Texas child care centers face new virus rules
State still developing restrictions as cases are confirmed at facilities
As cases of the novel coronavirus continued to be confirmed in Texas’ licensed child care centers, Gov. Greg Abbott ordered new rules Tuesday — less than two weeks after the state dropped earlier emergency restrictions for providers.
Child care centers, such as day care, before- and afterschool programs and registered homes, had not been required to enforce measures such as screening for illness since June 12, when providers were notified by email that the emergency rules were no longer in effect, a decision made by the Texas Health and Human Services Commission.
Under the governor’s reopening plan, child care centers have been allowed to operate at normal occupancy limits since June 3.
On Tuesday, Abbott directed Health and Human Services to enact new rules as COVID-19 cases surge and hospitalizations increase across the state. The governor’s order does not specify what the new standards will be. Kelli Weldon, a press officer for Health and Human Services, said the department is still working on developing new emergency
rules.
Although not obligated to, child care centers are being “encouraged” by the state to continue to follow guidance provided by Health and Human Services and the U.S. Centers for Disease Control and Prevention, which does recommend face coverings and social distancing measures.
Since the beginning of the pandemic, Isabelle Revelli, director of the Little Academy of Humble, has followed CDC guidelines. Even though it’s not a requirement for the center to continue to perform temperature checks twice a day, wear masks and sanitize more frequently, she said it’s essential to the health and wellbeing of the children she serves.
“It’s the reasonable thing to do,” she said.
Rising rates
“We’re seeing increasing numbers of infected kids of all ages,” said Dr. Stan Spinner, chief medical officer and vice president of Texas Children’s Pediatrics and Texas Children’s Urgent Care. “If you’re not requiring people to wear masks inside on a regular basis, that’s when there is the highest risk of spreading infections.”
There has never been a mask requirement for child care centers in Texas.
As of June 12, providers no longer were required to limit entry to staff, law enforcement, licensing officials and children. Pickups and drop-offs were no longer required to be completed outside of operations, and providers were no longer required to provide individual meals and snacks to kids to reduce the risk of spreading viral infections.
“Parents should be looking at the numbers — they’re climbing,” said Dr. Peter Jung, pediatrician and co-founder of Blue Fish Pediatrics in association with Children’s Memorial Hermann Hospital. “We’re at the point where we need to be more wary of sending kids to day care.”
As of June 16, 242 cases of COVID-19 at 203 child care operations were reported to Texas Health and Human Services. Of those cases, 167 were adult staff members and 75 were children.
There may still be a misconception among the public that children can’t get seriously ill from COVID-19, Jung said.
“The percentage of kids who get a severe case is small and the percentage of those cases that end in death is also small,” he said. “But the risk is real that they can get seriously ill.”
Multisystem inflammatory syndrome in children, brought on by a COVID-19 infection, can inflame the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, according to the CDC. It can show up to four weeks after the COVID-19 infection ends.
“It’s a very serious complication that we’re seeing, even in Houston,” Jung said.
The risk of sending children to day care must be evaluated by each family, Spinner said. Children with chronic medical conditions like asthma and diabetes are at a higher risk of contracting the virus. If other family members in the household have similar conditions that put them at a higher risk, Spinner said, parents should also take that into account.
A now-retracted statement made by the World Health Organization that asymptomatic carriers of COVID-19 are less likely to spread the virus has led to some confusion in the general public, Spinner said.
“Asymptomatic people can spread the virus,” he said. “Sometimes, you’re just not symptomatic yet. It can be a few days before symptoms start to show and you’re still very likely to spread it.”
A negative test for the virus also does not necessarily mean that the patient is not incubating the virus, the doctor added. That’s why it’s important to follow the CDC guidelines on self-quarantining for 14 days if it’s known that a patient came into contact with a confirmed case.
“Day cares are asking us to test kids, but a child should still stay home for that 14-day period,” said Spinner. “Everyone has to assume they have the potential to be asymptomatic. That’s why everyone needs to be wearing masks all the time. You should want to be protective of all those people around you, especially the young and vulnerable.”
Jung said children over the age of 5 should be wearing masks in public spaces. He recommends children between 2 and 5 also wear masks, but said it can be difficult for adults to ensure young children keep the facial coverings on.
Effect on child care
The pandemic has impacted the rate at which Texans use child care. There were 17,279 child care operations in the state in February, before COVID-19 was confirmed in the Lone Star State. Now, with 12,172 child care operations, 29.6 percent remain closed, according to Health and Human Services.
Revelli, of the Little Academy of Humble, said the day care was immediately hit financially by the pandemic. She said she had to lay off half of the staff because of the restrictions the state initially put on child care centers that only allowed the business to serve essential workers. There weren’t any relief funds or loans that applied to child care, Revelli said.
The parents who are still taking their children to day care are taking that risk because they have no other choice, she said. Many work for the state government as first responders or health care workers, she said, and for many, it’s been a struggle to find day cares that accept new clients.
Jung said parents should carefully vet child care centers to ensure they are following proper hygiene habits, such as good air ventilation, low room density, increased disinfection and required mask-wearing by employees.
Even if a provider follows CDC guidelines, there is no certainty that there won’t be any transmissions, Jung said.
“Those measures will reduce the risk,” he said. “But there’s no guarantee that everything in play is safe.”