SUPPORTING EARLY YEARS PROFESSIONALS IN PREPARING FOR RESPIRATORY ILLNESS SEASON

Nov 27

As the chill of winter settles in, so does the inevitable wave of respiratory illnesses that come with the season. From colds and the flu to COVID-19, navigating the complexities of illness prevention and response in childcare and educational settings can be challenging.

In this post, Heather Bywaters, RN, BScN, MN, from the Middlesex-London Health Unit, shares valuable insights and strategies to help professionals prepare for the season ahead. This blog post outlines general guidance on illness prevention, enhanced cleaning protocols, outbreak reporting and tips for supporting staff, children, and families during respiratory illness season.

The health unit provides information and guidance; however, please refer to your Centre's and/or organization's specific policies.

Currently, there are no recommendations from the Ministry of Health that specifically apply to Child Care Centres and other similar settings. To prevent the spread of colds, influenza, and COVID-19 in any setting, follow these recommendations:

Get vaccinated when you can. They are safe, effective, and the best way to protect you and those around you from infectious diseases.

Screen yourself daily for respiratory symptoms.

Stay home if you are sick; encourage other people to do the same.

Wear a mask in crowds to reduce your risk of getting sick.

Cough into your sleeve or your elbow.

Wash or sanitize your hands regularly with soap and water or alcohol-based sanitizers.

Follow your workplace masking and infection control guidelines.

Clean and disinfect high-touch surfaces and shared spaces more often and when visibly dirty.

Guidelines for Cleaning and Disinfecting Classrooms

Routine guidelines for cleaning and disinfection in your centre can be found in the Safe Healthy Children: A Health and Safety Manual for Childcare Providers (PDF) in the Infection Prevention Chapter. In this chapter, there is information about approved disinfectants and instructions for mixing different strengths of Chlorine (Bleach) solutions for different situations.

A Centre (or a network of Centres) can create their own enhanced cleaning protocols for respiratory Illness season, depending on their own unique situation and preferences (e.g., the frequency that you clean high-touch surfaces may vary).

Reporting an Outbreak

If you suspect an outbreak of illness at your Centre (i.e., when the number of sick children and staff is greater than your normal baseline level), call your Public Health Inspector or MLHU, at 519-663-5317, to speak to the Infectious Disease Control Team.

Report:

Gastrointestinal Illnesses

When there are two or more children and/or staff with gastrointestinal symptoms such as vomiting and/or diarrhea within a 24 – 48-hour period.

Respiratory Illnesses

When the number of sick children and/or staff who develop symptoms within a period (usually 24 - 48 hours) exceeds what is normal or there are multiple cases in different classrooms.

For more details about reporting an outbreak, see November EYO e-Newsletter.

Symptom Monitoring and Response

We are often asked, “What is the difference between cold and flu?” Their symptoms can be very similar; however, colds usually resolve without serious complications. In addition to the most common flu symptoms that adults experience, children may present with croup, ear infections, nausea, vomiting, and diarrhea. These symptoms are uncommon for adults. Here is a chart comparing flu and cold symptoms.

Current practice is to consider cold, flu, COVID-19, and other such viruses as a grouping under the banner of “Respiratory Illness”. Therefore, we refer to fall and winter as “Respiratory [Illness] Season.” It really does not matter which virus is causing symptoms in the individual, unless that person is at higher risk for complications related to COVID-19 or influenza.

Key symptoms that should be monitored for children and staff include:

Fever,

Cough,

Runny nose,

Congestion (nasal and/or chest),

Generally unwell,

Joint or muscle pain, and/or

Behavioural changes, such as being unable to participate in normal activities.

There are no longer protocols or safety measures that apply exclusively to COVID-19. In most cases, the recommendations for respiratory symptoms are the same, with the intent to prevent or minimize the occurrence of all respiratory diseases.

Completing the COVID-19 screening tool daily and following the recommendations provided can minimize illness in your Centre this season. Ideally, staff will self-screen and parents should screen their children every day.

If a child or staff member has respiratory symptoms, the COVID-19 screening tool will direct them to stay home (self-isolate) until:

Symptoms have been improving for at least 24 hours (or 48 hours for nausea, vomiting and/or diarrhea) and

There is no fever, and

No fever-reducing medications are being used, and

No new symptoms appear.

