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COVID-19 Child Care Settings Webinar

Middlesex and London Region August 10, 2020

Welcome

Presenter:

• Dr. Alex Summers

Associate Medical Officer of Health Middlesex-London Health Unit @alexsummers4

Mary Lou Albanese

Manager, COVID-19 Program

Surveillance Report

As of August 2nd , 2020:

• Over 18.2 million COVID-19 cases and over

693,000 deaths have been reported worldwide.

• 39 537 cases of this illness confirmed in

Ontario, including 2778 deaths

• Local:

Child Care Centre Guidance

Healthunit.com

Safe Healthy Children

https://www.healthunit.com/ uploads/safe-healthy- children-a-health-and-safety- manual-for-childcare- providers.pdf

COVID-19 symptoms:

Common symptoms of COVID-19 include:

• Fever (temperature of 37.8°C or greater)
• New or worsening cough
• Shortness of breath (dyspnea)

Other symptoms of COVID-19 can include:

• Sore throat
• Difficulty swallowing
• New olfactory or taste disorder(s)
• Nausea/vomiting, diarrhea, abdominal pain
• Runny nose, or nasal congestion – in absence of underlying

reason for these symptoms such as seasonal allergies, post nasal drip, etc.

Atypical COVID-19 symptoms

• Unexplained

fatigue/malaise/myalgias

• Delirium (acutely altered

mental status and inattention)

• Unexplained or increased

number of falls

• Acute functional decline
• Exacerbation of chronic

conditions

• Chills
• Headaches
• Croup
• Conjunctivitis
• Multisystem inflammatory

vasculitis in children

• Presentation may include

persistent fever, abdominal pain, conjunctivitis, gastrointestinal symptoms (nausea, vomiting and diarrhea)

Screening

• Staff and children to be screened daily before entry
• CCC to complete parent and child’s temperature check at the

beginning of the day

• Report from parent is not sufficient and end of day

temperature checks not necessary

• If the parent has a fever, the child should not attend the
• centre. The parent should self-isolate at home and get
• tested. If not getting tested, the child is to be excluded from

daycare for 14 days

• During business hours all people entering the centre need to

be screened by CCC staff. A record must be kept.

Screening

• Central screening for more than one program is allowable as

long as centre can ensure physical distancing

• Screeners need to wear a mask and eye protection when

screening children – a non-medical mask is sufficient

• Screeners can remove their mask once screening is

completed.

• If two metres physical distancing can’t be maintained

within your cohort your mask should stay on.

• Paper copies of daily screening to be kept for a minimum of

2 weeks.

What to do if a child shows COVID-19 symptoms:

• Child would fail the screening prior to entering the centre
• Not to be admitted to centre
• Sent home to self-isolate and recommended to get tested
• Instruct parent of ill child to wear a mask and monitor

themselves for symptoms

• Becomes ill with COVID-19 symptoms during course of the day,

e.g. fever, watery diarrhea and/or vomiting, call parents immediately and recommend going for testing

Illness and Exclusion STAFF

• Staff who fail the screen should be sent home to self-

isolate and recommended to get tested

• Individuals that test negative for COVID must be excluded

until 24 hours after their symptoms resolve.

• Individuals identified as a close contact of a confirmed

case must be excluded for 14 days after their last exposure

• Individuals that test positive for COVID must be excluded

for 14 days after symptom onset and remain excluded until cleared by MLHU

Illness and Exclusion Algorithm

Illness and Exclusion CHILDREN

• A child is to be sent home as soon as COVID- symptoms

arise or as directed by the CCC’s policy.

• When a child is sent home, the other children and staff in

the cohort should monitor for symptoms. Siblings of the ill child are to be sent home too.

• If a parent is ill, the child must be excluded from the

centre.

• Children with a runny nose, in the absence of an

underlying reason, should be excluded and referred for

• testing. If an underlying reason exists (allergies, etc.) the

child does not need to be excluded

Illness and Exclusion CHILDREN

• Children that test negative for COVID must be excluded

until 24 hours after their symptoms resolve.

