CCPRN Resuming Care & COVID-19 Zoom Chat Summary Discussion Notes: Ideas and Questions to Consider - Child Care ...
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CCPRN Resuming Care & COVID-19 Zoom Chat Summary Discussion Notes: Ideas and Questions to Consider June 3rd, 2020 • Reach out and consult your families as you plan to re-open. Align the risk tolerance to help determine what strategies you will put in place regarding cleaning, physical distancing, etc. Do you and your families share similar comfort levels around the potential risk of transmitting COVID-19? Can you collaborate to create strategies and write a policy that will work for everyone? For example, are your families all ok with the idea of a shared child care environment where maintaining a 2 meter distance will be encouraged but not enforced? • Continued discussion regarding infrared thermometers: each model is unique. Consider the measuring distance (how close do you need to be to use it?), temperature range, and accuracy. o Here is an example of a non-contact infrared thermometer that was shared after the chat: https://medicsupplies.ca/search?type=article,page,product&q=non- contact*+thermometers* Please note: we can’t speak to how well this model works—but delivery was quick and it is easy to use. • Update shared: Ottawa Public Health-- COVID-19 Guidance for Emergency Childcare Centres Revised May 27 2020 (French version below) https://www.ottawapublichealth.ca/en/professionals-and- partners/resources/Documents/childcare/COVID-19-Emergency-CCC-Guidance- May-27.pdf o Of note relating to screening: a fever is now considered to be a temperature of 37.8 degrees C or greater (previously 38.0 or greater) and runny nose, nasal congestion is considered to be a symptom “in
absence of underlying reason for these symptoms such as seasonal allergies, post nasal drip, etc.” • Shared strategies include o Implementing a staggered entry system for all families o Reducing hours of care, especially when parents are working from home and have no significant commute o Offering shorter days for the first week, an adjustment period o Discuss and expect that all families are following public health guidelines for physical distancing o Increase the rotation of toys to offset daily cleaning o Use individual bins filled with toys and art supplies for each child • Continued discussion regarding cleaning and disinfection o How often? What is realistic? Important to consider burnout prevention. What are the expectations of your families? For example, will you clean/disinfect the toilet between each use? o What to use and where to purchase? o Bleach Solution recommended from Ottawa Public Health: https://www.ottawapublichealth.ca/en/professionals-and- partners/child-care-ipac.aspx#Environmental-cleaning-and-disinfection- in-child-care-centres-and-schools Concentration Uses Mixture Contact Time During the COVID-19 20 mL of bleach with 1 1 minute pandemic, to sanitize litre of water *Note: The contact time, also 1000 parts per child care surfaces, known as the wet time, is the million diapering stations, OR time that the disinfectant needs to stay wet on a surface toys, play areas, pet 4 tsp of bleach with 4 to make sure it can kill all the cages and high touch cups of water germs. It is the length of time hard surfaces. you leave the solution on the surface before wiping it down. o Prepared Disinfectants: From Health Canada: All disinfectants that have a drug identification number (DIN) have been approved for sale in Canada. While most disinfectants will work against coronavirus, the following list of hard-surface disinfectants are supported by evidence following drug review, demonstrating that they are likely to be effective and may be used against SARS-CoV-2, the coronavirus that causes COVID-19. https://www.canada.ca/en/health-canada/services/drugs-health- products/disinfectants/covid-19/list.html#tbl1
