IN A SIGN of the continually evolving nature of the COVID-19 pandemic, the Department of Public Health on Wednesday quietly updated its guidelines for educational settings to no longer require children to quarantine if they are asymptomatic but exposed to COVID, even if they are unvaccinated.
The change in guidance will affect schools, camps, and daycares, but will have particular relevance for parents of children too young to be vaccinated, who have until now been subject to frequent quarantines.
The new rules were cheered Thursday by some parents who have struggled for more than two years to balance work and childcare, but they also raised concerns from parents and childcare providers who worried about safety. The new guidance is likely to set up a new round of discussions among schools, childcare providers, and parents, since the state guidelines are not mandatory and it will be up to institutions to decide whether to impose different policies.
The Executive Office of Education says the change “will better support programs in keeping children in child care while maintaining health and safety for families, children, and staff.”
The new guidelines say children who are exposed to COVID and asymptomatic, regardless of where the exposure occurred and regardless of vaccine status, should no longer be required to quarantine. These children should mask for 10 days and should be recommended, but not required, to test on days two and five after exposure.
Until now, unvaccinated students exposed to COVID outside of school had generally been required to quarantine for five days, even after the quarantine requirements were lifted for vaccinated children.
For kids too young to be vaccinated, that meant regular preschool absences. Quarantines lessened this year when the state instituted a test-and-stay program for childcares that allowed children exposed in school to stay in school and test daily, but the regulations still caused many disturbances.
The quarantine guidelines have generally been more relaxed in K-12 schools after a revision of the test-and-stay program ended contact tracing and allowed asymptomatic close contacts to remain in school without daily testing. But, in theory, unmasked, unvaccinated close contacts were still supposed to quarantine.
Dr. Lloyd Fisher, president of the Massachusetts chapter of the American Academy of Pediatrics, said eliminating quarantines for close contacts without symptoms makes sense, since it mirrors what workplaces are doing.
“People in other parts of society and in the community are not being quarantined based on their immunization status at this point,” Fisher said, noting that vaccines are no longer that effective against asymptomatic or mild infection.
Fisher said the decision needs to be about weighing the risks of missing school against the benefits of quarantine. Particularly in preschools, the risk of serious illness in young children is low. “The virus is going to continue to circulate. We know there’s going to be rises and falls in cases…. these children may be close contacts time after time and by excluding them from school we are really causing as significant amount of harm to them,” he said.
Also under the new rules, children who test positive for COVID must isolate for five days, then mask for another five days, similar to the old guidelines. Children unable to mask may return after five days with a negative rapid test. Children are encouraged to use rapid at-home antigen tests. While these tests are not approved for children under two, the state guidance says they may be used “off-label.”
Several parents of young children said they think the shift is an important recognition of the stress on parents when children must miss school due to an exposure. “Hopefully this recognizes that it’s been very, very difficult for parents of children under five to work and to balance childcare for over two years now,” said Caitriona Fitzgerald, whose 4-year-old son is at a Wakefield preschool. Her son was kept home for a couple of weeks due to in-class exposures before the school instituted test-and-stay.
Last week, her son’s father contracted COVID, and her son was kept home again, even though he remained healthy, because test-and-stay only applies to in-school exposures. Fitzgerald has not heard whether her center would adopt the new state guidelines, but she thinks they make sense.
“Obviously you want to have the public health balance, but it seems like often, depending on the extent of the close contact, the risk is low the kid is going to get it,” Fitzgerald said. “I’m incredibly privileged. I worked from home, have a flexible job and a supportive boss, and it was still hard. The weight of it is even harder on folks who are hourly employees or may not have bosses or jobs that are as flexible.”
Andrew Farnitano, who works in public relations, said his 7-month-old daughter was home Thursday due to an exposure in her daycare center in Dedham. She has no symptoms, but has to stay home until Tuesday. This is the second time in the two months she’s 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 handles COVID. “I think it seems reasonable to leave it up to parents to make the decision about what’s right for their kids, to judge whether they want to keep them home or whether they need the care,” Farnitano said. “It’s a struggle for me as a middle-class parent who’s able to work from home to have to scramble and arrange childcare at the last minute. That’s an impossibility for many workers that don’t have that luxury.”
But parents’ reactions are not always simple. The Franklin daycare center that 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 daycare in January, he had one close contact, and she had to take him to the pediatrician for a PCR test before he could return to school.
She’s happy to be able to send him to school even if he’s a close contact. But she worries about his health once all masking and testing requirements are lifted. “We’ve been so cautious this entire time, then all these little tiny kids are all in the same classroom together,” Franklin said. “We want to keep him in school but at the same time he’s unvaccinated, he’s in close contact with all the other kids and teachers who are also unmasked.”
Some providers worry about COVID spreading through their classes. Beth Sidel, a family childcare provider in Montague, worries that decisions are being driven by parents and economic concerns rather than science or children’s best interests. “If you’re unvaccinated and exposed, then you’re more likely to be carrying the virus,” Sidel said. She said children in her program have gotten COVID, and if she lets in a child who is exposed but asymptomatic, it could expose all the kids.
At the Guild of Saint Agnes, a Worcester-based childcare provider with multiple locations, the organization plans to continue requiring parents to test their kids daily for five days after an exposure, with the center providing the tests. Deputy director Sharon MacDonald said the agency continues to see asymptomatic children testing positive, and she worries about bringing exposed students back to school without testing. “We also have to be mindful of employees who are at risk,” MacDonald said.