Child Care Workers Aren’t at Greater Risk of COVID-19. Why?

The first major study of child care and COVID-19 says the safety measures are working.
Still from video call with Dr. Walter Gilliam on Child Care and COVID-19
October 28, 2020
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This month, researchers from Yale University released the world’s first large-scale study on the risk of COVID-19 to child care workers.

At the core of the study was one vital question: Does exposure to a child care environment increase child care workers’ likelihood of getting COVID-19?

In a word? No, it doesn’t. But it’s not fair to boil down such an intricate study into a simple yes or no.

In May and June, the Yale team surveyed over 57,000 American child care workers to learn about their experience with operating child care during the pandemic. Baked into this data is a great deal of conditional factors and important details — and understanding these nuances is critical to keeping child care safe from COVID-19 in the months ahead.

To understand just what this study means for child care workers, I called up the study’s lead author, Dr. Walter Gilliam. Walter’s research focuses on early childhood education, and how we create policy that improves the state of child care. He is the Elizabeth Mears and House Jameson Professor at the Yale Child Study Center, and President of the Board for Child Care Aware of America.

You can watch highlight clips from our interview just below, or find the full conversation at the bottom of the page. But first, here are the five biggest takeaways.

The big ideas

Dr. Walter Gilliam — 5 interview takeaways
  1. The study found that working in child care during the pandemic does not increase child care workers’ risk of contracting COVID-19 — provided you take the proper safety precautions.
  2. The vast majority of child care workers in the US are going to incredible lengths to keep everyone safe. Over 90% of respondents said they’re observing rigorous hand-washing for themselves and children, and disinfecting all surfaces at least once a day.
  3. These findings do not mean that we can get “back to normal” yet. It means our safety precautions are working, and we need to keep them up.
  4. Scientific research still suggests that children are less likely to contract and spread COVID-19 — but this doesn’t mean they’re immune.
  5. The success of child care workers in providing safe, quality care through the pandemic only highlights the strong need for increased federal support to the sector.
The core findings of the Yale study

So what’s the main takeaway? In Walter’s own words: “What we ultimately found is virtually zero relationship between working in a child care program and your likelihood of getting COVID-19.”

Of the study’s 57,335 survey respondents, about half stayed home due to center closures during the pandemic, and about half kept working at their child care centers. Both groups got sick at very similar rates.

However, there are a few very important conditions to this. First, child care workers still reflected the infection rates of their communities. So child care centers in counties with very high COVID-19 case counts still reported more illnesses among staff — and the same for Black, Latinx and Native American child care workers, who represent communities that have been more vulnerable to COVID-19.

As Walter explains below, the important distinction here is that these cases didn’t stem from child care centers themselves.

Child care doesn’t add to COVID-19 risks — if done safely

Walter clarifies that this study doesn’t mean child care providers don’t get sick. They do, and at the same rates as anyone else. But this research suggests that it’s not child care itself that’s making providers sick — they’re contracting it from some other source in their lives.

“I don’t want anybody to hear this and think that the study means that somehow, child care centers are places where you can’t get sick. That’s not true. What we’ve found was that child care centers — when implemented in the way they typically are during this pandemic — don’t seem to be adding to the risk. But that doesn’t mean there’s no risk at all,” Walter says.

In other words, this study suggests, working in a child care center while taking the proper safety precautions does not magnify your risk of contracting COVID-19.

“Child care providers are doing incredible things to keep children safe.”

That child care centers don’t appear to contribute to the risk of COVID-19 is not an accident. The study’s survey data shows that the vast majority of child care providers are going to enormous lengths to practice safe pandemic precautions.

According to the study’s data:

  • 75% of providers are doing symptom and temperature checks at the door for every child and adult
  • 90% are disinfecting every surface, handle and fixture once a day
  • 50% are disinfecting every surface, handle and fixture three or more times a day
  • 90% are maintaining rigorous hand washing and sanitizing for adults and children
  • The majority of providers are avoiding high-risk social situations and practicing social distancing in their personal lives

“Child care providers are doing incredible, near-Herculean things to keep children safe — and it appears to have worked,” Walter says.

Using face masks in child care

One interesting finding from Walter’s research is the relatively low usage of face masks in child care. According to the data, only 35% of child care providers reported using face masks themselves, and just 11% required the children (aged two and over) at their centers to mask up.

But, as Walter is careful to point out, this doesn’t mean masks are irrelevant or ineffective. As he sees it, this speaks more to the other great lengths providers are taking to keep safe.

“A lot of the people who don’t want to wear masks also don’t want to do things like social distancing or additional hygiene. Child care providers were doing these other things to an enormous degree,” Walter says. “So maybe part of it is that you don’t have to do everything all the time, but you can’t just do nothing.”

