Dr. Nina Fefferman: Emergency Childcare Best Practices During COVID-19

What can we do to reduce the spread of COVID19 in emergency childcares for essential workers?

We are in the early days of a health emergency, and the state is rightly taking aggressive steps to reduce and slow the spread of COVID-19. Governor Scott did the right thing in ordering a closure of schools. All of us need to work together to slow the spread of the COVID-19 long enough to:

  • Make sure our healthcare system is not overwhelmed, given evidence of community spread, as well as the rapid spread, of COVID-19, and
  • Figure out how to care for the children of essential workers without contributing to a surge of cases in our healthcare system.

Keeping as many hospital beds available right now is critical – for this reason, it’s essential that guidelines for emergency childcare be as extensive as possible.

But here is the reality. The governor ordered schools to provide childcare for essential workers, because they cannot work if their children are not safe.  However, at any given time, some children are likely to show no symptoms, but also be infected and contagious. All emergency childcares should operate with this hidden contagiousness in mind and take research-informed steps to reduce spread. The Governor rightly closed schools to avoid further spread of Coronavirus, but we all must make sure that the practices used in our emergency childcares also work to towards that aim.

I spoke this week with Dr. Nina Fefferman (nfefferm@utk.edu), a researcher who studies pandemic preparedness, spread of disease in schools, and about what kinds of practices programs can use to reduce the spread. 

These recommendations are not about politics. They are about public health. In that spirit, I am sharing Dr. Fefferman’s recommendations, which address practices not covered in the current guidance for childcares. These recommendations complement existing state recommendations and provide additional guidance for childcares (see links to state guidance at the bottom of this document).

Recommendations

Implement strategies for social distancing. Care for children in small (10 or fewer, as per VDH guidance), stable (fixed membership) groups that:

  • Don’t interact with other groups,
  • Remain in consistent spaces and don’t share common spaces, including restrooms. If it is not possible to give each group its own restroom, each classroom could have a rotation of “their turn to use the restroom.” (Of course, this will be harder for younger age groups). Prior to the start of each group’s turn, the teacher/caregiver for that group can clean the sink, toilet seat, toilet flush handle, soap dispenser, towel dispensers/buttons on air dryers, and door handles with a disinfectant wipe
  • Assign specific and consistent adults to each group of children, so that caregivers are not shared or working across groups. Remember that if groups of adults from different groups meet, this meeting could undo any efforts at social distancing between groups.

Schedule recesses – Don’t put the program’s entire population out on the same playgrounds at the same time.

  • Children should have outside time in the same small groups with which they spend the day. Playgrounds can be petri dishes. Partition the outside play area by group and have the area to which each group is assigned be fixed (i.e. don’t rotate which group gets to play in which area over days). This ensures students don’t interact with playground equipment or space that has been touched by other groups. Note: the virus might last 3-4 days on some surfaces, depending on the porosity of the surface, sunlight, dampness, and other conditions.

Teach, practice and emphasize proper good hygiene:

  • Washing of hands with soap at every transition. This can be structured as a game.
  • Reinforce social distancing and not touching one’s face.

Eating and Drinking:

  • Eating surfaces should be wiped and hands should be washed before and after eating.
  • Water fountains should be shut down. Water bottle filling stations that operate by proximity sensor should be fine.
  • Children should bring packed lunches or have packed (bagged) lunches delivered to them in their same groups.
  • No one should share food, beverages, plates, utensils, or cups.
  • All waste from eating (leftover food, napkins, plates, cups, etc.) should be packed away or thrown out immediately after eating and anything intended for transport home should be kept separately for each child.

Frequently clean facilities, as advised by the Vermont Department of Health. Remove hard to clean items, and clean surfaces throughout the day.

Be prepared to close groups or programs, as advised by the Vermont Department of Health, in the event of positive identification of any staff or children in a group or program. Each individual child and staff person should be evaluated for health on a daily basis and asked to stay home if showing signs of illness. Be aware that most children may be asymptomatic, so unfortunately, it is probable that some children in your facility may be affected and infecting others, but not symptomatic.

The state has provided some guidance for emergency childcare operations here, including guidance on cleaning practices:

Childcare for Essential Persons Information:

This is an unprecedented moment in our lives, and it will take an unprecedented response, both by individuals and by our state government. We will get through this, and we will do it by working together to help each other out.

Thank you for helping to keep Vermonters safe in this unprecedented time.