COVID-19 in a Child Care Centre or School
TBDHU is informed when any resident of the health unit area has a positive COVID-19 test. When such a report is received, a Public Health Nurse (PHN) quickly follows up with the individual who has COVID-19. After ensuring that the individual is isolating and managing with their illness, the PHN will gather detailed information about where they were, what they were doing and the nature of interactions they had with other people during the period of time when they could have passed the virus on to others (the “infectious period”).
If it is determined that an individual with COVID-19 was in a child care centre or school - for example, if it was a child, a staff member, or a visitor with COVID-19 - then further information will be gathered to assess the risk that the virus may have spread to others. Child care centres and schools are required to maintain records of attendance, cohorts and activities that they will provide to public health to assist in determining who may have been exposed to the individual with COVID-19 in that setting. Note that an individual with COVID-19 may not have been in the child care centre or school when they were infectious. In this case, transmission in that setting would not have happened and no follow-up with the child care centre or school would be needed.
Public health will work closely with the child care centre or school to ensure that anyone who is at risk for COVID-19 is informed and given instructions about what they need to do. Some individuals in the child care or school setting may be considered “close contacts” where the risk that they may have caught the virus is higher. These individuals will need to self-isolate at home for 14 days and will be followed by a PHN. Others will be considered ‘low risk’ and will be able to continue to attend child care or school with the guidance to be vigilant in monitoring for any symptoms. PHNs will follow-up and closely monitor the situation for period of time after any suspected exposure (usually two weeks or more as needed). During that time, if there is any indication that the virus has spread to others, public health will act quickly and introduce stronger measures to contain any ongoing spread of the virus.
As the parent or caregiver for your child, you would likely already be aware if your child was being tested for COVID-19 - perhaps because they were unwell and had symptoms of COVID-19 or because they were known to have been exposed to someone with the virus. In fact, you may have already had interactions with a Public Health Nurse (PHN) or a health care provider about your child.
If your child’s test came back positive, a PHN would connect with you and your child. Your child would need to be isolating for up to 14 days and taking appropriate precautions to reduce the risk of transmitting the virus to others, including to others in the household. The PHN would follow up daily to check on their overall health and wellbeing, answer your questions, and provide ongoing support and recommendations to help manage through this time. Public health will also advise you when your child is considered ‘cleared’ of the virus and can resume their regular activities, including returning to child care or school. In most cases, this is 2 weeks from when the child started getting sick. A repeat test is not needed - and is not recommended - for someone to be considered ‘cleared’ or ‘resolved’ of their COVID-19 infection. Your child must stay in self-isolation at home and not return to child care, school or other activities in the community until public health advises you that it is okay for them to do so.
Your child can be exposed to COVID-19 in the home, through interactions in the community or other settings, or at their child care centre or school.
As part of the public health follow-up on someone who has COVID-19, public health identifies individuals who may have been exposed to the virus through their interactions with the individual with COVID-19. These individuals, who are often referred to as “contacts”, are identified as being at higher risk or lower risk depending on the nature of their interactions with the person who had COVID-19. “Close contacts” are those who are at higher risk. To assess the level of risk, public health considers factors related to the interactions such as location, length of time, activities, distance apart, and the protective measures that were practiced at the time.
If an exposure to COVID-19 occurred at a child care centre or school, the facility will provide public health detailed information, including contact information for parents/caregivers, as part of the public health investigation of the exposure. Child care centres and schools are expected to maintain various records in order to assist public health with the quick identification of people who are contacts and management of COVID-19 exposures in those settings.
If your child has been identified as a ‘close contact’ of someone who has COVID-19, you will be contacted directly by a PHN. The PHN will get additional information from you and your child and the PHN will tell you what you and your child need to do and will answer your questions. Close contacts need to self-isolate at home and monitor for symptoms. Testing for COVID-19 will be recommended in some circumstances. The PHN can assist in accessing testing if and when that is needed. Public health will also continue to support you and your child, often through regular connection with you, through the self-isolation period and will advise you when your child can return to child care or school. Your child must not return to child care or school until public health advises you that it is okay for them to do so.
If your child is identified as being a low risk contact of someone with COVID-19, information and instructions will be communicated to you through the child care centre, school or public health communication. In most circumstances, low risk contacts can continue to attend child care or school in person as long as they remain without symptoms. You will be provided information on how to contact public health if you have questions.
Please ensure your child’s child care centre or school has up-to-date contact information so public health can reach you, during the day, as well as in evenings and on weekends.
Note that public health will not reveal the name or personal information of anyone who has COVID-19.
Symptoms and Screening
Preventing individuals who may have COVID-19 from entering a setting such as a workplace, facility or business, is an important part of reducing the risk of COVID-19 passing to other people in that setting. The same applies for child care centres and schools.
Everybody entering a child care or school setting - including children, staff, and any others permitted to enter the facility - are required to screen prior to entering. This screening is generally done through individuals assessing themselves for symptoms, and for possible exposures to COVID-19, before entering the child care centre or school. For children, parents/caregivers will be responsible for screening their child prior to leaving for child care or school in the morning - see the next question for details.
