Daycare and COVID-19: How to pick child care options amid coronavirus

Ryan W. Miller, USA Today

Parents' heads are surely spinning.

Schools are reopening virtually or with part-time "hybrid" models, parents are returning to work and general "coronavirus fatigue" has set in months since the start of the pandemic.

For many families, day care is the only option to support themselves and their children, but that opens up many other questions: How safe is child care in COVID-19 times? What protocols should day care centers have in place? Does it matter if kids are separated into pods?

To help with parents' decisions on when and where to send their children back to day care, USA TODAY spoke with three pediatric health experts to get some practical tips and questions to ask themselves and their child care providers.

No one approach is correct. Have a back up plan.

"I wish there was a simple answer," said Dr. Andrew Hashikawa, a University of Michigan pediatric emergency medicine physician. "Families are quite different."

Some families may have an adult living with them with an underlying condition that puts them at a higher risk, Dr. Charlene Wong, a Duke University pediatrician, said. In those cases, they'll need to consider if sending a child to a day center is the right choice.

But for many families, Wong notes, sending a child to day care is a necessity, given the high costs of private care and parents' work. Additionally, with competitive programs and limited capacities, the number of day care centers a family can consider may also be limited, Wong said.

In cases where there is only one option, Wong said families should be as communicative as possible about their specific needs with the staff. Hashikawa said, for example, if a child has asthma, do they have the necessary medication available to them while at the center or does the center know the child's asthma action plan?

Wong notes that centers also may be facing financial constraints amid the pandemic. "If there are families that can help out ... just ask the school if there are ways that they can help," she said. "Offer support for the staff who are all working so hard."

If a family has the financial resources, some have turned sharing a private tutor or babysitter with other families nearby – often dubbed a "pandemic pod." Hashikawa said asking a family member who is not at higher risk for complications to help may be an option, too.

In any scenario, Hashikawa said having a back up plan in place is important in case a center closes or a babysitter gets sick.

Know your local COVID-19 numbers.

Data should be driving families' and local officials' decisions about whether to send a child to a day care center and also in what capacity the centers are open, experts said.

"The number one thing to consider is what the rates of COVID-19 are in your community," Wong said.

If there is an active surge in cases in your town or county, it may be time to limit the number of people your children are exposed to, Wong said.

Sending a child to a day care center in parts of a state like Massachusetts poses a lower risk right now than states like Texas or Florida, Hashikawa noted. And it's unknown where and when future spikes could occur, making it all the more important to have the most recent and most local data available to parents, Wong said.

While pulling a child from a daycare is not an easy decision and won't be feasible for every family, Wong said it's still important to know the local numbers and stay informed.

Make sure there is podding of classrooms and outside time.

Wong said within day care settings, separating children into different pods with their own teachers that don't interact with the other students or teachers is one of the most important things a facility can do.

Asking for young preschool students to physically distance can be extremely challenging, but limiting the number of people they come in contact with once at school limits exposure risk, she said.

"If there is a case of COVID-19 in a teacher or student then the number of people exposed is the smallest possible," she said.

"If you are able to have truly separate pods, if you have teachers and students that can stay with those pods, it does make a difference," Hashikawa added. "If you're putting 15 to 20 people in a room, that's a lot different than having 8 or 9 in a room."

While the U.S. Centers for Disease Control and Prevention says there's no optimal minimum or maximum number of students that should be in one pod, the smaller the cohort, the better. Small cohorts also may not be truly separated from each other as students in one group may have a sibling in another, the CDC notes.

Additionally, a day care center that allots time to be outside can also help reduce risk, Dr. Camille Sabella, a pediatric infectious diseases specialist at the Cleveland Clinic, said. While there is a fear that children won't stay apart during recess, "being outside really is one of the best things we can do to prevent the spread of this virus from person to person," he said.

The CDC agrees. On its website, the agency says activities held outside in general are safer than inside, where there may be less ventilation.

Hashikawa said he's seen centers that are "recreating their play time" and trying to include being outdoors into the curriculum when feasible.