How could our understanding of COVID-19 change in the future?

While the findings of this study are important, they aren’t set in stone. As Walter points out, “this study exists within the context of an awful lot of moving parts. And when those parts move, then it’s not exactly clear what that means for our findings.”

There’s still much to learn about how the coronavirus behaves, and how we behave in response to the virus. Plus, factors like the changing seasons, cold-weather social dynamics and reopening schools could all have an effect on his team’s findings.

In the clip above, he explores some of the main factors that might affect how we understand this research moving forward.

Why are children less vulnerable to COVID-19?

Walter’s study focused specifically on the COVID-19 risk to adults working in child care — it did not collect data for infection rates among the children. As Walter says, the majority of scientific research suggests young children are less vulnerable to the coronavirus. They contract it less often than adults, and when they do, they are more likely to be either asymptomatic or only have mild symptoms.

In the clip above, he dives into some of the reasons why this might be the case. But, as he emphasizes, this doesn’t mean children are immune – they can still get sick, and it can still be serious.

Addressing misunderstandings

It’s important to know what this study means — but it’s also important to know what it doesn’t mean. To address any possible misinterpretations of this study, Walter underlined three key points:

  • You can still get sick at child care. To be clear, child care centers are not magical safe zones from COVID-19. “It’s just that in the way child care providers implemented their programs during the pandemic, child care doesn’t elevate that risk,” Walter explains.
  • This doesn’t mean we can “get back to normal” yet. The findings of this study depend on the fact that the vast majority of child care workers are practicing strict, detailed safety precautions against the virus. If we reopen child care in the “normal” way we did before the pandemic, we can’t expect that this study’s findings will still apply.
  • These findings do not apply to grade schools, high schools or universities. Child care centers are a unique environment in terms of how the days are structured, how adults and children interact, and the group sizes in classrooms. This study’s findings depend on this child care environment. It would be a misapplication, Walter says, to try to extend these findings to the vastly different daily dynamics of primary, secondary and higher education.
Child care workers’ bravery in the pandemic

At the end of the survey, Walter’s research team asked child care workers about their worries regarding child care in the pandemic. 77% said they were worried they’d get COVID-19 because of working child care, and 74% feared they’d bring it back to their families. 79% of respondents said they were afraid that they’d get children sick.

And yet, they kept coming in, and going to enormous lengths to provide safe, responsible care. To Walter, this speaks to the sector’s commitment to children above all else.

“This is a workforce that was very worried, primarily about the children. They wanted to make sure the children were safe, and they did incredible things to keep them safe. And it seems to have worked, and I think that’s an unsung story.”

How do we keep this up in the future?

Providing safe, high-quality child care during a pandemic doesn’t come easy. And as we move forward, child care providers will face difficult balances to keep up that good work. Securing enough sanitary supplies, adhering to strict cleaning routines and planning for social distancing all cost providers time and money. And, as class enrollments increase, all of this will become more challenging.

Addressing these challenges calls for outside help. Ultimately, Walter says, this hinges on greater respect and understanding for what child care workers do, and financial support from the government.

“Child care is an important infrastructure for society that we don’t fund that way,” he says. “They need more respect, and part of that is supporting them like you would any other essential infrastructure — not simply exploiting them.”

We’ve always known that child care is essential, and this study only underlines the immense commitment of the thousands of child care providers across the country. What comes next, Walter says, is treating them as the essential workers they are.

“They have the whole future in their hands, and we take that for granted.”

Full interview: Dr. Walter Gilliam on child care and COVID-19

Here’s the full interview with Dr. Walter Gilliam. We’ll go more in-depth on all the points above, and cover more additional details, such as:

  • Why the study focused specifically on adult child care workers, rather than children
  • Why adults tend to spread and contract COVID-19 more than children
  • Whether child care workers reported different experiences than child care owners and directors
  • How home-based providers fared differently than center-based providers in the pandemic
  • The factors that might affect how COVID-19 spreads this winter
  • The extraordinary lengths child care workers have taken to continue providing safe care through the pandemic
  • Why it’s so important we know how to apply these findings correctly
  • Why the child care sector needs support now more than ever
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Official Danish Government Reopening Advice

Guidance from the Danish Health Ministry, translated in full to English.

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UK Nursery Covid-19 Response Group Recommendations

The full recommendations from a working group of over 70 nursery chains in the UK.

Please note: here at Famly we love sharing creative activities for you to try with the children at your setting, but you know them best. Take the time to consider adaptions you might need to make so these activities are accessible and developmentally appropriate for the children you work with. Just as you ordinarily would, conduct risk assessments for your children and your setting before undertaking new activities, and ensure you and your staff are following your own health and safety guidelines.

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