COVID-19 Emergency Preparedness Plan for Child Care Providers

Episode 199 – Join us as we talk about how to build an actionable emergency preparedness plan with Andrew Roszak, Executive Director of the Institute for Childhood Preparedness. He shares his experience on the progression of the COVID-19 pandemic across the states and best practices on how to build out a plan that works in times of crisis. We also talk about steps to take if your center is also open as an essential service to control the spread of the COVID-19 virus.

Resources: 

• Corona Virus Resource for Child Care Centers
• Childhood Preparedness Website
• Childhood Preparedness Books    
• Childhood Preparedness Facebook Page  

Episode Transcript

Andy ROSZAK:

When we think about who really is on the front lines and what the impact of those first few years of life really do to the rest of our lives, it’s just so important to make sure that our early-childhood professionals have the tools that they need to be prepared and protect those young ones that are in their care.

Ron SPREEUWENBERG: 

Andy, welcome to the Preschool Podcast!

ROSZAK:

Thank you so much, it’s great to be here with you!

SPREEUWENBERG: 

It’s our pleasure, Andy. Listeners, we’re delighted to have on the show today Andy Roszak. He’s the executive director of the Institute for Childhood Preparedness. And of course, in the COVID-19 situation we’re in right now, we’ll be really keen to hear what he has to say about the current situation and how you can be prepared now and going forward in relation to COVID-19.

But let’s start off, Andy, learning a little bit about you and how you got into this field of childhood preparedness and emergency preparedness within early-childhood education, specifically.

ROSZAK:

Well, certainly. I started off as a firefighter-paramedic in the Chicagoland [Chicago Metropolitan] area. And I did that for, oh, I guess almost 10 years. After I left the fire department, I went to law schools. I’m actually a licensed attorney.

And I’ve been working on health and policy issues for the last 20 years. I’ve been working on emergency preparedness issues. I was the senior public health advisor at the US Department of Health and Human Services Emergency Care Coordination Center, where we worked on a lot of pandemic issues like H1N1. And I was also the senior director of Environmental Health, Pandemic Preparedness and Catastrophic Response at the National Association of County and City Health Officials.

And in that role I worked every day with the CDC and the 3,100 local health departments to help get communities better prepared for pandemics. So, it’s been interesting to see kind of how all the coronavirus stuff has been playing out and thinking about all the work that we’ve been doing for decades on pandemic preparedness.

After I left the federal government I started looking at early-childhood issues. And I’ve been working in early-childhood for the last six years with working with childcare providers every single day to make sure that they’re prepared for and able to respond to and recover from emergencies and disasters. So, I’m delighted to be here. And hopefully we can share a few tips with your listeners today.

SPREEUWENBERG: 

Interesting, that’s quite a unique background: a firefighter and went to law school. And all the combination of experiences really brings together a unique perspective, I guess. And just to touch on one final point there: You had all this great experience and you could have applied it in any sector or field. Why did you choose early-childhood education?

ROSZAK:

Well, to be honest, I always look for the opportunities where I can make the most impact and the most difference. And I had just seen a glaring need to make sure that our most vulnerable –our youngest of the young and the folks that work every day to serve them – have all the information and resources and tools that they need.

And when you look at emergency preparedness planning, kind of across the sectors, early-childhood is always one that struggles to get information. As you know, we’re sometimes forgotten about. And public schools and regular 9-to-5 type jobs get a lot of attention and a lot of resources. But sadly, the early-childhood education folks, we don’t get the same kind of attention. And I think that’s a really big gap.

And I’ve written extensively about the topic and published several articles and everything about it. But when we think about who really is on the front lines and what the impact of those first few years of life really do to the rest of our lives, it’s just so important to make sure that our early-childhood professionals have the tools that they need to be prepared and protect those young ones that are in their care.

SPREEUWENBERG: 

Yeah, absolutely. And we’re going be spending some time talking about COVID-19 and pandemics. Before we get too deep into that conversation, in a more regular context and setting what would you normally support childcare organizations and early-childhood education programs with when it comes to emergency preparedness?

ROSZAK:

So, it’s been really weird with the pandemic. Normally every single week we’re out in childcare programs and Head Start programs throughout the country. So, to not be on an airplane and not be with the many of you in your facilities has been really odd.

We do a comprehensive emergency preparedness planning so we can help you develop your plan; we can help you review your plan; we can help you do exercises with your plan. We have, I think, the only active shooter preparedness program in the entire country that’s devoted and developed specifically for that early-childhood workforce.

I’ve also published a book through Griffin House and Kaplan on preschool preparedness for an active shooter. So, for the past couple of years, we’ve actually been out and we’ve trained over 19,000 early-childhood professionals on active shooter preparedness and response, making sure their facility is more secure, implementing those safety protocols to really beef up security.

