How Childcare Centres Are Preventing the Spread of Illness

Episode 16: How Childcare Centres Are Preventing the Spread of Illness

On this episode of the Adeona podcast, Tracy and Zoe discuss all things relating to common daycare illnesses. Learn more about Adeona’s sick children policies and procedures for handling illnesses and exposure at our centers, as well as how you can help prevent the spread of illness in your center.

This episode covers:

Exclusion periods, policies and procedures for common childcare illnesses
How a childcare’s sick policies, procedures and guidelines are developed
The average illness amount for children in care and how long it takes to build up that immunity
The policies and procedures in place to prevent the spread of germs and illness in an early childhood education centre
Why child care services give a time limit for sick child pickup
What parents and caregivers can do to help prevent the spread of illness in childcare centres

How Our Childcare Health Policies are Determined

Our policies regarding illness, exclusion periods and how we manage certain illnesses within the service is dictated by the Staying Healthy document, which is produced and updated annually by the NHMRC (National Health and Medical Research Council). Likewise, we work closely with our Public Health Units who are managed by Queensland Health.

How We Manage & Prevent Illness

We follow a range of policies and procedures at Adeona to help prevent the spread of germs and illness, which are all informed by government sources and Queensland Health.

This includes the frequent cleaning and sanitizing of carpets, rugs, door handles, surfaces, and high-touch places. Likewise, if children are seen with a toy in their mouth, immediately after that child is finished with that toy it gets picked up and put in a bucket to be sanitised.

Additionally, if an early childhood education centre has more than 3 cases of gastro, that must be reported to the public health unit. The public health unit then performs an investigation, which includes working with the service to track which rooms the illnesses are in to ensure correct hygiene procedures. The public health units then advise the centre to help work through those processes, which often results in the service being advised to increase exclusion periods from 24 to 48 hours to ensure no one is returning while still contagious.

Helpful Links

Thank You

We’d love to hear from you! If you have any feedback, suggestions or questions about anything we discussed in this episode, please feel free to reach out – tracy@adeona.com.au.

Our Early Childhood Education Centres

Coorparoo | Mitchelton | Noosaville | Mackay

Podcast Transcription

Zoe (00:11):
Thank you for joining us for this episode of our podcast. You’re with Zoe and Tracy. We would just like to start by acknowledging that we are coming to you today from Yuggera and Turrbal land and we’re actually recording in NADOC week. So we would also just like to acknowledge that there is a significant gap in health outcomes for Aboriginal and Torres Strait Islander people in Australia. And we at Adeona are trying to support any government initiatives that look towards increasing the outcomes for our first nations people. So today we are also recording an illness podcast because at the moment in Queensland, we are heading into what they’re saying is possibly our third wave of COVID. And we’re also sitting smack bang in the middle of possibly the worst flu season we’ve seen in quite some time. And also what is also being recognized by a lot of health professionals is the fact that some of our younger children here at the center have been in isolation for a couple of years. And so haven’t had the extensive exposure to germs, which is interestingly causing them to be a little sicker I’m finding this year than normal. I don’t have statistics on that yet, but from being on the floor, we’ve definitely noticed a lot more illness going around, Tracy. Would you say that’s the same for most of the, Adeona’s?

Tracy (01:31):
Yeah, the same for everywhere. We have centers from Mackay all the way down to Brisbane and everyone of the centers is experiencing the same issues.

Zoe (01:39):
Yep. Children and adults. So it’s across the board. So just to start off, we thought, we’d look at some statistics that are, are available to us. There is a study by Ferguson and he looked at the Australian bureau of statistics around childhood illness in care. And what he found was that the main illnesses that occur in early childhood are respiratory and gastroenteritis. So gastroenteritis has a whole group of different illnesses that fall into that, but we’ll just group them together because that’s normally how it is presented to us. That research was then followed up by some studies by Wald, Augustine and Collins and they’re three separate studies that looked into what the average illness amount for children in care was. And they all found that the average amount of illness for most children is around six respiratory illnesses a year. So that didn’t include a lot of the other illnesses that we do see such as gastro, hand foot and mouth, conjunctivitis and general childhood illnesses.

Zoe (02:42):
So it’s a significant amount of illness that you can kind of expect. And their studies found that that starts to improve after a child has been in care for three years. So it’s a lot of exposure over a long time that builds up that immunity so that by the time they get to school, hopefully they don’t hit as much illness as they do in early childhood. So we thought we would today talk through some of our policies, how we manage illness here at the center, and just some other anecdotal bits and pieces that we have stumbled across over the many years of running childcare centers. So Tracy, I’ll hand over to you about, I guess, our policies and exclusion periods and things like that.

Tracy (03:19):
Sure. I think probably the most important thing for families to know is that our policies regarding illness, exclusion periods, how we manage certain illnesses within the service is dictated by what we call the illness Bible. It’s the staying healthy in childcare document. It gets updated every couple of years. I believe that they’re reviewing it currently ready for our next update. Um, obviously they probably need to put some COVID material in there, um, which hasn’t been in previous versions and we work closely with our public health units. Public health units are managed by Queensland health and they manage a region. So there’s a south public health south side unit. There’s a north side one. Um, so each sort of council region almost has their own public health unit. So for your standard run of the mill colds, coughs, respiratory illnesses that, Zoe mentioned that all children get quite frequently.

