By Pam Schaffner
We are suffering from “COVID fatigue.” When is this pandemic going to be over? Many people are asking this question of themselves. No one expected the catch phrase “three weeks to flatten the curve” would turn into over 2 years. We have also been hearing that once the pandemic phase is over, COVID will become endemic. What does that mean? If you look up endemic in Merriam Webster:
“If you translate it literally, endemic means “in the population.” It derives from the Greek endēmos, which joins en, meaning “in,” and dēmos, meaning “population.” “Endemic” is often used to characterize diseases that are generally found in a particular area; malaria, for example, is said to be endemic to tropical and subtropical regions. This use differs from that of the related word epidemic in that it indicates a more or less constant presence in a particular population or area rather than a sudden, severe outbreak within that region or group.”
Contrast that with what Merriam Webster says about pandemics: “occurring over a wide geographic area (such as multiple countries or continents) and typically affecting a significant proportion of the population.”
What that means is that we must learn to live with COVID. It will be a constant presence. The pandemic will eventually end, but COVID will not.
When the pandemic began, we had to make so many adaptations. We were asked to wear masks, remove soft items from the classroom, not allow parents or other visitors into the building, limit the mixing of groups of children, ventilate, spend more time outdoors, and update our HVAC systems. We had to be extra vigilant about disinfecting and hand washing procedures. We had to update our health and safety plans and report cases a certain way and close classrooms or entire programs when we had a case. (One case is considered an outbreak.) To see a complete list of healthy practices that were recommended, visit this CDC link.
What do we do as the world transitions from pandemic to endemic status? How do we provide quality care to young children with COVID enduring perhaps forever?
The answer necessitates that we look at quality standards for care, what is good for children. This means we need to separate what was necessary for the pandemic because of health needs but may not be developmentally appropriate on a grand scale from what was also developmentally appropriate in all circumstances. Let’s look at some of what we were asked to do and discuss them individually.
Mask wearing: Wearing a mask or not has been discussed a lot, especially in recent months. It is important to separate out best practice (or quality standards) from what the law (regulation) dictates. Laws and regulations are required. The Department of Human Services (DHS) regulates child care and therefore has the backing of law. There was a time when they required mask wearing. But what is considered best practice (quality)? The American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) are two examples of agencies that define quality standards. Both still recommend masks for individuals age 2 and over. For CDC mask guidance see here. For current guidance from the AAP on masks see here. Are masks required? No. Are they best practice? Currently yes.
Remove soft items from the classroom: At the start of the pandemic, efforts were made to remove soft items from classrooms including rugs, soft toys, dress up clothing, etc. COVID was a new virus, and it was unclear how it could spread (or not spread) through the touching of surfaces. It has been determined that transmission through touching objects is possible but much less likely. Here is a link to a CDC article on surface transmission. The CDC guidance for childcare recommends good sanitizing and disinfecting practices, but does not mention the removal of soft items anymore. Soft furnishings, toys, and dress up clothes are developmentally appropriate in childcare classrooms. They are important to child development and can be returned to classrooms with focused attention on keeping them clean and sanitary. Watch for children who may sneeze, drool, or put these items in their mouths. Remove those items if they become contaminated and launder them.
Visitors: During the beginning of the pandemic, programs were asked to not allow parents or visitors into the childcare facility. Allowing parents and visitors into the building from a quality perspective is important. Parents need access to their children and teachers. They should be allowed access to the classroom. Therapists and others who help children and programs are also vital to the program. The CDC has guidance on visitors/volunteers that express outside people follow mitigation strategies to minimize the occurrence of virus spreading when visiting these programs. Therefore, as we move forward, it is important to again allow parents/volunteers/therapists and others who help the program back in. The new guidance on visitors is under the heading “Visitors.”
Cohorting or limiting the mixing of groups: Cohorting just means keeping groups of children from mixing. This was done rather than social distancing of 6 feet between people in the early learning setting. Children needed to play together or can suffer significant social and emotional repercussions. Therefore, it was advised to keep children together in a group and not mixing with another group or classroom. This was analogous to one family not seeing or mixing with another family. While mixing of groups may need to happen to keep ratios, mixing should remain limited if staffing permits.
Ventilation: One of the “good” things that happened from COVID is that programs spent more time outdoors and many spent monies to update their HVAC systems or bought air purifiers. From a developmental approach, after the pandemic phase is over and we are at an endemic stage of COVID, should we still spend time outdoors and continue to buy high grade air filters. Yes! Prior to the pandemic, many programs didn’t take their children outdoors during the winter months. Now, programs are bundling children up and making use of the outdoors. Many COVID cases were avoided because of breathing fresh air. The seasonal flu, colds, and other illnesses were much less prevalent over these past few years of the pandemic. This was partly due to the fresh air. Programs opened more windows as well.
Hand washing and sanitizing/disinfecting: Should these continue? Absolutely. After two years, these practices have probably become habits. This means they have become second nature. Don’t go backwards and stop washing hands upon arrival, after nose wiping, after messy play, after restroom or diaper changes, or before and after eating. COVID has been added to the list of communicable diseases that we need to be mindful of in our programs. Hand washing and cleaning and sanitizing or disinfecting surfaces and toys is imperative in keeping the environment clean and children healthy.
Finally, it’s important to be “tuned in” to any signs and symptoms of illness going forward. If we have “flu-like” symptoms we need to stay home. We need to remind staff and parents that they too need to be mindful of how they are feeling and stay home if they don’t feel well. We have often in the past just worked through feeling sick or parents have brought children to care who are not feeling well. Through COVID we have learned that coming to work/school not feeling well has resulted in many people becoming sick that wouldn’t have otherwise. Staying on top this needs to continue.
The worry of COVID is lessening and lessening each week as case counts largely trend downwards despite some upticks in places. We can be less worried but not less mindful and aware of communicable illnesses and their levels of spread in our local areas moving forward. If COVID taught us anything, we have a duty to ourselves and those around us (the children in our care, for example) to do our very best for them. And that includes protecting their health. Frequently visit the CDC and the AAP websites and keep up to date and your finger on the pulse of health needs. Active diligence is the key.