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The Department for Children and Families and the Vermont Department of Health want to acknowledge the compassion and hard work child care providers have demonstrated during the COVID-19 pandemic. Throughout the pandemic, child care providers have worked tirelessly to keep programs open while keeping children healthy. As the pandemic has evolved, so has our knowledge about COVID-19 and our mitigation strategies. Child care providers adapted to changing guidance, the development of Test for Tots, and are now supporting their families through the rollout of vaccines for the 6 months to 5-year cohort. Throughout all the change, child care providers were pillars in the community, leading the way for children’s health and safety—and they continue to do so. Child care providers have continually modeled the value of collaborating with medical homes in their community, and throughout the pandemic continued to leverage these relationships to ensure the best outcomes for their families.
As we begin to think of COVID-19 as an endemic disease, we once again need to shift our thinking. COVID-19, like the flu, is now a part of our lives. For the upcoming year, our approach to testing will be a bit different. With testing no longer a first-line strategy for COVID-19 prevention in Vermont, this is an opportunity to identify possible improvements based upon lessons learned during the COVID-19 pandemic, keeping in mind public health principles in the prevention of all respiratory diseases.
Child care providers should revisit their pre-COVID-19 child care sickness policies. We are aware that good communication with pediatric medical homes in your area is paramount to the success of implementing these illness policies. Aligning your approach with local medical practices will promote better outcomes.
COVID-19 Sickness Policy Considerations for Fall 2022
Some things to consider when reviewing and updating sickness policies:
- If a child or staff member is not well enough to participate, they should be sent home from child care. They may return to care if their symptoms have improved, and they meet child care criteria for their illness. COVID-19 testing should not be required for symptomatic children or staff to return to child care.
- Child care sickness policy must be in compliance with child care licensing regulations.
- If a child or staff member has confirmed COVID-19, they should follow the Vermont Department of Health isolation guidance.
- Staff and children over the age of two who are not symptomatic should be permitted to exercise their own or their family’s decision-making to wear a mask in child care settings.
- A child over the age of two who is ill at child care should be required to wear a mask while awaiting pick-up from care to prevent the spread of infection to others. The decision to require masking should be made by the child care provider based on professional decision-making. Masks are not to be worn by children under the age of two.
- It is recommended that child care programs have space for a child to be separated away from other children due to illness (while still being able to maintain safe supervision of the child).
- Child care programs should follow best practices for infection control. These practices are designed to minimize the spread of infection among children and staff.
- Child care programs should encourage good respiratory hygiene practice. The CDC has published this resource which can be used to promote respiratory hygiene.
- It is recommended that children and staff keep up to date on all vaccinations.
- Child care programs should encourage frequent and thorough hand washing using soap and water to prevent the spread of communicable diseases. Hand sanitizer should only be used if there is no available hand washing option. If needed, use hand sanitizer with at least 60% alcohol. Children under the age of 6 should be supervised if using hand sanitizer. When done correctly, hand washing will help children, staff, and visitors avoid spreading and receiving germs.
COVID-19 Testing Recommendations for Fall 2022
- Antigen tests should be used exclusively for symptomatic children and staff; child care providers should use their professional judgment in determining when to use tests in child care. COVID-19 testing should not be required for symptomatic children or staff to stay at or return to child care.
- If an antigen test is positive, the child or staff member should be isolated, sent home and they should follow the Vermont Department of Health isolation guidance. The child and staff member should be required to wear a mask while onsite to prevent the spread of infection to others. Masks are not to be worn by children under the age of two. The Department of Health does not recommend families be required to obtained a note from their medical provider to return to child care.
- If an antigen test is negative, and the child or staff member is presenting with mild symptoms that may be attributable to another diagnosis, the child or staff member should return to child care. Mild respiratory disease symptoms include runny nose or nasal congestion, minimal cough, and absence of fever in an individual with no current or recent household exposure to COVID-19. This decision should be made by the child care provider based on child care regulations and the program’s sickness policy. A repeat negative test is recommended. A second test should be sent home with the child or staff member so it may be repeated before the start of care the next day. However, testing is not required to attend child care and is at provider discretion. Tests can be administered at child care or be sent home for symptomatic children and staff.
- Child care programs will require consent from families to do in-care testing.
- Antigen tests are only approved for use in children over the age of two. Children under the age of two who should be tested will need a PCR test. Parents/guardians should collaborate with child’s medical home to determine availability and access to PCR testing.
- If the child has had COVID within the last 90 days, PCR testing is not recommended. Encourage the family to consult with a healthcare provider and return to care when symptoms have improved and in accordance with child care licensing regulations. (Take home tests, including antigen and LAMP tests, have not been approved for this age group.)
- Antigen tests may be sent home to families of symptomatic children and staff; child care providers should use their professional judgment in determining when to dispense tests home.
- If a child care program requires additional tests to meet the needs of symptomatic children and staff, they may order more through the VDH ordering site. Please note, tests may be ordered while current supplies last.
- We encourage ongoing collaboration with your pediatric medical homes regarding testing recommendations, illness protocols, and return-to-care policies as the alignment of efforts will improve communication with children and families.
Thank you for your dedication to protecting Vermont’s children. We look forward to partnering with you this upcoming year and beyond.