There are many reasons to open up schools and child care facilities:
- Child care providers can continue to work and earn wages
- Parents can return to work
- Children receive educational, social, nutritional, and other benefits
However, one of the major concerns about opening up schools and child care facilities is the potential risk of COVID-19 transmission to teachers and child care providers.
Are child care providers at high risk for contracting COVID-19 from their young charges?
In a study early released in Pediatrics this week, Gilliam et al report the results of a multi-state survey of 57,335 child care providers, who completed surveys between May 22, 2020 and June 8, 2020 (10.1542/peds.2020-031971). The authors found that:
- Half (51.4%) of providers reported that their child care program had been closed since the beginning of the pandemic.
- The child care programs that remained open were smaller than usual (7.57 children for center-based programs, 5.62 for home-based programs); 81.1% of children were <6 years old.
- >90% reported frequent staff and child handwashing and surface disinfecting at least daily.
- Nearly 80% reported child or staff symptom screening and temperature checks.
- Half reported cohorting of children, social distancing, staggered arrival/departure times, and no sharing of food.
- 0.7% of providers had contracted COVID-19. There was no association between COVID-19 outcome and working in child care (OR 0.94; 95% CI 0.73-1.21).
- Home-based providers were more likely than center-based providers to contract COVID-19 (OR 1.59; 95% CI 1.14-2.23), but there was no difference in working in child care.
- Providers who contracted COVID-19 were more likely to live in high prevalence counties and to be non-white. None of the variables that were asked explained the lack of association between COVID-19 outcome and exposure to child care.
So, can we feel reassured about these results?
Drs. Heather Tubbs-Cooley, Emily Oster, and Katherine Auger, in a commentary, noted that there were many methodologic strengths of this study, including large sample size, high response rate, and rigorous statistical methods (10.1542/peds.2020-034405). However, they also note that this survey was conducted early in the pandemic, when national testing capacity was limited and when COVID-19 rates in children were low. They also caution that one cannot extrapolate these findings to school settings, as the policies and activities are different from those in child care settings.
