IN A SIGN Given the ever-evolving nature of the COVID-19 pandemic, the Department of Health quietly updated its guidelines for educational institutions on Wednesday, eliminating the need for children to quarantine if they are asymptomatic but exposed to COVID, even if they are unvaccinated.
The change in guidance affects schools, camps and daycares, but has particular relevance to parents of children too young to be vaccinated, who have often been quarantined in the past.
The new rules were hailed on Thursday by some parents who have been struggling to balance work and childcare for more than two years, but they have also raised concerns from parents and childcare workers worried about safety. The new guidelines are likely to spark a new round of discussion between schools, childcare providers and parents, as state guidelines are not binding and it will be up to institutions to decide whether to impose different guidelines.
The school board says the change “will better support programs to keep children in child care while ensuring the health and safety of families, children and employees.”
The new guidelines state that children who are exposed to COVID and who are asymptomatic, regardless of where exposure occurred and regardless of vaccination status, should no longer be quarantined. These children should mask for 10 days and it should be recommended, but not required, to be tested on days two and five after exposure.
Previously, unvaccinated students exposed to COVID outside of school were typically required to quarantine for five days, even after quarantine requirements for vaccinated children were lifted.
For children who were too young to be vaccinated, this meant regular absenteeism from kindergarten. Quarantines eased this year as the state instituted a childcare test-and-stay program that allowed school-exposed children to stay in school and take daily tests, but the regulations still caused many disturbances.
Quarantine policies generally became more relaxed in K-12 schools after an overhaul of the test-and-stay program ended contact tracing and allowed asymptomatic close contacts to stay at school without daily testing. But in theory, unmasked, unvaccinated close contacts should still be quarantined.
dr Lloyd Fisher, President of the Massachusetts Chapter of the American Academy of Pediatrics, said Removing quarantines for close contacts without symptoms makes sense as it reflects what the workplaces are doing.
“People in other parts of society and in the community are not being quarantined based on their vaccination status at this time,” Fisher said, noting that vaccines are no longer as effective against asymptomatic or mild infections.
Fisher said the decision must be about balancing the risks of being out of school against the benefits of being in quarantine. Especially in preschools, the risk of a serious illness in small children is low. “The virus will continue to circulate. We know there will be ups and downs in cases… These kids can always be close contacts and by expelling them from school we are really doing so much harm to them,” he said.
Also under the new rules, children who test positive for COVID must be isolated for five days and then masked for another five days, similar to the old guidelines. Children who cannot mask can return after five days with a negative rapid test. Children are encouraged to use rapid antigen tests at home. Although these tests aren’t approved for children under the age of two, state policy allows them to be used “off-label.”
Several parents of young children said they think the postponement is an important recognition of the stress for parents when children are forced to miss school due to exposure. “Hopefully this recognizes that it’s very, very difficult for parents of children under five to have been working and juggling childcare for over two years,” he said Caitriona Fitzgerald, whose 4-year-old son attends a preschool in Wakefield. Her son was kept at home for a few weeks due to exposure in class before the school introduced test-and-stay.
Last week, her son’s father contracted COVID and her son was kept back home, although he remained healthy, as the test-and-stay only applies to school exposures. Fitzgerald hasn’t heard if her center would adopt the new state guidelines, but she thinks they make sense.
“Obviously you want the balance of public health, but depending on the level of close contact, the risk to the child often seems low,” Fitzgerald said. “I’m incredibly privileged. I’ve been working from home, have a flexible job, and a supportive boss, and it’s still been tough. The weight of that is even heavier for people who work part-time or maybe don’t have as flexible supervisors or jobs.”
Andrew Farnitano, who works in public relations, said his 7-month-old daughter was home for an exposure at her daycare center in Dedham on Thursday. She has no symptoms but has to stay home until Tuesday. This is the second time in the two months she has been in daycare that she has been quarantined for multiple days.
As the virus continues to spread but fewer people are becoming seriously ill, Farnitano said society needs to evolve in how it deals with COVID. “I think it seems reasonable to let parents make the decision about what’s right for their children, judging whether they want to keep them at home or whether they need the care,” Farnitano said. “For me, as a middle-class parent who can work from home, having to take care of last-minute childcare is a struggle. That is an impossibility for many employees who do not have this luxury.”
but Parents’ reactions are not always easy. The Franklin Day Care Center, which Brittney Franklin’s 10-month-old attends, adopted the state guidelines as soon as they were released, and Franklin has mixed feelings. Since her son started kindergarten in January, he has been in close contact and she had to take him to the pediatrician for a PCR test before he could go back to school.
She is happy to be able to send him to school even though he is a close contact. But she worries about his health once all masking and testing requirements are lifted. “We’ve been so careful all along that all these little kids are all in the same classroom together,” Franklin said. “We want to keep him in school but at the same time he’s not vaccinated, he’s in close contact with all the other kids and teachers who are also exposed.”
Some providers fear COVID will spread to their classes. Beth Sidel, a family daycare center in Montague, fears decisions will be driven by parents and economic interests rather than science or the children’s best interests. “If you’re not vaccinated and exposed, you’re more likely to carry the virus,” Sidel said. She said children in her program have contracted COVID, and if she admits one child who is exposed but asymptomatic, all of the children could be exposed.
At the Guild of Saint Agnes, a Worcester-based childcare provider with multiple locations, the organization plans to continue requiring parents to test their children daily for five days after exposure, with the center providing the tests. Deputy Principal Sharon MacDonald said the agency continues to see asymptomatic children who test positive and is concerned about bringing exposed students back to school without testing. “We also need to look out for vulnerable employees,” MacDonald said.