Child Care Health Alert - Air Quality, COVID Updates, Immunizations
Wildfire smoke - Unhealthy air quality
Wildfire smoke has reached our region. It is important to take note of the outdoor air quality before bringing children outside to play. Air quality is measured using a color scale - green (good), yellow (moderate), orange (unhealthy for sensitive groups which includes children), red (unhealthy for everyone), and purple (very unhealthy). The current air quality in Snohomish County on 9/8/20 depends on where you are located but varies from orange to purple. Children should be kept inside today unless a significant change in air quality occurs. We encourage you to visit the Washington State Department of Ecology website over the next few days to determine whether it is safe to take children outside (i.e. green or yellow air quality). You can access the website here: https://enviwa.ecology.wa.gov/home/map
More information about outdoor air quality can be found in our online learning course (with optional STARS/In-service hours available for a fee).
COVID-19 Case Counts
Snohomish County has made great strides as a community and managed to receive approval to move to phase 2 in re-opening the economy. However, the number of cases of COVID-19 in Snohomish County rose this summer which means we have to work a little bit harder as a community to ensure that we continue on the path to fully re-opening.
In line with Washington’s Safe Start plan, Snohomish County’s goal is to have an incidence rate of less than 25 cases per 100,000 residents. In early June 2020, we were meeting our goal with around 23 cases per 100,000 residents. By August case counts rose to nearly 90 cases per 100,000. We are currently on a trend back down. We all need to play a part in keeping it that way. For up-to-date information, see Snohomish County Current Case Counts
Updated COVID-19 Guidance for Child Cares
Last week the Washington State Department of Health (DOH) updated its guidance for child cares, youth programs, and day camps. Snohomish Health District has updated its guidance to be in line with the new DOH guidance. Important changes to be aware of in the new guidance include:
A few additional reminders to help prevent the spread:
- Staff should be assigned to individual groups and not mix with other groups to the greatest extent possible
- Cohorting of children is advised when the group size is large. The maximum group size remains at 22; however, if groups have more than 15 children they should form 2 subgroups of children within their program area. The adult from one subgroup may briefly supervise the other subgroup to facilitate breaks but children from different subgroups should not interact.
- In rare circumstances a face shield with a drape may be used as an alternative to a cloth face covering
- Individuals with symptoms consistent with COVID-19 who have not received a negative COVID-19 test must stay home for 10 days after symptom onset and at least 24 hours fever free and symptoms improve. If a PCR COVID-19 test is done and comes back negative, the individual may return once it has been 24 hours since any fever resolves and symptoms improve. More information provided in the exclusion guidelines section below.
Updated Exclusion GuidelinesSnohomish Health District has updated its exclusion decision chart to be in line with the new DOH guidance. You can find the chart here: COVID-19 intervention table
- Keep groups as small as possible to prevent unnecessary exposures and closures.
- Keep staff and children in each small group consistent throughout the day and from day to day.
- Do not mix children or youth from different groups at any time during the day, or combine different groups at any point during the day.
More information on COVID-19 and health screenings is available in our blog:Snohomish Health District Blog: COVID-19 Updates for Parents and GuardiansAdditional information on Health Screenings:
- Anyone exhibiting symptoms must be excluded and either:
- Be tested for COVID-19. When the child or staff member can return will be based on the test result. If the test is negative the individual can return once they have been fever free for 24 hours and symptoms are improving.
- If no test is done, the individual must isolate at home for 10 days after symptom onset and until they are fever free for at least 24 hours without the use of fever-reducing medication and symptoms are improving.
Immunization Documentation UpdatesThe State Board of Health (SBOH) has updated the language to Chapter 246-105 of the Washington Administrative Code (WAC) concerning school and child care immunization policy. These rules apply to all public and private schools and licensed child care centers in Washington State, including Early Childhood Education and Assistance Program (ECEAP) providers. These new updates went into effect on August 1, 2020.The update includes:
- Health screenings must occur upon arrival for all staff/ children/ youth. Temperature checks can be done on site or parents can attest that the child's temperature was taken at home. Parents and staff should be verbally asked about symptoms each day.
