Walter S Gilliam1, Amyn A Malik2,3, Mehr Shafiq3,4, Madeline Klotz5, Chin Reyes5, John Eric Humphries6, Thomas Murray7,8, Jad A Elharake3,9, David Wilkinson5,10, Saad B Omer3,2,9,11. 1. Yale Child Study Center and walter.gilliam@yale.edu. 2. School of Medicine. 3. Yale Institute for Global Health. 4. Mailman School of Public Health, Columbia University, New York, New York; and. 5. Yale Child Study Center and. 6. Department of Economics, Yale University, New Haven, Connecticut. 7. Department of Pediatrics. 8. Yale New Haven Children's Hospital, New Haven, Connecticut. 9. Schools of Public Health and. 10. Tobin Center for Economic Policy, and. 11. Nursing.
Abstract
OBJECTIVES: Central to the debate over school and child care reopening is whether children are efficient coronavirus disease 2019 (COVID-19) transmitters and are likely to increase community spread when programs reopen. We compared COVID-19 outcomes in child care providers who continued to provide direct in-person child care during the first 3 months of the US COVID-19 pandemic with outcomes in those who did not. METHODS: Data were obtained from US child care providers (N = 57 335) reporting whether they had ever tested positive or been hospitalized for COVID-19 (n = 427 cases) along with their degree of exposure to child care. Background transmission rates were controlled statistically, and other demographic, programmatic, and community variables were explored as potential confounders. Logistic regression analysis was used in both unmatched and propensity score-matched case-control analyses. RESULTS: No association was found between exposure to child care and COVID-19 in both unmatched (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.82-1.38) and matched (OR, 0.94; 95% CI, 0.73-1.21) analyses. In matched analysis, being a home-based provider (as opposed to a center-based provider) was associated with COVID-19 (OR, 1.59; 95% CI, 1.14-2.23) but revealed no interaction with exposure. CONCLUSIONS: Within the context of considerable infection mitigation efforts in US child care programs, exposure to child care during the early months of the US pandemic was not associated with an elevated risk for COVID-19 transmission to providers. These findings must be interpreted only within the context of background transmission rates and the considerable infection mitigation efforts implemented in child care programs.
OBJECTIVES: Central to the debate over school and child care reopening is whether children are efficient coronavirus disease 2019 (COVID-19) transmitters and are likely to increase community spread when programs reopen. We compared COVID-19 outcomes in child care providers who continued to provide direct in-person child care during the first 3 months of the US COVID-19 pandemic with outcomes in those who did not. METHODS: Data were obtained from US child care providers (N = 57 335) reporting whether they had ever tested positive or been hospitalized for COVID-19 (n = 427 cases) along with their degree of exposure to child care. Background transmission rates were controlled statistically, and other demographic, programmatic, and community variables were explored as potential confounders. Logistic regression analysis was used in both unmatched and propensity score-matched case-control analyses. RESULTS: No association was found between exposure to child care and COVID-19 in both unmatched (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.82-1.38) and matched (OR, 0.94; 95% CI, 0.73-1.21) analyses. In matched analysis, being a home-based provider (as opposed to a center-based provider) was associated with COVID-19 (OR, 1.59; 95% CI, 1.14-2.23) but revealed no interaction with exposure. CONCLUSIONS: Within the context of considerable infection mitigation efforts in US child care programs, exposure to child care during the early months of the US pandemic was not associated with an elevated risk for COVID-19 transmission to providers. These findings must be interpreted only within the context of background transmission rates and the considerable infection mitigation efforts implemented in child care programs.
Authors: Kavin M Patel; Amyn A Malik; Aiden Lee; Madeline Klotz; John Eric Humphries; Thomas Murray; David Wilkinson; Mehr Shafiq; Inci Yildirim; Jad A Elharake; Rachel Diaz; Chin Reyes; Saad B Omer; Walter S Gilliam Journal: Pediatrics Date: 2021-08-27 Impact factor: 9.703
Authors: Johannes Forster; Andrea Streng; Paul Rudolph; Viktoria Rücker; Julia Wallstabe; Sandra Timme; Franziska Pietsch; Katrin Hartmann; Maike Krauthausen; Julia Schmidt; Timo Ludwig; David Gierszewski; Thomas Jans; Geraldine Engels; Benedikt Weißbrich; Marcel Romanos; Lars Dölken; Peter Heuschmann; Christoph Härtel; Ildikó Gágyor; Marc Thilo Figge; Oliver Kurzai; Johannes Liese Journal: JAMA Netw Open Date: 2022-01-04