So, day-to-day we’re working with programs across the country. We’re very lucky to have a partnership with the National Environmental Health Association and with the Region 2 Head Start association.

And in addition to all the preparedness work, for the last two years we’ve had staff in the U.S. Virgin Islands and Puerto Rico detailed to the health departments there, working with childcare providers and programs that have been impacted by the devastating hurricanes that happened – Irma and Maria.

So, we are looking at all aspects of emergency preparedness, again, from getting your plans prepared and developed to testing them through exercises and drills, all the way through response and recovery. So, we’re really the one-stop-shop for all things early-childhood emergency preparedness.

SPREEUWENBERG: 

It’s interesting because you would think that having some type of emergency preparedness plan would be, like, a requirement for early-childhood education programs. How does that work in terms of that being… is it a requirement in some states or jurisdictions? Or is it more sort of like a recommendation? Does it have any impact on things like accreditations? Just curious to know.

ROSZAK:

Yeah, so, many jurisdictions, when you go through licensing, you do have to have an emergency plan. And certainly if you look for the golden standard [in terms of] caring for our children, it is recommended to have an emergency plan for these kind of situations.

However, what we find is that early-childhood professionals – and even the folks at the state level or the licensure level – they’re not experts in emergency preparedness, nor can we really expect them to be. That’s not really all that fair. So, what we find most of the time is that the plans are not well conceived, they’re not well written and they’re certainly not grounded in any kind of operational reality.

So when we come in, we have that expertise that helps kind of bridge that gap and allows you to really develop a plan that’s meaningful, that’s actually workable in the real world and impactful. So, yes, there are many requirements for plans. It depends what kind of licensure you fall under.

And again, it’s going to be different if you’re a Head Start program. If you’re an after-school program, if you’re a family childcare provider, if you’re a center-based provider, it’s going to be a little bit different. But most of the time there is some kind of requirement to have a plan.

What we’ve found is, a lot of times people are just looking and saying, “Well, do you have a plan or not?” And it’s kind of a yes or no, a binary decision versus looking into the details of the plan and saying, “Does this really make sense? Will this really be something that can help you in your darkest hour, in your time of crisis?” Because, as we know, the more prepared we are ahead of time, the better it’s going to be, that the time to write your emergency plan is definitely not in the middle of the emergency.

SPREEUWENBERG: 

Yeah, yeah. It’s kind of the difference between checking the box on having the plan versus the quality of the plan. That makes a lot of sense. And of course, times like this are when we’re reminded of how important it is to have a quality plan.

So, let’s make that segue into the pandemic. And so, interestingly, you said you had some experience with pandemics previous to COVID-19. Let’s start with the initial response in the childcare and early-childhood education community. How did we do? Did we do the right things? Are we doing the right things relative to what you would have expected to see?

ROSZAK:

Well, I do think that it’s been a little bit of a rocky start and some of that was just based on the information – or rather the lack of information – that we were getting. So, this is a brand new virus. It’s a “novel” virus, one that we’ve never seen before in human-to-human transmission. So, from a science standpoint, there’s a lot of things that we didn’t know at the beginning. And quite frankly, there’s a lot of things we still don’t know.

But it’s interesting that, legally, the power really for the health and welfare of citizens is vested at the state level. So, what you’ve kind of seen and what is really expected is that actions are going to be taken differently by different states. This is why licensing, whether it’s an attorney, a doctor or a childcare center or a tattoo parlor, licensing really comes from the state level.

So, what you have is essentially 50 different states and then the territories able to kind of do their own thing. And I think we definitely saw that play out across the country as some states really went to extremes and locked down and in many cases closed childcare altogether, where, as we even sit here today, some states have said, “Well, you’re a private business. You do what you think is best,” and have offered really little guidance and then little structure on what childcare providers should be doing.

So, I will say it’s been interesting just to see the other industries, how they’ve responded to this. And if you start thinking about the grocery stores and even if you start thinking of something as extreme as a jail, jail is probably one of the most controlled environments that we have in this world as far as limiting people and stopping people from moving around and all that. And as you’ve seen, there’s been many, many outbreaks in jails across the country and even some jails that have chosen now to release prisoners because they can’t control the outbreak.

So, I think it’s interesting to note, if we can’t control coronavirus in a jail, which is a very controllable environment, it’s a real challenge for us to be able to control an outbreak in a childcare program.

SPREEUWENBERG: 

And so on that note, and while we have you on the show here, we’d be interested to hear some of your tips. So some states, like you said, have been more flexible, let’s say, and have encouraged businesses to open back up now or soon. And there’s also a lot of childcare programs out there that may be providing childcare services for essential workers that are out in the field so bravely right now. What’s your tips for those folks if you’re currently operating at some capacity or planning to or are open in terms of managing your center during this pandemic?

