A study of 57,000 childcare providers found no risk of increased COVID-19 spread between kids and adults

  • Being a childcare provider does not add to adults' risks of contracting COVID-19, as long as childcare programs follow safety precautions, a study found.
  • Protective practices like handwashing and disinfecting surfaces are vital to keeping the risk of infection low.
  • Rates of community spread were more likely to predict whether a childcare worker got sick.
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As the pandemic drudges on, parents and providers alike are looking for safe childcare options. 

The results of the first large-scale assessment of the risks of working in childcare settings, published today in Pediatrics, suggest that it could be safe to reopen such programs where the rates of community spread are low and safety measures are in place.

"If you can check both of those, then going to a childcare program seems to pose no greater threat of one getting COVID than just being alive in your community does," lead author Walter Gilliam, director of the Edward Zigler Center in Child Development and Social Policy at Yale University, told Insider.

Researchers at Yale's Child Study Center surveyed more than 57,000 childcare providers across all 50 states and found that those who returned to work in May and June assumed no additional risk of contracting the coronavirus, as long as their workplaces implemented safety protocols like handwashing and disinfecting surfaces.

That doesn't mean that childcare workers can't get sick, Gilliam said. Some 427 respondents said they tested positive or were hospitalized for COVID-19. But their risks of falling ill were equal to those who did not return to work, according to an analysis that controlled for age, gender, race, and level of community spread.

Frequent handwashing and disinfecting kept the risk of infection down

Infection control practices are essential to ensuring that childcare settings do not pose a high risk of disease transmission. Providers who work in these settings are already trained in health and safety measures, Gilliam said, and they've ramped up those efforts during the pandemic.

More than 90% of respondents reported high rates of child and staff handwashing and daily disinfecting of surfaces. Over half of them reported disinfecting three or more times a day.

Many respondents also reported using daily symptom screenings, putting children into small groups, and social distancing to minimize the risk of infection, although mask-wearing was less commonly cited.

"These childcare providers were doing nearly Herculean levels of effort to keep their children safe," Gilliam said. "If we can't continue to support their ability to do that, especially as we try to open up more of these programs, there's no guarantee that they can continue to keep children safe."

For childcare programs to reopen safely, community spread must be low

With 35% of jobs in child care lost between February and April 2020, many providers may be eager to return to work, and working parents may share this goal.

"It's understandable that families, employers, and early childhood development experts all want to see childcare programs reopen," Lynette Fraga, MD, CEO of Child Care Aware of America, said in a press release. "It's hard for parents to work without childcare — and it's hard for young children to thrive without opportunities to engage with attentive adults and other children." 

But Gilliam said that should not happen until community spread is under control.

"Although the findings suggest that childcare programs don't pose a risk to communities, that doesn't mean that communities can't pose a risk to childcare," Gilliam said.

He recommended against reopening childcare programs in COVID-19 hotspots, as childcare providers in high infection zones are more likely to get sick. A less than 5% positivity rate over a period of 14 days would signal it's OK to reopen.

Gilliam added that reopening childcare centers for younger children, who may be less likely to spread the coronavirus and typically stay with a small group throughout the day, carries different implications than opening K-12 schools where there's more potential for spread.

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