Examples of disinfectants from this list: Examples only, NOT necessarily recommendations, please research products carefully. • Spray Nine DIN 02160331 available at Home Hardware: https://www.homehardware.ca/en/heavy-duty-cleaner-disinfectant- 650-ml/p/4521880?page=search-results%20page • Buckeye Lemon Quat DIN 01962051 limited availability at Ren’s Pets: https://www.renspets.com/products/buckeye-sanicare-lemon-quat-gal • Maxill tb Minuteman NEX GEN Disinfectant DIN 02488981 (solution) & DIN 02488973 (wipes) https://www.maxill.com/ca/products/infection- control/disinfectants/tb-minuteman-nex-gen-disinfectant.html • Swish Miracle Disinfectant Spray ‘N Wipe DIN 02242836 https://swish.ca/default/sku2-4015-fm.html • Many household brands including Lysol, Clorox, Windex, Fantastik, reference DIN from the Health Canada link above to be certain. • Continued discussion regarding Personal Protective Equipment o Will you wear a mask? When? If yes, consider sending the child a photo of you wearing a mask. o What is your comfort level (i.e. only while changing diapers?)? What are your families expecting? o Consider having masks/gloves/spare clothes close by o Question regarding the effectiveness of wearing PPE after having been in close contact (i.e. is it useful to wear a mask while changing diapers if you and the children are already spending time together without masks?) o What type and where to purchase PPE? Options for purchasing PPE—Stock and pricing subject to change, shipping cost varies o Masks, Gloves, Shields: Medic Supplies https://medicsupplies.ca/ o Masks, Gloves, Shields, Infrared Thermometer, Hand Sanitizer https://www.wintergreen.ca/sanitizing-safety-solutions o Masks, Gloves, Shields: St. John Ambulance https://on.shopsafetyproducts.ca/products.php?page=1&sid=1&cid=37 o Masks, Gloves, Shields, Hand Sanitizer: Southwest Business Products https://www.southwestbusiness.ca/en/corporate-supplies/ppe/ o Masks, Gloves, Shields, Hand Sanitizer: Canada Care Medical
https://canadacaremedical.com/medical-products/personal-protective- equipment/ o Masks, Shields, Hand Sanitizer Dispensers: Scholar’s Choice https://www.scholarschoice.ca/ppe.html o Gloves: Wellwise by Shopper’s Drug Mart https://www.wellwise.ca/search?term=latex%2520gloves o Assorted Items: Ontario Medical Supply http://www.oms.ca/news/retail-store-reopening.aspx o Masks, Hand Sanitizer: CA Paradis https://www.chefsparadise.ca/ • Consider the developmental needs of the children and the importance of the caregiving role. How can/will you best meet their needs? Is enforcing physical distancing practical? How will you continue to support their social and emotional learning? What are your priorities in terms of offering care? How will you care for a child who is crying and/or in distress (i.e. pick up and comfort using a blanket, facing the child outwards)? How will you discuss and communicate your plans to your families? o This article « Lâchez le 2 mètres pour les moins de 18 ans ! » was shared— discussing the idea of not having toddlers physical distance from each other: https://www.ledevoir.com/politique/579320/il-faut-que- jeunesse-se-vive o Follow-up article “Physicians demand Legault ease restriction rules for children”: https://montrealgazette.com/news/quebec/physicians- demand-legault-ease-restriction-rules-for-children • Another waiver example: YMCA Dallas https://www.ymcadallas.org/sites/default/files/2020-05/COVID- 19%20ECC%20Waiver.pdf French waiver example “Clause acceptation des risques” from a Day Camp: https://municipalitestjeandematha.qc.ca/wp- content/uploads/2020/05/Clause-acceptation-des-risques.pdf and “Mesures de protection” example https://municipalitestjeandematha.qc.ca/wp- content/uploads/2020/05/Mesures-de-protection-COVID-19.pdf • Other Francophone resources: o Santé publique d’Ottawa: Orientation pour les services de garde d’urgence concernant la COVID-19 https://www.santepubliqueottawa.ca/fr/professionals-and- partners/resources/Documents/childcare/COVID-19-Emergency-CCC- guidance-May-27_FR.pdf o Santé publique d’Ottawa: Fournisseurs de services de garde d’enfants
https://www.santepubliqueottawa.ca/fr/professionals-and- partners/child-care-providers.aspx o Santé publique d’Ottawa: Mesures de prévention et contrôle des infections dans un service de garde d'enfants https://www.santepubliqueottawa.ca/fr/professionals-and- partners/child-care-ipac.aspx#Environmental-cleaning-and-disinfection- in-child-care-centres-and-schools o Ministère de la Santé COVID-19 – Document de référence sur les symptômes Version 5.0 – 25 mai 2020 http://www.health.gov.on.ca/fr/pro/programs/publichealth/coronaviru s/docs/2019_reference_doc_symptoms.pdf o Ministère de la Santé COVID-19 : Document d’orientation à l’intention des centres de garde d’urgence Version 2 – 8 mai 2020 http://www.health.gov.on.ca/fr/pro/programs/publichealth/coronaviru s/docs/2019_child_care_guidance.pdf o Coronavirus (COVD-19) Conseils Garderies