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Stephanie Gray has owned and managed the Books & Bibs Child Development and Learning Center for three years.
In January, she had a nearly full house, with 60 children from infant- to preschool-age children, enrolled at the Eastside day care. By April, she was down to 12, the children of parents who were considered essential workers.
Since then, her numbers have fluctuated as the State has dialed back restrictions and some parents have returned to work or received subsidized child care as part of their unemployment benefits. Recently, Gray had 54 children coming in regularly, which she said might soon grow to her capacity of 62 now that she’s reopened the infant room.
Running the child care center during the pandemic has been more of a math problem than ever for Gray with numbers shifting daily as she was forced to lay off employees, maintain child-to-caregiver ratios, limit class sizes and follow state rules for spacing, and balance her budget in the face of rising food and supply costs.
In the midst of it all, Gray became sick but was relieved when she tested negative for the COVID-19-causing coronavirus.
But her biggest concern, she said, is that no matter how much she sanitizes and maintains social distancing protocols to prevent the spread of coronavirus, a child could get sick.
“If a kid comes in here with it, there will be no defense against that,” Gray said. “And my biggest worry is that a parent will be concerned that they have it, don’t say anything to us, then go get tested, wait for four or five days, the results come up positive and the whole time the child has been coming back and forth every day.”
If that happened, “I may have to shut down my whole center,” Gray said. “I don’t know.”
In those cases, the Centers for Disease Control (CDC) currently recommends child care centers close for two to five days and then sanitize. “But the whole asymptomatic thing is scary because what if we just haven’t had symptoms?” Gray said. “It just makes me nervous … that it would affect the whole center.”
Nationally, in April, 60 percent of child care centers closed their doors altogether, at least temporarily during the initial onslaught of the virus.
In Texas, centers began to reopen in mid-May and provide child care services to everyone, not just essential workers. But by June 30, there were 950 reported positive cases of COVID-19 – 643 staff and 307 children – at 668 centers across the state, according to Texas Health and Human Services data.
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The Luv-n-Care center on the far North Side has not had any reported cases of the virus among its staff or children, said Sandra Nunez, regional director of Luv-n-Care, even though it has remained open throughout the pandemic. A screening process that follows CDC guidance is in place. However, low enrollment has made keeping the doors open a challenge.
With capacity for 314 children, infants to 12-year-olds, and 45 to 50 caregivers, Luv-n-Care recently had only 130 enrolled, an increase from a low of about 40 during April and May.
Many of the children’s parents work in the South Texas Medical Center area as teachers and administrators in area schools and in law offices and businesses that have permitted employees to work from home since March, Nunez said.
School starting this fall could pose another set of challenges, she said. If school-age children don’t return to their classrooms this fall, attendance may be lower than usual in the center’s after-school program. If children participate in distance learning, Nunez will have to accommodate that schedule and provide the necessary resources for kids in their care.
In the meantime, Luv-n-Care’s assessment for Texas Rising Star accreditation, which was put on hold in March, has been delayed until further notice due to the pandemic. Rising Star is a quality rating and improvement system for Texas early childhood programs. Of the more than 500 licensed day care centers in Bexar County, only 8 percent have earned Rising Star accreditation.
In a region with already limited quality child care centers, the pandemic’s impact on the economy and jobs has forced some to close completely, said Judy Ratlief, director of education for the United Way of San Antonio and Bexar County, who oversees the agency’s support of child care centers.
Almost all have had to lay off staff and are now struggling to rehire qualified caregivers as their enrollments increase and as the virus spreads within the community, she said. Without enough caregivers, a child care center must carefully monitor child-to-staff ratios.
“Every child care center that we have contacted is very proud of the fact that they are able to serve their families and, particularly, the essential workers,” Ratlief said. “They are doing everything they’re asked to do, and the standard of excellence for cleanliness for the childcare centers is very, very high.”
But a shortage of day care openings persists. When the state allowed child care centers to open to nonessential workers in May, a mandate that requires lowered ratios left some families in the cold, waiting for an opening.
The strain on child care centers extends to their basic operations as well, with directors working to limit the sharing of teaching resources, toys, and supplies, reworking schedules, creating new activities, rerouting foot traffic inside the center, washing garments multiple times a day, and wearing gloves and face masks. Purchase limits at local stores meant Gray couldn’t purchase enough milk without enlisting her friends for help.
Most noticeable at day care centers is the change to drop-off and pickup procedures which involve strict health screenings and social distancing before a child is admitted.
When Mona Ortiz de Coronado drops two of her four children at the International Children’s Academy in Stone Oak, she uses an app on her phone to answer screening questions and check the children in for the day and feels confident they are safe. “They’re going way [above] and beyond,” she said.
In April, Coronado kept her children home for about three weeks to make room for the kids of essential workers, at the request of the center. But her 3-year-old and 2-year-old are now attending regularly and eager to be there, she said. A 10-month-old stays home with her because he’s still nursing. But her 14-year-old daughter, also at home, is looking forward to returning to school in the fall, she added.
School attendance is a question on many parents’ minds and thus the topic of every single patient visit in Dr. Richard Schlosberg’s pediatric practice recently. A few weeks ago, he said, it was all about child care outside the home.
“Day care for some families is not a choice, it’s a necessity,” Schlosberg said. “What that means to parents is they must make sure the day care is screening employees and attendees daily.”
For children ages 4 and up, quality child care programs provide cognitive and social benefits that are important for healthy development, he said. Judging whether or not it’s safe during this pandemic is based on science.
“It appears with the data we have now on COVID that child-to-child transmission is less likely in children and adolescents as compared to their adult counterparts,” Schlosberg said. “Children get less sick with this virus compared to adults – the symptoms seem less severe. There appears to be less transmission.”
However, for infants and toddlers, and for those parents with the option, Schlosberg said, keeping kids home and away from others is the healthier choice.
On Friday, the American Academy of Pediatrics walked back earlier guidance advocating for schools to reopen this fall, stating, “Returning to school is important for the healthy development and well-being of children, but we must pursue reopening in a way that is safe for all students, teachers, and staff.”
Testing is not provided at Schlosberg’s practice, ABCD Pediatrics, which has five offices. But several young patients have tested positive elsewhere for the virus. Most have had mild symptoms and made full recoveries, he said.
When parents ask Schlosberg about testing their child for coronavirus, he reminds them that test results will only result in knowledge, not treatment. And the trauma of a nasal swab test may not be worth it unless someone in the household, such as an elderly grandparent, is at particular risk.
Meanwhile, as parents struggle to make the decisions that safeguard their children from the virus, kids who attend the Books & Bibs center appear to be adjusting well to heightened restrictions and screening protocols.
Gray called the children “chameleons” in their ability to adapt to all the changes. And because parents aren’t permitted inside the center, that means fewer distractions as the staff is able to devote more time to the children.