence that it can be provided. According to a national survey published in the journal Pediatrics, nursery teachers who continued to work early in the pandemic and were regularly exposed to infants were not at high risk of being infected with the virus. People at home — if safety measures are strictly adhered to.

More than 90% of survey respondents who worked in open facilities reported that they practiced hand hygiene between staff and children and frequently disinfected indoor surfaces and fixtures. Other safety protocols included keeping the size of the group small (an average of 6 children in the home program and a cohort of 8 in the center), symptom screening, and social distance.

“These child care programs have put a lot of effort into keeping children safe,” said the lead author of the paper and a professor of child psychiatry and psychology at the Yale University Children’s Research Center. Walter Gilliam says. He added: “Can you imagine cleaning and disinfecting all the surfaces and fixtures of a house three times a day? The amount of effort they have experienced is incredible.”

The results of this study appear to be consistent with another CDC report in August suggesting that childcare facilities can be safely reopened if the community is low and strict protocols are implemented.

Yale University’s study provides important information about what is known about childcare programs and COVID-19, said Yale Maldonado, head of the Department of Pediatric Infectious Diseases at Stanford Medical School.

“Such studies really help us to understand on a large scale what we think is happening,” said Maldonado, who was not part of the study. However, she added that the study has limitations, that is, it relies on self-reported survey responses.

“We don’t have test data, and we certainly don’t know if all asymptomatics have been identified,” she said.

Gilliam also focuses on whether children pose risks to adults in childcare facilities and has not investigated adult-to-child transmission or potential spread among children themselves. Said.

“In the end, even if you move from child to child, you’re expected to eventually grow up, but you didn’t see that,” he said.

Mayo Clinic’s Ohoro, who has a two-year-old son, said he felt “completely safe” so that his child could be in a preschool environment.

“Part of that is our confidence in local daycare, [the Yale study] It’s not just the local facilities that can manage this, it gives us the confidence that childcare across the country has found a way to adapt to the pandemic, “he said.

How do you assess the safety of day care and kindergarten?

Studies show that adhering to public health guidelines can slow the spread of the virus, said Xiaoyang Sung, head of infection control and epidemiology at the National Children’s Hospital.

“We know there are very effective ways to deal with this virus, so there’s no reason for anyone to panic,” Song said. “With proper precautions, life can continue.”

Gilliam encourages parents to assess whether the child care program has the resources and staff needed to implement the necessary safety measures, such as frequent surface disinfection, small group numbers, and social distance. It was. Song suggested creating a checklist of questions starting with whether the facility has a careful symptom screening process for children and staff.

According to Gilliam, parents also need to know what happens when an employee gets sick. Can I get paid even if I can’t get a job? Who will replace them? And he said parents should ask the provider if they feel they have what they need to maintain a safe environment.

“If not, that’s a concern,” he said.

In addition, Gilliam recommended that parents pay close attention to the level of coronavirus cases in the community.

“Child care programs don’t seem to threaten the community, but that doesn’t mean the community can’t threaten child care,” he said. “High infection rates in the community put a heavy burden on childcare programs and schools to prevent them.”

Science and expert opinion should take these decisions into account, but Oholo said it usually depends on how much risk people are trying to take.

“It will be a very personal decision about how much risk you can tolerate for your child and other family members,” he said.

Allyson Chiu is a writer for The Washington Post.