British Columbia public health officials held a virtual city hall on Wednesday night aimed at answering parents ‘and workers’ questions about new COVID-19 guidance for the province’s child care facilities.

The province released the new guidelines last weekwhich allows children or staff members who have been in close contact in a COVID-19 case to continue to attend the facilities, provided they remain symptom-free.

Under BC’s updated guidelines, vaccinated children and adults should stay away from childcare facilities for five days after contracting COVID-19, while unvaccinated staff should stay away for 10 days.

The guidelines also state that day care should not be closed for public health reasons unless instructed to do so by a medical health officer.

Some parents said they did not feel safe sending their children to daycare under the new guidelines, while others had questions about how the new regulations would work.

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Here’s a look at some of the key questions officials answered Wednesday.

How is it safe for an unvaccinated child exposed to COVID-19 to attend day care?

The change in guidance around close contacts is a reflection of the fact that the Omicron variant is much more transmissible, but less likely to cause serious illnesses, said dr. Mark Lysyshyn, deputy medical health officer for Vancouver Coastal Health said.

Children in particular, he said, are less likely to contract or transmit the virus.

“It really is an infection that acts much more like seasonal respiratory viruses that we are very familiar with in society, like flu,” Lysyshyn said.

“We therefore need to shift our management much more to how we manage those viruses.”

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The most important thing is for people to monitor for symptoms and stay home when they feel unwell or develop symptoms, Lysyshyn said.

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The reality is that there is currently a general risk of exposure in the community, he said.

“There is widespread transmission of the virus in the community. “People may know about certain exposures, but they are also exposed in other ways,” he said.

“It’s just not a viable strategy in our population to isolate all contacts at the moment.”

What is the definition of ‘feeling good enough’ to return to day care?

Deciding when symptoms have improved enough to end isolation after five days will require people to be aware of what is normal for themselves and their children, and to base decisions on that, Drs. Jason Wong, co-medical director of clinical prevention services for the BC said. Center for Disease Control.

“I appreciate how a little vague it is,” Wong admitted.

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Wong said evidence so far has shown that most transmission occurs in the early days of infection, and that as people begin to feel better, their chances of spreading the virus decrease significantly.

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“We ask people to think and think about how they feel, and typically when they feel better, the risk of transmission is smaller,” he said.

Lysyshyn said if someone still has a fever, they should continue to isolate, but that if they still have other symptoms that improve, such as a sore throat or runny nose, they can start returning to normal activities.

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If unvaccinated adults have to isolate for 10 days, why not unvaccinated children?

The updated isolation guidelines reflect the lower risk of children getting or transmitting COVID-19, but also the need to balance the harm of restrictions against the harm of the virus itself, several participants at City Hall said.

Deputy Provincial Health Officer, dr. Reka Gustafson, said after five days, the benefit of isolating longer is much smaller, and that exchanging a child for the extra time is not worth it.

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“When we apply public health measures, we also want to think about the harm of the measures, and keeping children (in) school and day care where they do their social and emotional learning is extremely important,” Lysyshyn added.

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“We thought it was important to reduce the isolation for children so that they miss school and day care as little as possible, because it is extremely important for their development.”

What about day care centers with immunosuppressed staff members?

Day care with immunosuppressed staff will function under the same guidelines as all others, said dr. Bonnie Henry, provincial health officer, said.

Henry said the most important thing those staff members can do is get vaccinated, emphasizing that scraping doses have been proven very effective in preventing infection as well as serious outcomes.

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Ensuring staff and children stay away when they are not feeling well is also crucial, she said.

“As an immune-compromised person, you have to do all the things that best protect you, get vaccinated yourself, make sure you wear a mask, take all those precautions to protect yourself, and those things, together. with all the other measures in place in day care, everyone should be protected, ”said Henry.

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“All the things that are in place make it a low-risk environment, even for people who are immunosuppressed.”

Why should day care not be closed for health reasons unless it is ordered by a medical health officer?

This guideline reflects concerns that some daycare may overreact to a staff member who tests positive and closes the entire facility unnecessarily, Gustafson said.

The message to operators is that they should check with their medical health officer before closing if they have concerns.

Lysyshyn said experience has shown that most exposures in day care settings do not actually lead to transmission.

“Closing the entire facility when there is an exposure could therefore disrupt the service provided to essential workers and all sorts of people who have to keep working,” he said.

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Wong said the guideline does not prohibit day care from closing, noting that they may have business or operational reasons for closing the doors – such as a lack of available staff.

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Daycare should continue to notify their licensing officer and parents if they hear of a confirmed case, Lysyshyn said, but noted that with less testing, fewer cases will be confirmed.

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Why is there no vaccine mandate for day care staff?

Workplace vaccination requirements are for the most part not within the powers of the provincial health officer, Henry said.

The one exception to this is the healthcare sector, such as doctors, nurses and long-term care staff, she said.

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“In every other environment, it’s really about the employer-employee relationship around vaccination and the risk in their environments,” she said.

“There are many institutions where we strongly recommend it and where we have supported employers.”

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Henry said she believes all daycare workers should be vaccinated, and that they should be given early access to both their initial shots and, as a result, to their reinforcement shots.

How will the rapid tests for the child care system be used?

BC distributes a quarter of a million rapid antigen tests to state-funded child care centers.

Henry said the tests are not for children, and should be used by symptomatic staff members.

She said the tests are not a silver bullet, and are only one tool to be used with all other layers of protection.

A positive test is a “red light,” she said, but a negative test is not a “green light.”

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“If you have symptoms and you test positive, then you should stay home for five days or 10 days, depending on your vaccination status,” she said.

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“If you test negative, you have to look… ‘How bad are my symptoms? Can I go to work? ‘ And if you make that decision to go to work, then you have to wear a mask, you have to make sure you wash your hands carefully, you do all those other things that are in place to protect us from spread, even when we know we do not have the virus. “

Bars, gyms and dance studios were ordered to close, so why not daycare?

Henry said the decision to close certain businesses was not taken lightly, and had to be weighed against its negative impact.

Businesses ordered to close are home to more discretionary activities or social gatherings, while schools and daycare provide an essential service, she said.

“We know the negative impact on children, on families, on people working in that sector, but we also know that they can be operated safely, and that’s how we need to adapt to ensure that we have that important support for children in our sector. care, ”Henry said.

Gustafson said when BC implemented more widespread closures early in the pandemic, it was partly because much was unknown about the virus.

She said public health has since learned a lot about COVID-19, including that it is mostly distributed at home and in unstructured gatherings.

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Officials do not want to normalize closures beyond the primary response to infection prevention, she said.

“In general, this is not how we manage communicable diseases, and we return to that way of managing COVID-19.”

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