https://www.cchst.ca//images/products/pandemiccovid19/pdf/day_car es.pdf o Institut national de santé publique du Québec: Recommandations intérimaires concernant les travailleuses des services de garde https://www.inspq.qc.ca/sites/default/files/covid/2984-travailleuses- services-garde-covid19.pdf May 27th, 2020 • Survey your families to determine childcare needs vs wants • Discuss with parents ahead of time alternative options—i.e. open for ½ days only to start, staggered entry dates • Provide families with lots of information upfront—photos or video tour of your space if it looks different, copy of any new guidelines or policies, video/photo of you wearing any PPE, etc. • Consider burnout prevention—there will be a lot more work involved with extra cleaning and disinfecting, also increased costs associated with cleaning/disinfecting supplies and purchasing PPE. • Waiver acknowledging risk—a template has been shared and is available at https://ccprn.com/resources/. • Screening practices—paper vs digital forms (one idea that came up after the meeting was to provide parents with a paper form to keep at their house, have them complete and sign daily, take a photo and email to the provider—a template is available at https://ccprn.com/resources/), also consider what questions to ask (i.e. has the child received any medications within the last 4 hours?). It was mentioned that some infrared thermometers are not as
accurate (especially outdoors)—an alternative option would be to wear full PPE, use an ear thermometer, and disinfect after each use. “Fever Bears” were also mentioned to monitor a child when a fever is suspected. • Think about implementing physical distancing and public health guidelines The goal would be to do whatever you can to reduce the risk of transmission. Eliminating the risk is impossible right now. What strategies will you implement? o Increasing individual activities o No group or shared sensory play—what about individual trays or bins? Discard and clean the bin at the end of each day? o Increased outdoor play o Sleeping as far apart as possible, place the children toe to toe otherwise. o What about mealtime? Outdoor picnics allow for more room between the children. One idea was to have parents supply the lunch/snacks. Each child is then only touching the food/items from their own house. A comment after the meeting noted that this might be more difficult/risky for the provider who will then be touching the food/containers/items from 5 different houses as they tries to assist each child. o Belleville Public Health has suggested no car travel (too much close and confined contact), using a spray sunscreen, using gloves when distancing is not possible (i.e. to apply sunscreen) and/or paper towels for shared products (apply toothpaste to a paper towel and then transfer to the child’s toothbrush to avoid the toothpaste touching each toothbrush). o What about stroller use? • Consider payment options, sick days, and how to survive financially—what will work for you and your families? Some ideas could include: o giving each family a certain number of "free" sick days per year, once used they will then have to pay o increasing the daily fee by $1 or $2 to offset the future potential loss of income due to Covid-19 "i.e. put away for a rainy day" o working out a compromise with the families to charge a lesser amount for sick days o reducing your hours (i.e. one hour less at start and end of day) to compensate for increase cleaning needs but keep daily rate the same o have parents provide food and snacks but keep the daily rate the same o charge a fee to cover the costs of buying extra supplies (cleaning/disinfecting products and for paper towels, etc.) o requesting a COVID-19 test when symptoms are present might reduce the need to wait 14 days before returning to care (depends on test result turn around time)
o think about any outstanding vacation time—how do you want to address this with families? • There are currently no official guidelines/requirements for resuming home child care from the City of Ottawa or the Province (some other local health units do have guidelines in place for home childcare). One suggestion was to contact your local MPP to voice concerns and request information. • CCPRN has compiled many online resources which can be found here: https://ccprn.com/wp-content/uploads/2020/05/COVID-19-and-Resuming- Care-Updated-June-3rd-2020.pdf
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