• Parents are not required to notify the CCC of their COVID-

19 test results

• Children identified as a close contact of a confirmed case

must be excluded for 14 days after their last exposure

• Children that test positive for COVID must be excluded for

14 days after symptom onset and remain excluded until clearance by MLHU staff.

Illness and Exclusion

• Staff and/or children are ill and not tested must be

excluded for 14 days from symptom onset and be symptom free for 24 hours before they can return

• If there is a COVID positive staff member, only close

contacts will be required to quarantine or self-isolate. It’s important for staff to physically distance from other staff members to prevent exposure.

• If enteric outbreak is declared at the centre, exclusions for

children with enteric symptoms will be extended to 48-72 hours after symptoms resolve.

Illness and Exclusion Algorithm

Cleaning and Disinfection

• Outside play equipment should be disinfected between

cohorts

• Sand and water tables are not able to be cleaned properly,

therefore play in these should be suspended

• Health Canada has a list of disinfectants to use against

COVID-19

• If using a fogging system, routine manual cleaning and

surface disinfection is still required

Cleaning and Disinfection

• Disinfection of personal belongings aren’t required but

should be stored in designated areas within a cohort.

• Soiled personal belongings should be bagged and sent home

with the parent at the end of the day.

Staffing

• Face masks (medical or non-medical) are to be worn by all

staff members when physical distancing is not possible

• If staff is not able to wear a mask, centre operators are

encouraged to find alternate work for staff members

• Staff can leave the building on their break, but should

complete proper hand hygiene upon re-entry. No re- screening is required

• Staff encouraged to limit their locations of work as much as

possible

• Documentation must be maintained to show which staff

members were working with a particular cohort of children

Staffing

• Resource consultants should continue with virtual visits

where possible. If they must visit multiple cohorts they should wear a mask, maintain physical distance, and practice frequent hand hygiene.

• Cohorts should access the washroom separately, hand

washing must be performed and supervised by staff members, frequently touched surfaces should be cleaned and disinfected at least twice a day or when soiled. Maintain a cleaning and disinfection log.

Masking

• All staff are required to wear a mask if they cannot maintain

two metres physical distance from either the children or other staff.

• A face shield is not a replacement for a mask
• ASTM Level 1 certification masks are acceptable for use by

screeners and when caring for symptomatic children

Food Service

• Meal services must ensure that there is no self-service or

sharing of food or utensils between children

• Each child is to be served on an individual plate
• Staff members who distribute food should use utensils when

serving

• There are no changes to food handling or cleaning and

sanitizing requirements in the kitchen

• Outside food should only be brought in the centre when
• necessary. Clear procedure on storage, handling, and serving of

these foods are required.

Reporting

• CCC are not required to report all

symptomatic staff and children to MLHU

• MLHU is notified of all COVID-19 positive

cases and will follow-up as necessary with CCCs

Other FAQs

• Transportation can be offered if children are screened prior

to boarding and children are limited to the same cohort. A different cohort can use the same vehicle after it has been

• disinfected. If a child must be held or carried during loading,

a gown or blanket over the staff member’s clothing must be changed between children

• You can sing outside while keeping two metres distance
• Maximum number of children is 15 per cohort
• The health unit will not report testing results to the CCC due

to confidentiality. Parents are encouraged to communicate with the centre

Other FAQs

• Workplaces can order PPE through: https://covid-

19.ontario.ca/workplace-ppe-supplier-directory

• Questions related to symptomatic staff members or children,
• r for questions about screening and testing, etc. call MLHU

519-663-5317 and ask for the Outbreak and Facilities Team between 9a.m. and 6 p.m. Monday to Friday

• Questions related to policies, procedures, infection prevention,

and control call MLHU and ask for Infectious Disease Team

COVID-19 Briefing Webinars

• The MLHU will be hosting weekly briefing

webinars for community stakeholders

• Held on Tuesdays at 12:30 p.m. to 1:00 p.m.
• Please send your questions to covid@mlhu.on.ca

Contacting MLHU

• Call 519-663-5317
• Monday to Friday 9:00 a.m. – 6:00 p.m.

– For telephone calls and email communication with COVID investigators

• www.healthunit.com

Questions?