Child care centers, such as day cares, before- and after-school programs and registered homes, had not been required to enforce measures such as screening for illness since June 12, when providers were notified that the emergency rules were no longer in effect.
Child care centers have been allowed to operate back at normal occupancy limits since June 3, under the governor’s reopening plan.
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 the Texas Department of Health and Human Services, said the agency is still working on developing the new emergency rules.
Though 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, which does recommend face coverings and social distancing measures.
“Just like any other person, children absolutely can contract coronavirus. In our clinic, we are seeing quite a few children who are now positive for coronavirus. As small as just a couple months old now,” said Dr. Robert Sanders, pediatrician at PediExpress Urgent Care in San Antonio.
He said a couple children at his clinic test positive every day for coronavirus.
Sanders compared day cares to nursing homes and other indoor congregant settings with an increased risk of spreading the infection.
There has never been a mask requirement for Texas child care centers.
As of June 12, providers no longer were required to limit entry to staff, law-enforcement, licensing officials and children. Pick-ups 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.
“In general we know the symptoms are a little less severe” for children, Sanders said. But “we have to remember, too, a lot of children can be completely symptom free, but still be very contagious to the people around them.”
In other words, implementing protections at day cares doesn’t just protect the children — it also protects their families.
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.
Children with chronic medical conditions like asthma and diabetes are at a higher risk of contracting the virus. And pediatricians are urging parents to also take into account whether family members in the household have similar conditions that put them at higher risk.
Sanders said there was “definitely a misconception” that young people need not worry about the virus.
“You look at even our local San Antonio data where we see, unfortunately the majority o the mortalities of coronavirus are older, right? But that doesn’t mean that a lot of young people aren’t getting really sick,” he said.
Some health experts say children over the age of 5 should be wearing masks in public spaces.
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. The severe illness can show up to four weeks after the COVID-19 infection ends.
Sanders said his clinic has seen “a number of concerning” potential cases of the syndrome, though they were not officially diagnosed. Two, in particular, seemed highly like to be that syndrome. The children were sent to the hospital.
On Abbott’s order, Sanders said “Going back to the previous guidelines that were a little more tight are a step in the right direction.”
The 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.
Isabelle Revelli, director of the Little Academy of Humble, said the day care was immediately hit financially by the pandemic. Revelli 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, she said.
The parents who are still taking their children to day care are taking that risk because they have no other choice, Revelli said. Many work for the state government, as first responders or healthcare workers, she said. For many, it’s been a struggle to find day cares that are accepting new clients.
Dr. Peter Jung, pediatrician and co-founder of Blue Fish Pediatrics in association with Children’s Memorial Hermann Hospital in Houston, said parents should carefully vet out child care centers to ensure they are following proper hygiene habits, such as good air ventilation, low room density, increased disinfection and requiring employees to wear masks.
Even if a provider follows CDC guidelines, there is no certainty that there won’t be any transmissions, said Jung.
“Those measures will reduce the risk,” he said. “But there’s no guarantee that everything in play is safe.”
Staff writer Silvia Foster-Frau contributed to this report.