- Monitoring for symptoms should occur throughout the day.
- Parents/guardians should remain on site until the health screening process is completed, in case a child needs to be excluded.
- Staff/children/ youth exhibiting symptoms must be excluded at the time of screening. If the parent has already left, the child must be separated from other children until the parent can return.
- Any staff/child/youth exhibiting symptoms should be excluded and tested for COVID-19.
More information on this is available from Washington State Department of Health at: www.doh.wa.gov/schoolimms2020Guidance for vented masks:
- On or before the first day of attendance, all students must have turned in documentation of at least one of the following:
- Up-to-date immunization by vaccination or titer for all diseases that immunization is required.
- Initiation of a schedule towards up-to-date immunization if they are behind.
- Complete Certification of Exemption (COE) form.
- Effective the 2020-2021 school year, vaccination records for school or child care entry must be medically verified. This change affects: all students attending a new child care, private school, or school district and all new documentation turned in starting 8/1/2020. This does not affect: students staying at the same child care or school or attending a new school within the same district.
- Medically verified documentation options include:
- Certificate of Immunization Status (CIS) printed from the Washington State Immunization information System (IIS).
- Complete hardcopy CIS form filled out by hand.
- Must be validated by a health care provider signature; or
- Validated by a school nurse, child care health consultant, administrator or designee with medical vaccination records attached.
- Schools using the IIS School Module can verify immunizations are complete in the WAIIS in lieu of a CIS.
- Changes to conditional status:
- Students must turn in paperwork before they can start child care or school.
- No automatic 30 day conditional period from the 1st day of school is given.
- Students must have all vaccinations they are eligible to receive on or before the 1st day of attendance.
On August, 7th 2020, The Centers for Disease Control and Prevention (CDC), has advised that masks with exhalation valves or vents should NOT be worn to help prevent the person wearing the mask from spreading COVID -19 to others (source control).FDA Hand Sanitizer Warning:
Additional information can be found on the CDC website, Considerations for Wearing Masks
The Food and Drug Administration (FDA) has issued a warning and is recalling specific hand sanitizer products. This is due to a couple of different reasons.
Please see FDA Website, here for product names being recalled and additional information on the recall. Remember that washing hands with soap and water, for at least 20 seconds, whenever possible is a key step in preventing the spread of germs.
- Certain brands that do not contain an adequate amount of the active ingredient: ethyl alcohol or isopropyl alcohol, that is needed to kill germs. The Centers for Disease Control and Prevention (CDC) recommends consumers use an alcohol-based hand sanitizer that contains at least 60% (ethyl or isopropyl alcohol as the active ingredient) to be effective. Many brands contain between 60 – 70% alcohol; anything stronger is not necessary or recommended.
- Some brands are being recalled because they contain a harmful ingredient called methanol. Methanol must not be used due to its dangerous effects when absorbed through the skin or ingested. In Addition, this harmful ingredient may not be listed on the bottle as an ingredient.
This new in-service training (STARS training) is intended to be a one-stop-shop for COVID-19 including background information, what the science tells us about its spread and how to control it, and specific guidelines for limiting exposure in out-of-home settings including child care and preschool centers, family home child care and school-age care programs. It will also provide the most updated guidance for engaging in all the regular daily activities children do in child care while practicing physical distancing and sanitation including physical activities, games and play, and gardening activities. More than ever, it is important for children's mental and emotional health to have a stable, familiar and safe place to be while parents and caregivers are at work. Child care remains a critical place for children to thrive, grow, and develop. This class is supported by a grant from the American Academy of Pediatrics and the Washington Chapter, AAP.
How to sign up for the FREE COVID-19 Training:
Along with all of our trainings, this class is now available on our website: SHD Child Care Learning Portal. This course is being offered for a limited time at no cost as a public health service to the child care community of Washington State and offers 1 In-Service hour (1.0 STARS credit) to everyone. The COVID-19 course has the most up to date guidance for child care providers available from Snohomish Health District. Log in and select Course Catalog. Scroll down until you see the familiar COVID-19 image.
Please contact the Child Care Health Outreach Program
if you have any questions: