Virus cases rise in state’s child care facilities

California child care facilities are reporting five times as many coronavirus cases as of last week than they were a little more than a month ago.

It is unclear how alarming this statistic should be for parents and preschool teachers in the state. Although the number of cases increased, less than 2% of open child care facilities reported any cases, according to state data. More programs did open in that onemonth period, but that increase was only about 14%.

“I think the jump in child care facilities probably reflects the jump in cases in our community in general,” said Naomi Bardach, a doctor and associate professor of pediatrics and health policy at UC San Francisco. However, she added, there isn’t enough information yet to know what the data means. “It’s hard to interpret what is going on. Is that because they’re getting it at home, or is that because they’re getting it at day cares?”

Licensed child care facilities, which include both centers and programs operated out of providers’ homes, are required to report any case of the coronavirus among staff, children and family members to the California Department of Social Services Community Care Licensing Division, which oversees licensing for child care facilities. The facilities serve infants, toddlers, preschoolers and some school-age children up to 12 years old.

As of June 4, licensed child care facilities across California had reported 202 cases of the virus to the department.

By July 12, the total had gone up to 998, a fivefold increase from the month before. Close to a fifth of those cases were among children. About a third of the cases were among staff, and another third were among parents or other adults who pick up or drop off children at the child care center. The remaining cases were other family members of children, or people who lived with child care providers.

The vast majority of open child care facilities in California have not reported a single case — only 658 out of 38,113 facilities that are open reported any. That means most of those that have reported cases have reported only one or two per facility, which might indicate that most staff and families are getting sick elsewhere in the community and not at the child care centers themselves.

But the California Department of Social Services has not disclosed how many cases were reported at each center, or if there were any centers that had more than two cases. That information could help show if the coronavirus is spreading within some child care programs. The department declined a request for an interview. The state Department of Public Health did not respond to an interview request.

The social services department has not disclosed how many children and staff attend and work at each facility. The number of family members for each child also is unknown, since that information is not tracked. That information would help show the rates of the coronavirus in the population.

In addition to the state requirement, child care facilities are required to report cases to the families they serve and to their county public health department, which then advises them whether to close and for how long and who needs to quarantine.

In general, those who are in contact with someone who has the virus have to quarantine for 14 days to contain the spread. The county departments of public health might also ask all close contacts to get tested.

The increase is concerning to Marcy Whitebook, director emerita at the Center for the Study of Child Care Employment, or CSCCE, based at UC Berkeley. The center researches policies for improving conditions for the early education workforce.

Whitebook and others at the center have called for more state and federal funding for child care facilities to stay closed until it is safe to open, as well as hazard pay and health insurance for all providers.

“I was hoping to be proven wrong, that when we opened up more, we wouldn’t see an increase,” Whitebook said.

When the shelter-in-place order began in California in March, child care facilities were available only to the children of essential workers, such as nurses, grocery store clerks, child care providers and farmworkers. But in early June, child care facilities were allowed to reopen for all children, if they met health and safety guidelines like wearing masks and keeping children in small groups and 6 feet apart, as much as possible.

Whitebook said child care providers have told her organization that they have struggled to get the masks, face shields, gloves and cleaning supplies they need to keep themselves safe, and many providers are unsure what to do if someone in the center is exposed to the virus or tests positive.

“There’s generally a feeling out in the child care community that people are being asked to make these choices around their own health, the health of their families. They have deep questions about whether or not it’s safe, and they also have to work because of their own livelihood,” Whitebook said. “The population of people who are doing child care, just looking at California, is majority Black and brown women. It’s a population that has been more exposed and more at risk for COVID. And we also know that generally speaking they may not have health coverage, they may not have paid sick leave. Many providers are older. They’re living in multigenerational families or in households where it’s very hard to get distanced. Are we doing those things that would mitigate the risk?”

Lupe Jaime, director of Lighthouse for Children, a child care center for children 5 years old and younger in Fresno, said that the center reopened earlier this month, and that it wasn’t until last week that she found out her facility needs to report cases of the virus among family members, in addition to staff and children.

Jaime said it is overwhelming to keep on top of all the health and safety standards. So far, there have been no coronavirus cases at the facility.

“To be juggling health and safety standards, knowing that our COVID-19 cases remain on the rise in Fresno County, and to maintain quality and individualized care, is just really difficult, and difficult to juggle,” Jaime said.

Carolyn Carpenter, who runs a preschool out of her home in Oakland, said she knows of one provider who had a parent test positive. She’s worried about the risk as the number of cases goes up and more families return to work.

“It seems like it’s getting harder and harder to hope that I’m not going to come into contact with it,” Carpenter said. She is doing the best she can to meet the health and safety guidelines, but she says some of them are not realistic, especially with toddlers.

“You can’t social distance from kids you’re taking care of,” she said. “And it’s unrealistic to expect that kids are going to stay 6 feet away from each other.”

Bardach, the doctor from UCSF, said it is important for preschool teachers and other child care providers to be especially careful around their colleagues, parents and other adults because most transmission of the coronavirus appears to be from one adult to another, rather than from children to adults.

“The places where we have the biggest risks in these settings is, for example, people who go to break rooms and take off their masks together because we’re used to thinking the patient is where my risk of infection is, or the student is where my risk of infection is,” Bardach said. “We tend to take down our guard when we’re around friends and colleagues.”

As schools and child care centers reopen, Bardach said, it is important to make sure it is done safely.

“We know more now than we did in March about how to keep things safe, but the safety measures have to be in place, and they have to include good testing capacity to also find cases and stop transmission as quickly as possible,” Bardach said.