ROSZAK:

Well, I think the first tip is that if you are able to stay closed, if parents are able to care for their kids at home, that’s definitely the safest thing that we can do right now. And to be brutally honest with everybody, this pandemic is not going to go away anytime soon. And until we have either a vaccine or a cure or really widespread testing, we’re going to kind of be in this altered state of reality. And that’s just the way it’s going to be, to be completely honest and transparent with you.

I will say I totally get and I totally appreciate those that are on the front lines. I’ve advocated for you and will continue to advocate for you to get hazard pay because I think you need to be recognized and acknowledged for the work that you’re doing to keep your communities up and running. I’ve been excited to see a few states now start to actually provide incentive payments for those that are remaining open.

But make no mistake about it, if you are remaining open right now, it’s not an easy time. And as much as you’re going to try to prevent the spread of coronavirus, your odds are you’re probably going to run into it. We have about 50% of the population that gets infected with coronavirus that shows no signs or symptoms. So it’s very, very hard to detect. And that’s one of the reason we really need to get more screening out there, more testing.

I was asked by some leadership in New York, New Jersey and Connecticut to help them put together some guidance for programs that were going to be open and programs that were going to serve essential workers. So, I did that that’s available now on our website. It’s a 28-page document; it’s very, very comprehensive. It’s way beyond what you see from some of the state or some of the federal resources in that we actually get into operational issues about, what should you really be doing at your program? So, that’s free to grab off our website. I hope everybody takes advantage of that because it’s a really good resource.

But if you are open, you really want to limit access into your building. You want to limit, you want to really control that environment. This is not the time to be having delivery people; this is not the time to be having parents. It’s not the time to be having visitors. And I know this is going to be a change that many of us, we let the parents come all the way into the program and all the way back into the classroom and drop the kids off each day and then the same process for picking the kids up.

There’s been a lot of studies that have been done. There was just one that came out recently in the last few days looking at affected areas of the hospital. And what they found is about half of the ICU staff – so, the nurses and doctors that work in the intensive care units – actually had coronavirus on their shoes and they were tracking it to all sorts of different areas in the hospital, like the pharmacy.

And the pharmacy is obviously not seeing coronavirus patients but it tested positive for the presence of coronavirus. And what they found is that doctors and nurses and everybody are picking this up on their shoes and now they’re spreading this all the way throughout the hospital.

In the same token, for us, we have to make sure that we’re limiting access because the more people we let in, the more potential exposure, the more potential contamination that we have. So, I think for right now, for pickup and drop-off, we have to stop parents at the front door. We have to meet them outside and take the kids, from the outside and then bring them into the program.

And also, what you want to do is really get your ratios down as low as you possibly can. If you can get it to one teacher and three or four kids, that’s really good. But just recognize, those are going to be kind of your [coronavirus] “buddies” and you’re going to be with them throughout this pandemic.

We don’t want to see a lot of mixing. So, we don’t want to see kids on the playground playing with each other; we don’t want to see kids go into the cafeteria all at once and eating together, all those kind of activities that bring everybody together as a group. Temporarily, we have to stop those to keep our ratios really small and keep our group separated. That way, it prevents the spread of this virus throughout the facility and throughout the community.

SPREEUWENBERG: 

That’s a very interesting story with the nurses tracking around the virus on their shoes. This is the kind of information, like you said, we still don’t know a lot about this novel coronavirus. And that’s one of the things that is new information for me, is just how easily it can be tracked around through different materials, including somebody’s shoes.

So, it sounds like certainly your advice as to err pretty aggressively on the side of caution. And if we can stay closed, that’s the best thing to do right now. If we’re open, we should take every precaution possible. And this resource that you’ve created sounds phenomenal. Usually we wait till the end of the episode to share a website but I want to make sure that our listeners can get access to this. So, your website, it’s www.ChildhoodPreparedness.org? Is that right, Andy?

ROSZAK:

Yes, sir. And if you go on www.ChildhoodPreparedness.org we have a special coronaviruses pages stood up. We have one in English and we have one in Spanish. So, on there you’ll find a whole host of resources, the guidance document that I just mentioned as well as we have a whole host of online training that you can take on coronavirus. We’ve got one on mental health considerations for coronavirus, one on domestic violence for coronavirus, one on food safety in the time of coronavirus.

And we’ve got a couple more coming about restarting your program and what to look at when you do start to think about those decisions as well as the legal concerns. And I’ll say, as an attorney, I’m constantly kind of tracking where the lawsuits are coming from. And we are seeing a pretty disturbing trend right now of businesses being sued because people have either gotten sick or, unfortunately, they’ve died as a result of the coronavirus. There was one that was just filed against Wal-Mart a couple weeks ago. I’ve seen now some New York-based nurses associations have filed against some of the hospitals.

