Reviewed by Emily Thorell, MD MSCI, University of Utah Health and Zachary Willis, MD, MPH, UNC Health Care
Return of children to childcare and school settings is critical to economic recovery from the COVID-19 pandemic. Doing so safely is necessary to mitigate community transmission and prevent morbidity and mortality among staff and attendees. Two recent studies contribute to our understanding of COVID-19 safety in the school and childcare settings.
Parents of young children, including a substantial portion of the healthcare workforce, experienced a sudden upheaval in childcare during the COVID-19 pandemic. Childcare settings inherently include close contact between childcare providers and young children, who are often mildly affected or asymptomatic with COVID-19 infections and exhibit lower adherence to personal hygiene measures. Patel, et al., surveyed childcare workers nationwide, obtaining 21,663 responses with a robust response rate of 37.8%, finding that childcare workers tended to be vaccinated at higher rates than the general adult population: 78.2% vs 65%. Similar trends to the US adult population were seen when examining vaccine uptake by race, ethnicity, age, household income, and state. While the overall results are encouraging, they also provide guidance to local policymakers for targeting of vaccine education and outreach, which will become increasingly important as the youngest children will be the last group to be vaccinated.
Quarantines for exposures to SARS-CoV-2 that often do not result in disease transmission when masked have also been especially difficult on parents and school children. A large school district in Omaha, NE eliminated quarantine for mask-on-mask exposure while continuing all other mitigation strategies, part way into the school year in 2020. They found that the rate of quarantine was reduced by 41% per primary infection and no cases of within-school transmission occurred in exposed students who avoided quarantine. School based transmission is known to be low in masked settings. Modification of quarantine in these circumstances may be a reasonable method to further maximize in person learning, which after last year, is the goal for so many reasons. And, masks work, go figure.
References:
Patel KM, Malik AA, Lee A, et al. COVID-19 Vaccine Uptake Among US Child Care Providers. Pediatrics. 2021;148(5). doi:10.1542/peds.2021-053813
Angelique E. Boutzoukas, Kanecia O. Zimmerman, Daniel K. Benjamin, Kevin J. Chick, Jake Curtiss, Tracy Beth Høeg; Quarantine Elimination for K–12 Students with Mask-on-Mask Exposure to SARS-CoV-2. Pediatrics 2021; 10.1542/peds.2021-054268L