Coronavirus: It is Time for Child Care Programs To Close

These are unprecedented times. Throughout the country we have seen mass closures of a wide variety of businesses - from movie theaters, bars, restaurants, houses of worship, automobile factories, the entire professional sporting industry to even the cancellation of the White House Easter Egg Roll. Despite the closures, there is one group that continues to provide services - the early childhood sector.

On first glance, it would appear that child care programs have been shuttered as well, especially considering that at least 42 states have closed K-12 school systems. However, this is not the case for those working in early childhood. Those working to care for our youngest have been faced with an astounding lack of direction and leadership. Mixed messages from elected and public health officials have only compounded the confusion, leaving early childhood professionals to make decisions on their own.

States, such as Colorado, Nevada, Oregon, Michigan, Wisconsin and Oklahoma acknowledge the essential services that early childhood professionals provide and urge them to stay open. Whereas states, such as Rhode Island, Alabama, Kentucky and Massachusetts have ordered early childhood programs to close. Vermont ordered all child care programs to close, but those serving essential personnel are allowed to remain open. As of March 22, 2020, a study conducted by the Institute for Childhood Preparedness found that only 8 states have ordered early childhood programs to close. Across the pond, the United Kingdom has ordered all child care programs and nurseries to close as of March 20th, with the exception of those caring for the children of essential personnel.

Early Childhood Programs Needs to Close

We do not yet know all of the nuances of this new virus. What we do know is that it is of the utmost importance to protect human life and prevent the spread of the virus. While originally it was believed that this virus only impacts the elderly and those with underlying conditions, new studies have provided evidence to the contrary. This has led the World Health Organization to warn that “children can also experience severe disease.”

A newly released study found that 90% of coronavirus cases in children were asymptomatic, mild or moderate. However, 6% were severe or critical. Of those severely ill, more than 60 percent of the children were less than five years of age and 32% were under 12 months old. Further, studies examining the virus in children have discovered evidence that the virus can remain active in a child’s respiratory tract and in their stool for several weeks after diagnosis.

The average age of a child care worker is 36.3 years of age and new findings reveal that this age group may also be at risk. A CDC analysis of 2,400 COVID-19 cases in the United States found that between 1 in 7 and 1 in 5 people between the ages of 20 and 44 with confirmed coronavirus cases required hospitalization. Further, examining data from France, the Netherlands and the United States reveals that nearly half of those hospitalized from coronavirus were under the age of 65. In the Netherlands, half of those in intensive care units were under the age of 50.

Further, new data shows the challenge of detecting the virus. In Iceland public health officials were able to test a substantial portion of their population. They have found that half those who tested positive have no symptoms of COVID-19. Additionally, new data from China, as reported in the March 22nd edition of the South China Morning Post, as many as 1/3 of the people who test positive show delayed symptoms or no symptoms at all.

As we continue to learn more about this new virus, we must proceed with caution. These new findings are indeed troubling. It is becoming evident that our early childhood staff are at risk. It is also evident that young children can experience severe illness and also spread the virus in their community.

Child Care Closures Will Impact the Economy

The decision to close child care programs is not an easy one. Child care contributes enormously to the economy. In 2012, the childcare industry generated over $41.5 billion in revenues and accounted for an additional $41.6 billion in indirect output to other sectors. All told, the early childhood sector represents nearly $1 trillion in economic activity in the United States.

Further, many early childhood programs are small businesses. This is important as small businesses account for 99 percent of all companies and employ 50 percent of all private-sector employees. According to data from the 2012 US Census, 768,521 child care establishments were operating in the country, with 90% being classified as family child care programs or one-person operations. Closing these small businesses will unquestionably have a substantial impact on the economy and communities.

Those programs that are funded by the Administration for Children and Families (ACF), such as Head Start programs in the United States, have been provided guidance to “continue to pay wages and provide benefits for staff unable to report to work during center closures necessary to address COVID-19”.

Likewise, ACF has provided lead agencies funded through the Child Care Development Block Grant flexibility around payments. “Lead agencies may pay providers based on child’s enrollment rather than attendance”. The lead agencies are also allowed to modify absence policies.

While these efforts by ACF are laudable, there are a tremendous amount of early childhood programs that will not be impacted by these changes. As child care providers make $11.18 an hour on average, federal legislation must include the early childhood workforce as part of any financial relief package.

Essential Personnel Will Need Child Care

Where child care is needed for essential employees, it should be coordinated by state or local governments. Federal authorities should allow the use of FEMA’s Public Assistance Program. This program, which is used during emergencies, allows for child care costs to be reimbursed by FEMA. This includes payments to early childhood professionals, some who would otherwise be out of work, along with the supplies and equipment needed. Government entities may provide and coordinate these services directly or they may also contract with private entities or voluntary organizations for this service. The Child Care Resource and Referral agencies that are located throughout the United States would be a natural choice to assist.

