‘Really demoralizing and operationally very, very hard’: Child-care providers try to stay open in COVID surge

At the Ellis Early Learning center in Boston, Emmanuel, 4, has a snack with his teacher, Colleen Donovan.. Child care providers are trying to stay open amid the state's COVID surge but they're struggling.Suzanne Kreiter/Globe Staff

The COVID surge descended with a boom Wednesday at the Ellis Early Learning center in the South End. On its first morning open since Christmas, five teachers tested positive for COVID, joining four others already home with infections. Several classrooms closed, leaving some families without child care.

Ellis’s experience could foreshadow what other child-care centers see when many reopen this week after winter break. Early education providers said they’re concerned that the rise in COVID cases in Massachusetts threatens their ability to keep classrooms open, imperiling parents’ ability to work.

“It’s really demoralizing and operationally very, very hard,” said Lauren Cook, Ellis’s chief executive. “How do we keep these classrooms open and how do we keep our kids and our teachers safe? They don’t always complement each other.”

At the Ellis Early Learning center, Ian, 4, worked with his teacher, Matt Wallace. Child care providers are trying to stay open amid the state's COVID surge but they're struggling. Suzanne Kreiter/Globe Staff

Already on Monday, some child-care centers were struggling. In Chelmsford, Springboard Schools center notified parents mid-afternoon that classrooms would close for the rest of the week due to known positive tests and potential exposures. Otherwise, more than 80 percent of students and staff would need to quarantine.

At Ellis, the increased contagiousness of the recent COVID mutation became clear in December, Cook said, when three classrooms experienced what appeared to be spread among students within them, totaling about 10 infections. Previously the center had prided itself on seeing no transmission in school.

One Ellis mother last week pulled her infant daughter out of the school, saying she couldn’t handle the off-and-on closures. “They’re either going to have to do a nanny or maybe someone’s going to leave the workforce,” Cook said. She asked families to test children before returning to the school, but she couldn’t require it as many of her families come from low-income households and may struggle to access testing.

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. That rise tracks with an overall increase in cases among all ages in Massachusetts and in students and staff in schools serving kindergarten through 12th grade. Schools are also bracing for chaos as they reopen this week.

But early education providers have fewer tools than K-12 schools to handle COVID. Children under 5 aren’t eligible for vaccination. Infants and young toddlers don’t wear masks. Naps and meals are unmasked. And it’s impossible to expect young kids to socially distance. When someone tests positive, programs often have to close an entire classroom, notify the classmates’ parents that they were exposed to COVID, and send them home to quarantine for five to seven days, until they can be tested and see if symptoms arise.

K-12 schools in Massachusetts have praised the state’s “test and stay” program that allows students exposed to COVID at school to keep attending class if they test negative on a rapid test every day. That initiative has been credited with keeping large numbers of children in school and was recently touted by the US Centers for Disease Control and Prevention as a model for the rest of the country.

But the state doesn’t offer “test and stay” to early education providers due to logistics.

“There would be many challenges in implementing a test and stay type of program in the 5,000-plus private day care businesses across the state, many of which are run from private homes,” said a spokeswoman for the Department of Early Education and Care.

The department, together with the nonprofit Neighborhood Villages, offers free pooled testing of asymptomatic early education staff and children age 2 and older, but so far only about 6.4 percent of providers, or 320 organizations, have signed on to the initiative. Since Thanksgiving, more programs have enrolled due to increased awareness and the COVID surge, Neighborhood Villages spokeswoman Emalie Gainey said.

The state also offers free COVID drive-through testing for child-care workers and families at eight locations. The state announced Wednesday that early childhood centers are among the entities eligible to purchase rapid tests at state-negotiated prices ranging from $5 to $26 per test through a state contract.

Dr. David Hamer, a Boston University professor of global health and medicine, said test and stay policies could work “just as well” in early education as they do in K-12 settings, but the challenge is availability.

“If we can have a better supply and a better, more reasonable cost per test,” Hamer said, “we’d be able to use that as an effective control measure to try and prevent outbreaks in preschools.”

But because children are less likely to show COVID symptoms, keeping early education providers open will require asymptomatic testing as well, he said. Otherwise, “you could have an explosion on your hands.”

Experts say young children have a very low chance of contracting severe illness from COVID. But Dr. Julia Koehler, assistant professor of pediatrics at Harvard Medical School and an infectious disease clinician, cautioned that doctors still don’t know the long-term effects of infections in young children. She called for more state assistance to child-care providers in low-income communities to ensure adequate testing, ventilation, and air filtration.

“The state needs to be providing day care and child-care facilities, as well as families, with the information and the resources they need to optimize the multiple layers of protection for children,” Koehler said in an e-mail. “This is currently vastly insufficient especially in frontline communities that have the highest infection and death burdens and the lowest vaccination rates.”

Emmanuel had a snack with his teacher, Colleen Donovan. Suzanne Kreiter/Globe Staff

Early childhood advocates also called for the state to continue distributing federal pandemic relief payments to providers through June 2023, then permanently increase government funding for early education, which will allow centers to boost wages and retain workers, making services more reliable for parents.

“If [the state] can’t make those investments, teachers will continue to leave the field and families will be locked out of the care solutions that they depend on in order to go to work,” said Lauren Birchfield Kennedy, co-president of Neighborhood Villages, a nonprofit that provides services to five Boston-based providers.

Mary Pat Reed, director of Panda Bilingual Childcare in Cambridge, which charges $2,230 to $2,840 for full-time care per month depending on the child’s age, asked all families to test their children just before returning on Monday. She hasn’t had many issues with COVID so far this school year, as her families tended to work from home and stayed cautious for their unvaccinated children.

“I’m one of the luckier schools,” Reed said. Still, “We’re not going to be naïve and say, ‘It’s not going to happen here.’”

One father whose daughter attends Panda said he was thankful the center was requiring COVID tests for kids to return. Dennis Jen, a software developer in Cambridge, said he wants to protect his 3-year-old daughter, Dahlia, but also believes she will likely contract COVID at some point.

“It’s hard because as a parent, you want to keep your child safe, but at the same time you want your child to engage with other kids and develop socially,” Jen said. “And also, you yourself have to work.”

Globe staff writer Stephanie Ebbert contributed to this report.