Wednesday, July 15, 2020

Midsummer check-in


I hope this finds you all well! It’s been awhile since I last checked in. For those of you who closed in the spring, I hear your concerns about safely reopening in the fall. Others who stayed open (or closed only temporarily) have ongoing concerns about common childhood illnesses in the context of the pandemic, especially given that people with COVID-19 have had a wide range of symptoms reported, ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. According to the CDC, people with these symptoms may have COVID-19:
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
Guidelines suggest that centers should continue to follow their usual inclusion/exclusion criteria for managing fever (temp greater than 100.4 F) and other symptoms. Some centers have modified their policy to require a child to remain fever-free without fever-reducing medication and be symptom-free for up to 72 hours before return to the center. Symptomatic staff should be held to the same standards as the children. Some are also requiring provider documentation before the child can return. The CDC Decision Tree can help with decisions about exclusion and school closure: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html#schools-prepare. School closure is indicated only if an infected person has been in the building (not someone who may have been in contact with an infected person), and then only for 2-5 days to allow for deep cleaning and disinfecting.


Decisions regarding COVID-19 testing are guided by the CDC, contact tracing, and family discussions with providers about whether testing is warranted, based on symptoms and likelihood of exposure. There are no recommendations for testing as a screening/preventive approach. This is the Keep Maine Healthy web page that addresses testing: https://www.maine.gov/covid19/restartingmaine/keepmainehealthy/testing. The Maine standing order can be found at  https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/documents/MEDHHS_StandingOrder_COVID19testing_06-08-2020.pdf. Eligibility requirements for testing need to be met. Testing facilities can be found at https://get-tested-covid19.org/ - type in your zip code, and you will get a list of testing sites within a 40-mile radius. As I understand it, insurance companies are waiving fees for COVID testing and it is free for uninsured persons.

The CDC website states the following regarding quarantine at home for positive COVID-19:
Persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:
  • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
  • At least 10 days have passed since symptoms first appeared.
This guidance is just that – guidelines, not mandates – as each center has unique environments and situations. Any decisions made about modification of health policies need to be clearly communicated to families in writing and consistently implemented.

Please share any newly developed or modified practices and guidelines that you’ve found to be effective in maintaining a safe environment during this pandemic – you can comment directly to this post. I continue to marvel at your courage, resilience, and flexibility to ensure the wellbeing of the children you serve as well as your own staff.

Stay safe and be well!
Deb

Sunday, May 31, 2020

Sharing our collective wisdom


It’s been a month since I last checked in. Some of you have stayed open since the beginning of this pandemic, some recently reopened, and still others are preparing to reopen. I understand your feelings of uncertainty and concern for safety. I am impressed with your courage, resilience, and flexibility to ensure the wellbeing of the children you serve as well as your own staff. I recently finished teaching two sessions of the Maine Roads to Quality Foundations in Health, Wellness, and Safety course, which provided an excellent forum for child care providers to share their expertise and wealth of knowledge, including how they are managing the pandemic challenges. It’s also a great way for me to connect those providers to evidence-based resources to support their efforts. I’m hoping that this blog might provide a similar forum for you all to share newly developed or modified practices and guidelines to maintain a safe environment. 

As a reminder, the CDC provides excellent guidance for schools and child care centers (https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html), interim guidance for centers that stayed open (https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-childcare.html), and guidance for reopening and scaling up child care (https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/childcare-programs.html). I rely on these resources to help draft new and modified guidelines that meet your unique circumstances. Please share your experience and what is working for you.

Stay safe and be well!
Deb

Thursday, May 14, 2020

Latest CDC Decision Tree for Child Care

This is the link to the latest CDC Decision Tree for Child Care Centers to guide decisions about opening: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/Childcare-Decision-Tree.pdf?fbclid=IwAR328PVRa1a14sWr3dHIbe60Nn6RT1NEbzDUVUbUXehjp9xFqtGE1RIt-ro.  

As always, the CDC is our best source of information to support policy development and decision making regarding health and safety.

Thursday, April 30, 2020

Preparing to reopen?


It’s been awhile since I posted – it’s been a whirlwind for the past five weeks, trying to adjust to all the challenges and changes presented by this pandemic. I hope you’ve all been well. Some of you stayed open for your families who are essential workers, and for that I am grateful. You have likely experienced significant decreases in your numbers of both staff and children. Others needed/opted for closure and are preparing to reopen in the next few weeks.
You may be wondering about safe practices under these circumstances. The CDC provides excellent guidance for child care centers that stayed open, and it is relevant for reopening centers: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-childcare.html#pickup

The guidelines include modified social distancing, intensified cleaning and disinfecting efforts, modified drop off and pick up procedures, and health screenings upon arrival.

Caring for Our Children provides excellent guidance on proper cleaning practices: https://nrckids.org/CFOC/Database/3.3.0

Pay particular attention to Appendices J and K for cleaning schedules and choosing appropriate products. Additionally, the EPA provides guidance on approved products for cleaning and disinfecting: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

These are still uncertain times, and I will do my best to help you navigate through these rough waters. The Maine CDC and your licenser can provide additional guidance.


Stay well!

Deb