Mass. to launch ‘test and stay’ program to help child care centers remain open

Originally Appeared in Boston Globe
By Naomi Martin and Stephanie Ebbert

January 5, 2022

“We know that our families are relying on child care to go to work,” said Samantha Aigner-Treworgy, Massachusetts’ commissioner of early education and care. “So we do want to provide alternatives to pulling children out of care for quarantine, but making sure we do so safely.”

Aigner-Treworgy said Tuesday the state decided to launch the program to help keep children and educators in classrooms amid the Omicron surge that hasthreatened to close many centers. But she acknowledged the difficulty of coordinating rapid testing among the state’s 7,000 independent child-care providers. Just a week earlier, her spokeswoman told the Globe such a program was logistically unfeasible.

Early education leaders are working with the state Department of Public Health to craft protocols for the test-and-stay program that will look different from how it works in public schools. For instance, Aigner-Treworgy said, families may be asked to swab their own children and wait 15 minutes for the results during morning drop-offs. There are also practical challenges with testing infants and toddlers. Parents’ consent will be required, she added.

State officials said they still were working out how much the program would cost and the source of the funds.

The state partnered with Neighborhood Villages, a Boston-based nonprofit that provides scalable solutions for early education providers, to distribute 40,000 rapid tests for child care workers this week. About 2,100 providers have signed up to receive rapid tests so far; more can enroll on a rolling basis. That pipeline is also how the state will deliver the test-and-stay supplies.

“It’s not easy. But it’s not rocket science,” said Sarah Muncey, Neighborhood Villages’ co-founder and chief innovation officer. “This is possible and it’s critical because we are going to need to get through the next six weeks. And then we’re going to need to get through whatever comes next.”

Early education providers praised the upcoming test-and-stay program, even as they wondered what took the state so long.

“Schools have had test-and-stay throughout the school year — we need to start incorporating early education into decisions as well, whether it’s supplies or funding,” said José Masso, co-executive director of United South End Settlements, which operates an early education center in Boston. “More support overall in this sector is vitally needed.”

Early education providers have fewer tools than K-12 schools to handle COVID. Children under 5 aren’t eligible for vaccination. Infants and toddlers don’t wear masks, and it’s impossible to expect young kids to socially distance. When one child tests positive, a program often sends the rest of the class home to quarantine for five to seven days while awaiting symptoms or test results.

Last summer, Neighborhood Villages began offering a statewide, state-funded pooled testing program of asymptomatic workers and children — one of the only programs of its kind in the country. Until this week, only about 320 child care providers had signed up for the testing, but the Omicron surge has prompted several hundred more providers to enroll.

Infections among children under 5 doubled in December, state data show, from 2,000 cases in the two weeks before Dec. 2 to 4,100 cases in the two weeks before Dec. 23. Children are unlikely to fall seriously ill from COVID, but doctors still aren’t sure of long-term effects of COVID infections.

A combination of pooled testing and rapid testing has helped some early learning centers manage, by swiftly identifying which staff member is positive and allowing the rest to stay.

“We’ve been able to not be short teachers because of being able to rapid test,” said Michelle Sanchez, principal of the Epiphany School and Early Learning Center in Dorchester, which has already been offering rapid tests to children, as well as staff.

“I’ve probably personally done maybe 5,000 rapid tests,” said Sanchez. “I’ve done 100 in a day.”

Medical experts have said a test-and-stay program in child care centers could work well, particularly if the state provides the rapid tests, which are costly. But one challenge is the state’s current high COVID transmission rates.

“Test and stay could be an excellent strategy in principle, even for childcare centers, if viral transmission was not as stratospherically high as it now is in Massachusetts,” Dr. Julia Koehler, assistant professor of pediatrics at Harvard Medical School, said in an email. “The higher the number of infected people in the community, the likelier a negative test is a false negative. So in child- or day care settings with young children, where masking and distancing is not possible, one infected child can infect the whole group.”

A 15-minute wait for test results at drop-off could complicate the morning for many working parents. But they likely will be grateful to avoid days of home quarantining, said Aisha Anderson, a mother in Stowe. Her son, Henry, who turns 2 in March, has had to stay home several times this year due to his daycare’s staffing challenges and quarantining rules.

“That was very challenging,” said Anderson, a health policy project manager.

Though Henry handles nose swabs “like a pro” at home, Anderson said her daycare center isn’t testing children under three, because those tests must be handled by medical professionals.

That creates the potential for another inequity in child care, as centers in affluent areas may have families who can provide that service, while others go without.

At Temple Beth Shalom Children’s Center in Needham, medical reserve volunteers from the community have stepped up to help, as have parents who are EMTs, nurses, or doctors, said Ellen Dietrick, senior director of learning and engagement. That has allowed all staff and nearly all children to be tested in pooled PCR tests and rapid tests twice a week, she said. The kids have grown accustomed to their “nose tickles,” she said, and teachers find the testing reassuring in a workplace filled with unvaccinated children.

Upon returning from break this week, one teacher tested positive — and was able to isolate before any exposure to the children, Dietrick said.

“How wonderful that we have the technology,” she said. “We’re in a different place than we were a year ago.”

But with numbers surging, tests may only help so much. Seven of Epiphany’s early educators are already out with COVID, Sanchez said.