COVID-19 in daycare: Little oversight provided by state

Almost 50 centers report cases

(Photo: Getty Images)
(Photo: Getty Images)

At least 47 Tennessee daycares have reported positive cases of COVID-19 among staff or children, though the precise number is unknown due to vague regulatory oversight by the state.

Six additional daycare centers identified possible cases and are waiting on test results as of Friday, when the data was provided to the Tennessee Lookout.

Daycares are licensed by the Tennessee Department of Human Services. How daycares handle positive cases is of intense interest as parents weigh whether to send their children to school when classes resume next month.

Tennessee Department of Human Services
Tennessee Department of Human Services

But, there is a regulatory question for how the handling of COVID-19 is enforced by the state since the Department of Human Services said it acts in a “support and technical assistance” role.

Although daycare providers are asked to alert Human Services when a staffer or child tests positive, it’s unclear what happens if an operator fails to report a case or respond properly to a positive test.

And, Human Services does not maintain a tally of how many children or staffers have tested positive, which means the public is left in the dark for how widespread the spread of the virus has been within daycares. For comparison, the Texas Department of Health and Human Services told the Texas Tribune on July 6 that 1,695 people from childcare facilities had tested positive.

Since the pandemic hit, DHS has referred daycare providers to guidance from the federal Center for Disease Control, which suggests social distancing protocols, regular cleaning and basic health screenings.

To read the guidance, click here.

“This information is presented as guidance, consistent with communications from the CDC,” Human Services spokesman Sky Arnold said. “Based upon their specific circumstances, a child care provider may have to adapt protocols to fit the situation at their program. We have asked providers to report information, such as positive COVID diagnoses, to their licensing program evaluator.

“As providers and families work to respond and adapt to COVID-19, DHS is approaching providers in the spirit of support and technical assistance.  DHS staff are reaching out to providers on a regular basis to check-in, gather information, and offer suggestions for how to strengthen agency operations.”

Human Services does not maintain a tally of how many children or staffers have tested positive, which means the public is left in the dark for how widespread the spread of the virus has been within daycares.

The CDC recommends daycares separate children in different classrooms based on age. Teachers in different classrooms are recommended not to interact. Parents are required to drop off and pick up their children outside of the building, and activities like lunch and recess are staggered so that teachers and children in separate classrooms don’t come in contact with each other.

How county health department responds if there’s a positive case

The Metro Department of Health investigates positive cases in daycares through its contact tracing efforts the same as it would handle a positive case in another setting.

“If a staffer or child at a childcare facility were to test positive for COVID-19, we would identify the positive case(s), then our case investigation team would do interviews to determine the close contacts of the case(s),” health department spokesman Matt Peters said. “Those close contacts would then quarantine at home for the first 14 days after their last close-contact interaction with the case.”

The Tennessee Department of Health has not “issued any health directives” for daycares. A spokeswoman said daycare facilities have not been major sources for infection but the department has identified a few clusters of illness associated with child care facilities, one with five or more cases. 

Centers close for cleaning, while close contacts are quarantined 

Many daycares were forced to close due to orders from county mayors or Gov. Bill Lee in response to the pandemic, though the state allowed centers to stay open to provide care for children of essential workers from healthcare, government, food distribution and other industries.

Daycares began to reopen in May in accordance with the CDC guidelines recommended by Human Services. The guidelines say when feasible, staffers and older students should wear face coverings and call on daycares to have a response plan in case a positive case is identified.

To view a list of daycares with positive cases as of July 10, click here.

When the Gallatin Church of Christ Daycare had two teachers test positive for COVID-19, the center underwent a deep cleaning, according to chair of the childcare board Kathy Walters.

The kindergarten section closed for two weeks since there was a confirmed case on that side. Although there were no confirmed cases on the infant and toddler side of the daycare, the Gallatin Church of Christ Daycare still closed that section of the facility for one week so it could clean, Walters said.

Lawmaker calls for more oversight

Arnold did not directly answer what happens if a daycare fails to report a case or chooses not to follow CDC guidelines such as alerting parents to positive cases or requiring staffers to quarantine.

“The appropriate response for a child care agency that’s impacted by COVID is influenced by their specific situation,” Arnold said. “The health department plays a critical role in providing guidance based upon the unique facts occurring at the agency. DHS licensing staff only maintains the authority to issue licensing violations determined by rule or statute, if appropriate.”

Because there is no clear regulatory action if a daycare fails to report a case or does not respond within CDC guidelines, state Rep. Gloria Johnson, D-Knoxville, said she believes Tennessee needs to do more when it comes to making sure daycares are following CDC protocol.

Rep. Gloria Johnson, D-Knoxville (Photo: Tennessee General Assembly)
Rep. Gloria Johnson, D-Knoxville (Photo: Tennessee General Assembly)

“We should be spending our Cares Act money making sure the administration has staff to monitor daycare facilities more closely during COVID, ‘giving guidance’ is not a plan or strategy,” Johnson said. “I am not at all comfortable that everything is being reported or followed up as it needs to be. The number of daycares with COVID cases demonstrates this.”

Although Johnson said comparing daycares to in-person classes for school is “apples to oranges,” she expressed concern about school districts reopening while the virus continues to spread at a high rate in some areas of the state.

“Opening schools won’t help the economy, it will do the exact opposite,” Johnson said. “All the studies are showing transmission in clusters of folks inside: living or working together or at events like weddings, funerals, and church services.

“School is 8 hours a day, 5 days a week and will clearly increase community spread–you can’t improve the economy if you don’t contain the virus.”

Tennessee Lookout Editor Holly McCall contributed to this story.