When all four of the conditions above have been met (i.e., self-isolation has finished), for 10 days after the day symptoms started:

Wear a well-fitted mask in all public settings (including school and child care)

Avoid non-essential activities where you need to take off your mask (i.e., playing a wind instrument in music class or removing your mask for sports or dining out)

Avoid visiting anyone who is immunocompromised or may be at higher risk of illness (for example, seniors)

Avoid non-essential visits to highest risk settings such as hospitals and long-term care homes.

Currently, there are no recommendations for COVID-19 testing, unless the individual is considered at high risk. Please keep an eye out for updates from the Ministry of Health.

Vaccination Information

Flu (Influenza Vaccine):

The flu vaccine is recommended for everyone 6 months of age and older. It protects against several strains of currently circulating flu viruses.

The vaccine is safe, even for children and pregnant individuals

The vaccine is free even if you do not have an Ontario Health Card

It is important to get the flu vaccine each year because the vaccine is updated based on trends and the latest evidence.

Children 6 months to under 9 years of age who have never received a dose of flu vaccine are recommended to have two doses at least 4 weeks apart.

COVID-19 Vaccine:

Children can begin receiving COVID-19 vaccine starting at 6 months old. The vaccines are safe, effective, and are the best way to protect your child and those closest to them from COVID-19.

Where to get Respiratory Vaccines in Middlesex-London

*These vaccines can be given at the same time, same day or before or after any other vaccine dose (i.e., COVID/flu vaccines, RSV, routine vaccines).*

If your health care provider does not offer these vaccines, , or you do not have a health care provider, you can visit a local pharmacy. Pharmacy locations offering vaccines can be found at https://www.ontario.ca/vaccine-locations

Health Education for Children and Families

The health unit has up-to-date information on healthunit.com that can be used to educate children and families about respiratory illness prevention.

COVID-19

FLU (Influenza)

Parents with questions are also welcome to call 519-663-5317 to speak to a public health nurse, Monday to Friday, 8:30 am to 4:30 pm.

If you would like to discuss a situation with a public health nurse or inspector, email: EarlyYearsOutreach@mlhu.on.ca or call 519-663-5317.

Remember – your Centre’s policies are important! The health unit provides information and guidance; however, well-written policies provided to families upon their child’s enrolment make expectations clear and help decrease illness in the centre.

Staff Health and Well-being

This guidance is important for protecting vulnerable staff or children who may be at higher risk of complications. Some folks cannot be vaccinated; others are vaccinated, but their immune systems are compromised and may not benefit from the same level of protection.

It is important for you to find the time to take care of you. Providing care and education for groups of children can be stressful, especially during times when there is illness circulating in the community.

Seek out activities that help you to relax and reduce stress. Try to make them a part of your everyday routine. The more you practice techniques like deep breathing, muscle relaxation, mediation, and yoga, the more effective they will be to help you to manage your stress. Alternatively, spend time outside in nature by going for a walk, talking to a friend, taking a bath, and/or doing something creative you enjoy. Both the College of ECEs and Strive have curated some great opportunities.

Try to prioritize getting enough sleep. Being rested helps you deal with stressors that are sure to come your way.

Consider your nutrition. Think about what your body needs to function at its best.

Ask for and accept help when you need it. Speak to your employer or find resources here: Mental health support: get help - Canada.ca.

Contingency Planning

Contingency planning in childcare is difficult right now. We acknowledge that many centres must cope with insufficient staffing and staffing challenges become worse during respiratory illness season. We know there are limited supply staff. Centres that belong to a network of sites can negotiate temporary staff transfers, but sometimes a room or even a Centre must be closed.

Strategies that prevent illness and promote health and wellness are the best approach to minimize health-related disruptions during respiratory illness season. Communicate with your families – honestly, early, and often – to help minimize surprises and service disruptions.

Ensure your policies are up to date and cover all potential scenarios:

What would you have to do if various numbers of children and/or staff became ill?

What happens when a “room” needs to be closed?

How are decisions made?

How might families whose children are not sick be affected and what can they do?

Respiratory illness season is an annual event that cannot be avoided. All we can do is learn from previous experience and share best practices. Please reach out if you need information or have questions.

We wish you the best of health,

Early Years Outreach at MLHU

For more information: