Data shows inconsistent closures at Utah child care facilities with COVID-19 outbreaks

(Trent Nelson | Tribune file photo) A room in the teen learning center at the Murray Boys & Girls Club, May 14, 2020. LeAnn Saldivar, the organization's CEO and president, said she had expected more guidance from state and local health officials after the facility had a confirmed coronavirus case.

Fifty-seven child care facilities in Utah have reported coronavirus cases so far — but state data shows responses to the disease have varied greatly from one center to another.

Some of the care centers reopened after a day or two. Others shut down for weeks. And nearly a dozen didn’t close at all.

The state has required child care providers to disclose any cases of COVID-19 to officials and parents but largely leaves the rest up to them. In deciding whether to close and for how long, these providers have to weigh health risks against the child care needs of the families they serve, and a handful told The Salt Lake Tribune they wished they’d gotten more direction from officials.

Suzanne Leonelli, CEO of Root for Kids in southern Utah, said she would’ve preferred a government mandate to close her facility after five staff members tested positive for the coronavirus. Instead, the nonprofit voluntarily shut down its child care center for two weeks.

"Nobody wants to be the bad guy and make that decision to close," Leonelli said. "It does leave us in this huge dilemma of trying to find the right authoritative person or body to guide us in what's recommended."

Simon Bolivar, administrator of child care licensing for the Utah Department of Health, said officials have avoided a one-size-fits-all approach to child care centers during the pandemic because each situation is different.

"It all depends on what really happened at the facilities," he said. "We cannot say that every case has to be treated exactly the same."

A state database, which The Tribune obtained through an open records request, indicates that child care facilities in Utah have collectively reported 82 cases of COVID-19 so far and that more than a third of these centers never closed their doors in response. But several told The Tribune they closed for longer than the state’s database shows or that their closures were precautionary, coming before they ever had a caregiver or child at the center test positive for COVID-19.

Some of the facilities that remained open told The Tribune they closed a classroom or section of the building to protect the health of those who may have been exposed, while still remaining operational.

Overall, Bolivar said child care providers have been diligent about keeping the virus out of their centers and conscientious when cases do emerge.

Even one case of COVID-19 at a child care center is too many, Bolivar said, but there haven’t been as many outbreaks as health officials had feared. Fewer than 5% of the state’s 1,280 licensed child care centers have reported cases to the state, though several child care facilities told The Tribune they had more cases than the state’s database shows.

In gauging their approach to child care centers, Bolivar said, health officials have also kept in mind that children often show very mild symptoms of COVID-19 or experience none at all.

But that doesn’t mean a case at a child care center is inconsequential.

“The big concern is that they’re going to bring it home to someone in their life who is immunocompromised, has an underlying health condition or is in a higher risk group due to age,” said Nicholas Rupp, a spokesman with the Salt Lake County Health Department. “We’re mostly concerned about children being carriers and infecting others and causing serious illness rather than the children themselves being seriously ill.”

‘Why are they open and you’re not?’

As more people have gone back to work and needed a place to send their children during business hours, outbreaks in child care facilities in Salt Lake County have risen, the county’s COVID-19 database shows. Outbreaks at the facilities have been a mixture of children and staff but are mostly the latter, Rupp said.

The first reported outbreak in the county occurred April 7 at a day care with two positive cases. In June, positive diagnoses became much more frequent, with caregivers reporting a confirmed case more days than not — though that’s a trend Rupp said is not altogether surprising.

“Most everything has increased for outbreaks except homeless shelters,” he said, noting that the county also tracks outbreaks at schools, correctional facilities, long-term care facilities and worksites.

LeAnn Saldivar, president and CEO of the Boys and Girls Club of Greater Salt Lake, said her organization decided to close its Murray location for seven business days when two staff members tested positive for the virus. Even though the employees had gotten infected outside the center, Saldivar said her organization wanted to go above and beyond what's required to protect staff and children.

(Trent Nelson | The Salt Lake Tribune) An empty room at the Murray Boys & Girls Club on Thursday, May 14, 2020. The Boys & Girls Club has moved activities online for all of their members. Teens are meeting via zoom and the club is using Facebook to post activity videos for younger kids.

"We want our staff to feel like we are not playing fast and loose with their health," she said. "... We just want people to feel like we are acting as much in the interests of our employees as we are in the interests of the community that we're trying to serve."

Saldivar said her group leaned heavily on advice from other boys and girls clubs as well as guidance from the Centers for Disease Control and Prevention, which urges centers to create a plan in case someone becomes sick, establish an isolation room for symptomatic children and clean and disinfect often. But she said the input from state and local health officials was “not particularly instructive.”

“I really expected that the health department would be able to quite specifically say, ‘Yes, you should probably close for a couple of days,’ " she said.

While Utah’s guidelines don’t prescribe when and for how long facilities should close, the state has adopted rules for child care providers under each of its color-coded safety designations. Those differ across risk levels but largely call on day cares to increase cleaning and disinfecting and encourage children to be 6 feet apart as much as possible.

Some providers, such as Karla Pardini of the I.J. and Jeanné Wagner Jewish Community Center, said the state’s health guidance was sufficient.

Pardini, the center's programming director, said her assigned state licenser answered phone calls from her nearly every day in April and May and helped the center leaders decide what to do after an employee contracted COVID-19. The center had already closed its early childhood center as a precaution, Pardini said, and opted to keep it shut after the case surfaced. The center is now running its summer camp.

“We always felt good. We knew who to talk to,” she said, although she did add that many families were puzzled by the differences between day care centers. “Parents were asking all the time, ‘Well, why are they open and you’re not?’ ”

Bolivar said whenever there's a crisis, opinions differ about how to handle it.

“From the beginning, we have been making these decisions governed by data and the evolution of the illness,” he said. “We don’t consider it necessary to force anyone to close because many parents and employees need child care during this time.”

In some cases, centers can isolate classrooms, Bolivar said. That way, if a staff member or child in that room contracts the virus, providers can focus their sanitizing efforts on that part of the building and quarantine the children and employees who worked there while keeping the rest of the center open, he said.

Utah was suffering from a shortage of child care providers even before the pandemic, he said, and COVID-19 has only exacerbated the deficit.

(Rick Egan | Tribune file photo) Children at the Jewish Community Center walk like mummies to help with social distancing as they take a nature walk, July 2, 2020.

‘Parents need them to be open’

Anna Thomas, a policy analyst at Voices for Utah Children, said the disparate provider reactions to COVID-19 seem related to where the caregivers are located and the communities they serve.

On the whole, child care providers followed rigorous hygiene standards long before the pandemic hit, she said, but they've stepped up their hand-washing and cleaning practices even further. They know how much rides on their ability to keep functioning.

“Providers, by and large, have taken their responsibility very, very seriously,” Thomas said. “And they understand the parents need them to be open.”

West Jordan resident Annette Harris said she “really struggled” with the decision of whether to send her 1-year-old son back to day care after the pandemic hit. But she also knew that waking up at 3 a.m. to try getting a few hours of work in before he woke up or holding a screaming baby during meetings was unsustainable.

“It was the hardest thing I think that I’ve ever had to do,” she said.

Harris, an epidemiologist who works at BioFire Diagnostics, said her decision was made easier because of the changes her day care, Smart Kids in West Jordan, has implemented in response to the pandemic.

The day care has separated children by age groups to reduce the risk of a positive case in one cohort infecting others throughout the facility. It has implemented temperature checks and has been transparent about policies and procedures around cleaning and disinfecting, Harris said.

Shortly after the pandemic came to Utah, a teacher in the same room as her son had a family member who tested positive, Harris said. The day care closed the facility until the caregiver’s results came back negative and had her quarantine for 14 days.

“This happened kind of early on, so it was like our nerves as parents were already worried and then this happened and we were like, ‘Oh, no!’ ” she recounted. “But then just that they were so quick and open and transparent and so thorough in following health department guidelines made us feel better.”

Had that test been positive, she said her expectation as a parent and a public health professional would be for the day care center to close the room with the positive exposure for 14 days after the diagnosed caregiver or child was last in the facility.

Lauren Simpson, policy director for the Alliance for a Better Utah, said she recently took her 9-month-old daughter to the pediatrician for a checkup and was surprised to discover that there were fewer precautions in the doctor's office than at her child's care center.

At the First Baptist Child Development Center in Salt Lake City, she said, parents must wear masks while dropping off and picking up their children. The center takes children’s temperatures when they arrive and asks parents if any household members have been experiencing symptoms, she said.

But while most child care facilities seem to be vigilant about keeping employees and children safe from COVID-19, Simpson said state officials have a responsibility to provide direction.

“Ultimately, in the absence of state-based leadership for child care providers, the day cares are just sort of on their own to figure it out,” she said. “That’s a really heavy burden to expect day cares to figure it out on their own, and a lot of them are, and they’re doing a fantastic job.”