Head Start and Early Head Start programs successfully implemented Centers for Disease Control and Prevention (CDC)-recommended guidance and other ancillary measures for childcare programs that have remained open during the COVID-19 pandemic, allowing them to continue offering in-person learning, reported the CDC. These approaches were documented to guide implementation of mitigation strategies in childcare settings.
Implementing and monitoring adherence to recommended mitigation strategies can reduce risk of SARS-CoV-2, the virus that causes COVID-19, transmission in childcare settings. These approaches could be applied to other early care and education settings that remain open for in-person learning and potentially reduce the spread of COVID-19.
The Head Start program, including Head Start for children aged three to five years and Early Head Start for infants, toddlers, and pregnant women, promotes early learning and healthy development among children aged zero to five years whose families meet the annually adjusted Federal Poverty Guidelines throughout the United States.
In response to the COVID-19 pandemic, most states required all schools (K-12) to close or transition to virtual learning. The Office of Head Start gave its local programs that remained open the flexibility to use CARES Act funds to implement CDC-recommended guidance and other ancillary measures to provide in-person services in the early phases of community transmission of SARS-CoV-2 in April and May 2020, when many similar programs remained closed.
Guidance included information on masks, other personal protective equipment, physical setup, supplies necessary for maintaining healthy environments and operations, and the need for additional staff members to ensure small class sizes. Head Start programs successfully implemented CDC-recommended mitigation strategies and supported other practices that helped to prevent SARS-CoV-2 transmission among children and staff members. CDC conducted a mixed-methods analysis to document these approaches and inform implementation of mitigation strategies in other childcare settings. Implementing and monitoring adherence to recommended mitigation strategies reduces risk for COVID-19 transmission in childcare settings. These approaches could be applied to other early care and education settings that remain open for in-person learning and potentially reduce SARS-CoV-2 transmission.
Factors facilitating successful implementation of mitigation strategies included extensive communication with consistent messaging to staff members and parents; ongoing training and support to staff members; continuous engagement of community partners and parents; and collaboration with program nurses, local health departments, hospital systems, and community organizations (e.g., United Way and Boys & Girls Club). Challenges included maintaining recommended social distancing, ventilation, weather concerns during the fall and heading into winter, parental mental health concerns (e.g., chronic stress, depression, anxiety, and trauma related to losing a loved one to COVID-19), questions concerning effects of staff members wearing masks on infant and toddler psychosocial development, maintaining guidance vigilance, and concern that programs were being overly cautious.
Implementing and monitoring adherence to CDC-recommended mitigation strategies could play a crucial role in reducing SARS-CoV-2 transmission in childcare settings. CDC developed tools and resources for childcare programs, including examples of evaluation questions, related qualitative and quantitative indicators, and suggested data sources to understand the impact of COVID-19 mitigation strategies in childcare programs. For example, childcare facilities can identify facilitators, barriers, and other factors affecting implementation of mitigation strategies. Baseline information can include characteristics of the child care program (e.g., number of children in the program, child-to-staff member ratio, parental or community attitudes and involvement, and rates of retention or attrition among staff members and volunteers). This can help identify gaps and areas where additional mitigation strategies can be implemented or strengthened.
