Through multiple rounds of school closures, Ontario daycares have stayed open since the first wave — a rare spot of relief for the parents of small children in a pandemic year that’s been especially punishing for working families.
But with variants out of control, some experts are warning that parents in hotspot areas should be pulling their kids from daycare if they have the means to do so. Meanwhile, advocates are calling for child-care staff to be immediately prioritized for vaccination — a move that would help protect workers in a critical sector that many families rely on.
“If people are in a privileged position, I’d recommend keeping (kids) home right now, because the numbers are just so high,” said Dr. Janine McCready, an infectious disease specialist at Michael Garron Hospital. “It’s a really, really hard decision to make. But I think it’s at a level where if you can keep your kids home — at least until we see things improving — now is the time.”
McCready acknowledged that this isn’t a choice many people can afford to make, especially single parents and low-wage earners. She said that if daycares are kept open, then child-care workers should be prioritized for vaccinations and further steps taken to improve safety conditions inside child-care settings.
McCready also noted some caveats. She doesn’t know the current incidence rate of COVID-19 in daycares — a metric that would show whether transmission risks are higher in these settings for either children or staff. According to Toronto Public Health, this data isn’t currently available but the health unit is “looking into the feasibility of calculating an incidence rate for this setting.”
And while cases linked to daycares are indeed higher than ever — provincial data shows a record 484 new cases linked to licensed daycares during the week of April 4 — the vast majority of Ontario’s 5,500-plus licensed child care centres and 131 home care agencies are not currently reporting any COVID activity.
In Toronto, there are currently 42 active outbreaks in child-care settings, though the city has more than 1,000 licensed facilities, according to Toronto Public Health. “As cases continue to rise in the community, it is not surprising that there has been an increase in cases in childcare centres, as these settings often reflect what is happening in the community,” associate medical officer of health, Dr. Vinita Dubey, said in an email.
But many child-care advocates say that daycares are, in many respects, even riskier than classrooms, which have now been moved online indefinitely. Yet no steps have been taken to make them safer in the face of variants of concern, which are more transmissible, infecting younger age groups, and carry a higher risk of hospitalization or death.
Early childhood educators “do close caring work with unmasked children,” Carolyn Ferns, spokesperson for the Ontario Coalition for Better Child Care, said in a presentation to the Toronto Board of Health on Monday. “They’re involved in toileting, diapering … playing with a preschooler who might pull off your face shield, a toddler who might sneeze right in your face.”
And in hot spots like Toronto, Peel and York — where COVID-19 is spreading uncontrollably and hospitals are reaching capacity limits — front-line workers are seeing worrying trends in daycare settings.
“The child-care workforce is exhausted and they are actively getting sick,” Abigail Doris, an early childhood educator and executive co-ordinator with The Toronto Community for Better Childcare, told the board of health.
“In the past few weeks we’ve seen a rapid rise in COVID cases in our child-care centres, driven primarily by the more contagious variants of the virus.”
At Michael Garron, where McCready regularly calls patients who have tested positive for COVID-19, she’s seeing more cases linked to daycares, along with more onward spread. She recently had a case where someone linked to a daycare was infected at a family gathering — that person then went on to spread the virus to three or four other families at the daycare.
“When you have an outbreak in a daycare, it seems to be spreading more rapidly,” McCready said. “You’re not just seeing one or two other cases; you’re seeing a number of other cases, and those are subsequently spreading to the families as well.”
McCready said child-care workers definitely face heightened risks, given the nature of their jobs. Researchers are still trying to understand COVID-19 transmission dynamics in kids, but a recent study by Public Health Ontario scientists, which analyzed 6,280 households with pediatric COVID cases, found that children aged zero to three had the highest odds of household transmission among age groups compared to kids between 14 and 17. The study is a pre-print, meaning it has not yet been peer-reviewed or accepted for publication.
McCready agrees with child-care advocates who say daycare workers should be prioritized for vaccination, especially if the province plans to continue keeping daycares open “through the worst, most uncontrolled transmission we’ve seen.”
Doris said a large proportion of daycare workers are racialized women, many of whom lack paid sick leave, make $20 an hour or less, and rely on public transportation. She said daycare staff are feeling increasingly scared at work — and not being immediately prioritized for vaccinations is only “heightening that fear.”
“Toronto Public Health is deeming that our schools are not safe, and yet our child-care centres remain open,” Doris said. “Child-care workers are feeling that decision makers are saying how essential they are for the support of our economy — yet in the same breath, they are not willing to support them by vaccinating them.”
On Monday, the Toronto board of health passed a motion calling on the province to ensure that child-care staff are included in plans to vaccinate education workers in hotspot areas starting this week.
In an emailed statement to the Star, a spokesperson for the Ministry of Health said child-care workers are included in a group of essential workers who are expected to begin vaccinations in mid-May.
Meanwhile, a spokesperson for the Ministry of Education said the province is committed to vaccinating “every single child care worker in Ontario” and is awaiting “more vaccines from our federal partners to deliver on this urgent imperative.”
“Every single child care worker living in these hot spot communities is eligible to now get the vaccine,” the statement said, referencing the recent plan to vaccinate people 18 and older living in hotspot postal codes. “Any child care worker 55+ has access to AstraZeneca and 60+ has access to Pfizer and Moderna.”
At the board of health meeting, Doris urged Toronto Public Health to follow in the footsteps of public health units like Niagara, which has taken the initiative of prioritizing daycare workers for vaccinations. When asked by the Star whether TPH planned on following suit, Dubey said the province determined COVID-19 vaccine eligibility and “questions related to this topic should be directed at them.”
Some are now wondering if daycare closures are also inevitable, especially if COVID-19 rates continue their precipitous climb. In the meantime, many parents in hotspot areas are pulling their kids from daycare, often at great personal expense, both financially and mentally.
On Monday, Jacqueline Whyte Appleby and her husband decided to pull their high-energy toddler from daycare, even though they are already stretched thin at home caring for a newborn and helping their five-year-old with online school.
Whyte Appleby and her husband, who works from home, knew this was the right move for their family. But it didn’t feel like much of a choice.
“I’m enraged,” she said. “In January and February, it seemed like a lot of the medical community was warning where we’d be if we didn’t make changes. And things have unfolded precisely as they predicted they would — which tells me we didn’t have to be here.”