Signs are posted at child care centres and schools reminding people to screen themselves for symptoms and to not enter the facility if they have symptoms consistent with COVID-19 or if they have a risk of exposure to COVID-19. Child care centres and schools can also limit where people can enter the facility to ensure that everyone is aware of the screening expectations.
Yes, parents/caregivers are expected to screen their child(ren) prior to leaving for child care or school in the morning. Your child should not go to child care, school, go on the school bus, or attend any before or after school programs, if they have symptoms of COVID-19 or if they have a risk factors for exposure to COVID-19. See the "When should my child NOT go to child care or school" section below for more information.
The following tools can be used to screen your child(ren) every day before child care or school:
- Ontario COVID-19 School Screening Tool (online version)
- Ontario COVID-19 School Screening Tool (PDF version)
For details on what to do if the screening tool indicated not to send your child to child care or school, your child has symptoms, how to arrange testing and when they can return to child care or school and other activities, see the Child with Symptoms & When to Return page.
As part of the guidance from the Ministry of Education, child care centres and schools are required to designate a place in the facility where individuals who develop symptoms while in that setting can go to be separated from others.
Individuals in that space will be expected to wear a medical mask, practice good hand hygiene and respiratory etiquette with proper disposal of any tissues used. A medical mask will be provided to them by the child care centre or school and any cloth mask or face covering your child was wearing while be placed in a bag or container and returned to you. If there is more than one individual in the space, they will keep physically distance (i.e. be apart by 2 metres or more). Child care centres and schools are required to arrange enhanced cleaning of the space, including when individuals vacate the space.
The child care centre or school will contact you when your child has symptoms and your child will need to be picked up as soon as possible. Your child will not be able to go on the school bus or public transit to get home. Older students who are only mildly symptomatic and are able to get home (eg. walking or biking), can return home on their own if both you and the school agree on this. The student should be alone or be at least 2 metres apart from anyone else they are traveling with.
There are a number of reasons when your child should stay home and not go to child care or school. These include:
- The daily screening indicated that your child should not attend child care or school for whatever reason (this is also called “failing the screen”).
- They have any new or worsening symptoms that are not related to other known causes or conditions, even if mild, that are consistent with COVID-19.
- They are recovering from being sick. For details on when they can return to child care or school and other activities, see the Child with Symptoms & When to Return page.
- Public health has advised you that they need to self-isolate at home because they have had a close contact with someone who has COVID-19 in the household, community, child care or at school.
- They have returned from travel outside of Canada in the last 14 days and are required to self-isolate under the federal Quarantine Act.
- If you think your child was exposed to someone with COVID-19, or been to a location with a COVID-19 outbreak, even if you haven’t been advised this by public health.
Note that in many of the above circumstances your child should be able to participate in home-based learning activities that your child’s school may have arranged if they are feeling well enough.
Preparing for School
There are many things about going to school that are very familiar and normal to your child; however, there are many things that are quite different. This is the ‘New Normal’ as we adjust to living with COVID-19. Many of the usual practices and activities that your child might be used to are being done differently. Some are not being done at all. Your child might not be able to interact with others who they know in the school setting because of cohorting and physical distancing requirements. Teachers look different in that they are wearing masks and face shields or goggles that partly cover their faces.
Continue talking with your child about what school is like right now. Work with the school to help your child adjust. This may take time.
Times like this can have significant impact on emotional and mental health. Take advantage of the various supports that are available through your child’s school and through public health to promote the overall health and well-being of your child.
Masks will be required (with some exemptions) for students in grade 4 and above. Masks can also be worn by children in earlier grades. Discuss this with your child. If you can, find masks that your child likes and that are comfortable for them to wear. Practice wearing these for longer periods of time. Encourage younger children to try masks for varying periods of time. This is particularly important for children who take the school bus. Many younger children can comfortably tolerate wearing a mask for shorter amounts of time, like a school bus ride. Note that if your child feels unwell when at school or gets symptoms, your child, regardless of their age, will be given a medical mask to wear while waiting to get picked up from school.
Parents/caregivers should have a back-up plan for when your child cannot or should not go to school. Your child will likely have more absenteeism from in-person instruction this year compared to other years because of the pandemic. There are many reasons when your child should not go to school or child care - see the Child with Symptoms & When to Return page for details. Your child’s school may have options where your child could participate in some home-based learning opportunities while they are at home if they are feeling well enough.
You are also encouraged to have plans for how your child can get home from school during the day if needed. If your child develops symptoms when at school, they will need to be pick up from school as soon as possible. Your child will not be able to take the school bus home or attend child care or after school programs.
Please ensure that your contact information and back-up/emergency contact information is always complete, up to date and accurate with your child’s school. There are a number of reasons when the school will need to contact you during the school day or afterwards. Also, schools will be providing contact information to public health if it's needed to in touch with you about your child.
Consider alternatives to taking the school bus if you have other options. Active transportation, like walking or biking, are good options if they are feasible. A group of students can do this together to get to school as long as they can maintain physical distancing. Carpooling of students, who are in the same class/cohort at school or if they are in the same family or social circle outside of school, is another option if feasible.