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To learn more about COVID-19, Yale University researchers have asked a key question: How has the virus spread through early childhood programs?

The answer is featured in a report – “COVID-19 Transmission in US Child Care Programs” – published in Pediatrics, the official journal of the American Academy of Pediatrics (AAP).

“Central to the debate over school and child care reopening is whether children are efficient COVID-19 transmitters and likely to increase community spread when programs reopen,” the report says.

Led by Yale University professor Walter Gilliam, the research team surveyed 57,000 child care providers across the country about their experiences earlier this year. The researchers compared child care programs that had closed to programs that had remained open.

The report’s encouraging finding:

“Within the context of considerable infection mitigation efforts in U.S. child care programs, exposure to child care during the early months of the U.S. pandemic was not associated with elevated risk for COVID-19 transmission to providers,” the report says.

“Until now, decision makers had no way to assess whether opening child care centers would put staff at greater risk of contracting COVID-19,” Gilliam says in a Yale University article. “This study tells us that as long as there are strong on-site measures to prevent infection, providing care for young children doesn’t seem to add to the provider’s risk of getting sick.”

“While plenty of U.S. child care workers contracted COVID-19 in May and June, it wasn’t driven by whether they were working with children or not.”

Gilliam explains more about the study in this webinar.

The report, however, comes with a warning.

“One factor that did play an important role was the level of SARS-CoV-2 transmission in the community,” an AAP article explains.

The report adds:

“Even after adjusting for other variables, community-level transmission remained a significant predictor of child care providers testing positive or being hospitalized for COVID-19, highlighting the importance of reopening child care programs only when background transmission rates are low and decreasing.”

In addition, the article notes that the odds “of having COVID-19 were linked to being American Indian/Alaska Native, Latinx or Black.”

Another key factor to bear in mind is the extensive mitigation efforts that Gilliam refers to, including keeping children in small groups; hand washing; wearing masks; sanitizing surfaces; daily symptom screenings; and temperature checks.

The Yale researchers “could not say for certain whether their findings would have been different if so many child care programs hadn’t been taking precautions to minimize the spread of the virus. The study also did not look at transmission between children or from adults to children. Authors cautioned the results cannot be applied to schools or universities,” the AAP article says.

What are the report’s implications?

“…protective measures against COVID-19 in child care centers are needed as the spread of COVID-19 from child care workers to children may lead to children’s family members, including those most vulnerable to the virus (e.g. the elderly and individuals with underlying medical conditions), contracting COVID-19 from their children or grandchildren,” the report says.

Responding to the study, The Center for the Study of Child Care Employment at the University of California, Berkeley warns:

“We’re now at a very different time. US COVID-19 cases reached 8 million this week, growing at a rate not seen since this summer’s peak, with hospitalizations rising as we head into the colder months. Cities and counties are relaxing rules, and restaurants, bars, and schools are reopening. The risk of transmission has increased, as evidenced by the spike in cases in many states…”

The center calls on policymakers to provide child care programs with free personal protective equipment and sanitizing supplies as well as access to COVID-19 testing services, guaranteed paid sick leave, and guaranteed health coverage.

“These findings should make clear that policy makers and leaders are not absolved from protecting the health and safety of the people providing critical child care services. Rather, they have a responsibility to safeguard their well-being and acknowledge the real fear that people have, especially that of educators of color and those working in communities with high infection rates.