Early childhood programs should be included in the groups that are allowed to access essential supplies. Supply chain disruptions are likely to occur, and it is important that access to food, diapers, baby wipes and other critical supplies are maintained. Further, early childhood professionals should be deemed ‘essential’ and allowed to traverse through local road blocks and check points on their way to and from work, if and when checkpoints or closures are implemented.

In addition, states should provide flexibility in child care licensing regulations - and allow non-traditional spaces - such as gymnasiums, shuttered sporting stadiums, hospitals, libraries, and K-12 schools the ability to receive temporary / provisional licenses to operate. By using these non-traditional venues, many of which are much larger than normal early childhood programs, staff and children can spread out more easily and follow current social distancing recommendations more readily.

Regulatory authorities should consider modifying ratios and square footage requirements, to keep in line with current mass-gathering and social distancing guidance issued by public health authorities. Along those same lines, early childhood professionals should be provided with personal protective equipment - such as gloves and masks and provided with appropriate disinfecting and cleaning products.

Recommendations

• We must protect the early childhood workforce and the parents, grandparents, children and families that they serve. Based on the new data and research, states should close child care programs, just like K-12 schools have been closed.

• Where child care is needed for essential employees, it should be coordinated by state or local governments. Federal legislation should allow the use of FEMA’s Public Assistance Program. This program, which is used during emergencies, allows for child care costs to be reimbursed by FEMA. This includes payments to early childhood professionals, who would otherwise be out of work, along with the supplies and equipment needed. Government entities may provide and coordinate these services directly or they may also contract with private entities or voluntary organizations for this service. The Child Care Resource and Referral agencies that are located throughout the United States would be a natural choice to assist.

• Early childhood programs should be included in the groups that are allowed to access essential supplies. Supply chain disruptions are likely to occur, and it is important that access to food, diapers, baby wipes and other critical supplies are maintained.

• Early childhood professionals should be deemed ‘essential’ and allowed to traverse through local road blocks and check points on their way to and from work, if and when checkpoints or closures are implemented.

• States should provide flexibility in child care licensing regulations - and allow non-traditional spaces - such as gymnasiums, shuttered sporting stadiums, hospitals, libraries, and K-12 schools the ability to receive temporary / provisional licenses to operate.

• Social distancing should be encouraged. By using these non-traditional venues, many of which are much larger than normal early childhood programs, staff and children can spread out more easily.

• Regulatory authorities should consider modifying ratios and square footage requirements, to keep in line with current mass-gathering and social distancing guidance issued by public health authorities.

• The Centers for Disease Control and Prevention should issue specific guidance for early childhood programs - those serving children aged 0-11. Current guidance is not specific to the operational realities that early childhood professionals face and is confusing, as it is included along with guidance for K-12 schools.

• Early childhood professionals should be provided with personal protective equipment - such as gloves and masks and provided with appropriate disinfecting and cleaning products.

• Caring for children on a daily basis is a noble profession. Under the current situation, caring for children is akin to being a first responder. Those early childhood professionals who serve during this time should be recognized and rewarded. Several states, such as New Jersey, Arkansas and Texas are providing additional monetary incentives for early childhood professionals to continue to work. This should be required, as these brave individuals are indeed facing situations that definitely merit hazard pay.

A Final Note

We are at a point where hundreds of thousands of workers are being temporarily furloughed and everyone is being encouraged (or told) to stay home. In this current reality, we must ensure the early childhood workforce and the parents, grandparents, children and families that they serve are protected. Based on the new data and research, states should close child care programs, just like K-12 schools have been closed.

Many have long recognized the need for closer alignment of early childhood services with emergency response plans and protocols. In November 2014, the Child Care and Development Block Grant (CCDBG) passed with bipartisan support. New rulemaking required states to create a Statewide Disaster Plan, as per the CCDBG legislation. These plans were to address the continuation of child care services during an emergency or disaster. Given this disaster, it will be telling to see how many jurisdictions took this requirement seriously.

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Andrew Roszak, JD, MPA, EMT-Paramedic, serves as the executive director for the Institute for Childhood Preparedness. Roszak has worked on emergency preparedness issues at the local, regional, state and federal level for the past twenty years. Roszak was formerly the Senior Director of Emergency Preparedness at Child Care Aware of America, Senior Public Health Advisor for the US Department of Health and Human Services' Emergency Care Coordination Center and Senior Director of Environmental Health, Pandemic Preparedness and Catastrophic Response at the National Association of County and City Health Officials, where he worked each day to help prepare communities for pandemics and disasters.