Why the child care industry was more prepared for COVID-19 than others

Hygiene, disease prevention was already part of program DNA, but other factors have made weathering the pandemic tough.

Long before the pandemic began, child care providers operated under policies designed to keep children safe and reduce illness spread — and, as a result, they’ve had to make fewer changes than many families, businesses and even schools to cope with the novel coronavirus.

But they haven’t avoided all the challenges related to COVID-19, including a drop in enrollment related to more parents staying at home with their kids and difficulties finding personal protective equipment that was not prioritized for them the way it has been for school teachers.

Sound policies are key to keeping children safe in child care, according to experts who say parents should watch for both solid practices and mitigation plans in case illness starts to spread.

A study led by Yale University researchers published in Pediatrics, the journal of the American Academy of Pediatrics, said the heart of the debate over keeping open or reopening child care and schools has been whether kids efficiently transmit COVID-19. To figure it out, the researchers compared COVID-19 outcomes among child care providers who continued to provide direct in-person child care during the first three months of the U.S. COVID-19 pandemic with those who did not. 

Because of the “considerable infection mitigation efforts in U.S. child care programs,” they said child care was not associated with elevated risk for COVID-19 transmission to providers. The caveat was the findings had to be within the context of transmission rates in the community and heightened infection mitigation efforts that are required of child care programs before the pandemic hit.

Not without challenges

The pandemic in some communities has been rough on child care arrangements, but the nonpartisan organization Capita said child care in many parts of the country was hurting well before COVID-19.

The pandemic just made it worse.

Capita’s national survey found nearly half of families lost their pre-pandemic child care, but even before that, care was hard to find close to home and often not affordable. Families also faced inflexible child care hours that didn’t always match their work hours. And many employers have reacted to the pandemic and the need to social distance by staggering shifts in ways that may not be child care-friendly.

Meanwhile, Brookings Institution reported on inequities in how educators in child care are treated, compared to those in schools. For example, while much of the public discourse about reopening schools focuses on keeping teachers safe, there’s been far less mention of protecting child care employees. That’s true even though many child care providers have risk factors that make them vulnerable should they get COVID-19.

Brookings said it doesn’t matter whether they labor with toddlers or fourth graders, in day care or schools, those who “teach young children every day do complex work, scaffolding children’s academic, social and emotional development during a foundational period in their lives. They also provide essential child care to ensure working parents can do their jobs — a reality highlighted by COVID-19.”

But they are treated and paid very differently based on the age of their charges, it said, noting those who work in schools “experience substantially better working conditions than those working in child care centers.”

For instance, when schools shut down, teachers went online and still got paid. At child care centers, staff members got paid if they provided in-person care for children — initially primarily for offspring of essential workers and first responders. When enough parents started working from home and keeping their children there, many child care providers felt a real financial pinch.

Brookings found that nationally, just over a third of child care teachers weren’t employed after COVID-19 hit, and of those working, 27% had reduced hours and thus less pay. Many of them reported difficulty paying for bills and being able to afford health insurance, food and housing, compared to school teachers.

States like Utah, where child care regulators collaborate with and include child care providers in decision-making, have been able to adjust more quickly to changes required by COVID-19, according to Jody Zabriskie, owner of A to Z Building Block child care centers, which combined care for about 350 children.

“States that have a strong child care association are more successful,” she said, noting Utah has a state child care licensing committee and works closely with the child care industry to make sure providers understand policies. Knowing how to keep children safe has allowed centers like hers to stay open from the beginning of the pandemic.

Keeping children safe

Existing rules on cleanliness and safety have served children and their families well.

Zabriskie said child care providers have had to make few changes to meet pandemic standards. “Hand washing was already in place. Cleanliness, cleaning toys, rotating toys through — that was already being done.”

Simon Bolivar, Utah child care licensing program administrator, says certain policies protect kids and give parents something on which to rely, with or without a pandemic. He said parents need licensed day care — and not a city business license, but one licensed by the state specifically to provide day care that gets inspected and is governed by rules, with a promise it will be monitored and folks will be trained to follow procedures.

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He lists background checks and set ratios of children to caregivers, driven by policies that are protective, as vital. Rules about sanitizing and disinfecting were in place even before COVID, but took on added salience. During COVID, care centers should be conducting screenings for symptoms, too, said Bolivar.

The pediatric academy’s Healthychildren.org agrees that with health checks like taking temperatures, as well as required cleaning and disinfecting, children should be fine in child care. But it says adult providers need protective gear and children over 2 should wear masks in cases where social distancing isn’t possible.

Zabriskie said early in the pandemic, parents were not allowed inside and had to pick up children at the curb, but as everyone’s become used to social distancing and precautions, that’s loosened up successfully. She said her centers added a few precautionary measures like screening families for elevated temperatures and requiring that masks be worn in common areas, though she doesn’t require that small children wear them in their classrooms because masks are very challenging for children. Instead, they focus on social distancing.

While Bolivar notes masks help, he said Utah has chosen to recommend them but not mandate them in child care settings with young children because children are developmentally at different stages of being able to wear them successfully. And they can hamper effective communication.

Alise McGregor, the CEO and founder of Little Newtons Early Education Centers, which has five locations in Minnesota and Illinois, said they didn’t have any cases of COVID-19 for months when the pandemic began. The key, she agreed with Bolivar and Zabriskie, is hygiene.

Before opening her centers, McGregor was a cardiac nurse and she said she, too, takes cleaning very seriously as a way to avoid infections. “We intensified those efforts by hiring cleaners who are CDC-certified and very well-educated on COVID-19. We also do temperature checks for students. We have sanitation stations at the doors, and anyone who comes into the building must wear a mask.”

McGregor’s plan for COVID cases includes disinfecting the schools overnight. “I would recommend schools and businesses find a similar cleaning company. They can come in quickly enough that we wouldn’t need to shut down.”

It also helps to make children partners in hygiene, she noted. They learn that washing hands and following rules is how they do their part to protect themselves and each other, said McGregor.

The policies are working, said Bolivar, who notes that “providers are following procedures really well. We’ve seen almost no problems from COVID-19. It’s almost impossible to avoid being exposed entirely — but providers are very, very safe.”

The policies protect the whole family, Bolivar said. “You have to keep in mind that every individual may have underlying conditions. Young children are at less risk than adults, but every child is from a different world. Every employee is in a different world. So we protect them all.”

Because anyone can be a carrier of COVID-19, Bolivar said it’s important to make sure everyone follows sound practices — and not just from COVID-19.