So, I just want to put that out there: this is not without risk. If you are running a childcare program right now and caring for kids, legally there’s some risk here. And I’m pretty certain that your insurance is probably not going to cover you on some of these claims that are coming in. It’s definitely a conversation you need to have with your insurance carrier.

And if you have a lawyer that helps you out I would definitely take a moment and call your lawyer. But you really should be considering, for the parents that you are serving, having them sign some kind of liability release so that they can’t come back later try to hold you liable if they get sick or their kids get sick or if your staff members get sick.

So, there’s a whole bunch of operational considerations and then there’s a whole bunch of also kind of these legal issues. And we can talk about H.R. [human resources] issues about how this virus is impacting folks that have immunocompromised diseases and chronic conditions and the elderly.

There’s a lot of H.R. issues, too, about if you have staff that fit that criteria. Quite honestly, for their health and safety, they shouldn’t be working right now. And normally we can’t just tell people that are old, “Hey, don’t come to work,” because that’s discrimination. So, when we start to wade into some of these H.R. issues, there’s a lot of legal issues that can also pop up in that realm as well.

SPREEUWENBERG: 

That’s super, super useful information for our listeners. And for all of you out there, please, listen to this advice and action it. The point that Andy made about a liability release could be very material for you because who knows what’s going to happen? And I think, especially in early-childhood education, everybody has their heart in the right place and is trying to do what’s best for their families and their kids. But you also have to watch out for yourself.

And if you’re trying to help out your families by staying open, if they’re working in a central services, for example, you should strongly consider getting this liability release or talking to an expert lawyer and talking to your insurance company to check out your coverage. Very good tips there from Andy.

We’re quickly running out of time, Andy. Any last thoughts for our listeners out there in terms of dealing with everything we’re dealing with right now?

ROSZAK:

Well, again, I just want to caution everyone that this isn’t going to go away in the next couple of weeks. So, prepare for the long haul. There’s a very good chance that this is going to be around through the rest of 2020 and maybe even in the 2021. If we think about historically, there’s not a lot of events we can compare this to, except for the 1918 Spanish flu, the big influenza that killed 50-plus million people across the country.

And I think it’s important to just recognize that in the Spanish flu of 1918, the biggest death toll came in that second wave. So, they actually had three waves: they had the beginning wave, they had the second wave – which [had] the highest death – and then the third wave. And I’m a little bit concerned, as a lot of public health folks are, about that second wave potentially coming this fall, especially if we have a bad flu season. We know last year the flu season was pretty bad, it killed a lot of kids.

So, the social distancing that you see is going to be around for a while. I think we need to just acknowledge that. And I really want to make sure that you’re mentally prepared for that. So, I’d encourage you to take our courses. We’ve got the mental health course that talks you through mental health for you, mental health for your staff, what to look for kids when they start coming back to your program. So, how do we return to some sense of normalcy for kids? And then how to talk to parents as well. So, that’s the mental health course.

The reopening considerations course gets into a lot more of these legal issues and a lot more operational issues. We also have a whole bunch of downloadable resources within the course. So, you can get, like, a sample liability release, a sample policy document, those kinds of things. What we’re trying to do all we can to help everybody out.

But I want to make sure everybody’s taking time [to do things such as] spend 30 minutes [to] go outside for a walk, get some fresh air; try not to watch the television nonstop and try to limit some of your exposure to the TV coverage because this is going to create a whole new post-traumatic stress disorder among us, to be honest with you. We’re all impacted by this. We don’t know when this is going to end. For those of us to like to be in control, this can produce a lot of anxiety.

So, I want to make sure that everybody is trying to stay as healthy as you can. If you need help, don’t be afraid to reach out. We’ve got a lot of people going through this, 180-plus countries. We’re all going through it together. If you need to talk, there’s no shame in that. So, please make sure you use those resources that are at your disposal, your networks, or even some of the help lines that have been set up.

But the main thing is, thank you so much for helping your community. Thank you for doing all that you do for the children. We want to make sure that you’re as safe as possible and we’re here to help in any way that we possibly can.

SPREEUWENBERG: 

Yeah, that’s a great advice there, Andy. And thanks for sharing that and addressing that point. And you know what, it really brings it all together because this is a challenge in terms of our mental health. It creates a lot of stress, a lot of anxiety. And one of the best ways to deal with stress and anxiety is being prepared and having a plan. And so to the extent you can start to think about some of these things and, as Andy pointed out, we might be in this state for a while. So, the more prepared we can be, the better.

Andy, you’ve been the perfect expert for us to have on our show here today. Thank you so, so much for joining us and sharing all these wonderful, wonderful resources with our listeners, including your website, which I’ll remind people is www.ChildhoodPreparedness.org. Andy, thank you so much for joining us on the show!

ROSZAK:

Thank you very much, it’s been a pleasure! And everybody stay safe and stay healthy out there!