Tracy (04:18):
We have guidelines within that book about, you know, if that illness produces a fever within a child, how long that child has to be excluded for from when they have that fever, their last fever or gastro from when they have their last vomit or loose bowl movement. So generally with those sorts of common illnesses that go around in our community, it’s a 24 hour exclusion period since the last time they registered a high fever. So it’s not from when they start the fever, it’s from when the fever has broken and not returned, 24 hours from then, and same with gastro. So the last time though, they have their last vomit or their last runny bowel movement. So they have to have all of that under control for 24 hours before they’re allowed to return to care. However, at the moment, given how heightened things are in their health space, or if say in a service we have, if it’s more than three cases we have to report like, so if we have more than three cases of gastro, for example, we have to actually report that to the public health unit.

Tracy (05:20):
And then they will generally advise they will do a bit of an investigation. We have to track what rooms the illnesses are in. So they can see that we are following proper hygiene procedures, and know if we are helping stop the spread or increasing the spread of the disease and advise us to help us work through those processes. So once we’ve had more than three gastro cases or cold / flu in the center, we contact public health and generally nine times out of 10, they would advise us increasing that exclusion period to 48 hours just to make sure that nobody’s coming back to the service while they are still contagious. Now, obviously the center then relies on parents being really vigilant and honest in terms of that, so that we are not making more families and little ones and staff members unwell.

Zoe (06:13):
Yeah. Just talking about that quickly because I guess part of the reason why they try and send that a little bit too is because for particularly our youngest children, sometimes it’s really hard to pick up when they are ill and by the time they actually get a fever or have the bowel movements or gastro some extent, they’ve already been infectious for a period of time before we even get to that point. So by extending that a little bit, that just gives us a little bit more breathing time as well, to make sure we are getting on top of potential, extra illness outbreaks.

Tracy (06:47):
Yeah, absolutely. With a lot of these illnesses, it’s the two weeks leading up to the beginning of symptoms that is they’re actually at their most contagious. And so, yeah, definitely a great point. And I guess probably that this is a good point to sort of also mention that even if your child isn’t showing symptoms yet, but you can tell that they’re a bit off, they’re not their normal selves. If you’re having to give them Panadol to send them to care, to get them through the day, it’s probably a sign that maybe you should just keep them home, see what’s happening, that they could be coming down with something. We would certainly, you know, if they’re unwell enough to require Panadol, to be able to come to the center, even if it’s just for teething or something, they’re not gonna have a great day. They’re not going to be able to, you know, yourself when you’re, you’ve got a toothache or you’re feeling unwell.

Tracy (07:33):
You just wanna be home with the ones that you love for some extra snuggles and cuddles and children are the same. So probably if you can see that they’re looking a little glassy eyed, a little run down, you know, they’re crying because their teeth are hurting, whatever. It’s probably a good sign just to try and keep them at home today. If you can. I also wanna take this point now though, to acknowledge, we understand how hard it is for working families to be able to take time off what feels like continuously for some families with their little ones. Especially if you’ve got a couple of kids in care and they keep getting it one after the other, we really wanna acknowledge that we understand how hard that is and that it’s not easy, but unfortunately it is part and parcel of, of having children in care. And if it doesn’t happen now, as Zoe said it will happen when they start school. And so, you know, unfortunately there’s not a lot we can do to change that, but I really do wanna acknowledge that we do understand it is difficult and we don’t like making those phone calls saying, oh, you have to leave work to go and get your child.

Zoe (08:28):
And as much as we try to encourage children to, you know, have sneeze etiquette and cough etiquette, our little friends are not so great at not sharing their germs. So <laugh> yeah. Um, they like to be close to each other and share lots of things like toys. So yeah, we, we try to be vigilant with that, but of course it’s not a hundred percent full proof if we remove items once they’ve been touched or, or licked by children, it’s still not a hundred percent foolproof. So they, you know, lots of germs do spread around.

Tracy (09:00):
That’s right. That’s right. And that probably leads me into my next part about what Adeona does to sort of manage and prevent illnesses. We do have a lot of policies and procedures, as you can imagine, that dictate, you know, that if we see a child with a toy in their mouth, that immediately when that child has finished with that toy, that toy gets picked up and put in a bucket to be sanitized. Pillows, rugs, clean frequently, door handles and high touch places are constantly being sanitized, wiped down, warm, soapy water everywhere. Once again, those policies and procedures come from government sources, Queensland health, so that we know that we are doing the right thing, using the right products and staying on top of it. So it’s certainly not something that we are lax about at all. And we are very thorough and we are very vigilant in making sure that those policies are followed even coming down to the way when we change nappies, how the gloves are.

Tracy (09:55):
And the nappies disposed of are very particular methods that are used to try and keep everybody safe. So looping back to our exclusion periods with illnesses, I sort of mentioned that for fevers and gastro symptoms, it’s 24 hours or 48 hours. If there’s a bit of an outbreak. For other illnesses, we use our staying healthy in childcare document. So I know that hand foot and mouth is currently doing the rounds at some of our services. And so there’s a different exclusion period for that. We look up the illness, this little book has most common illnesses in it. And we pull out the fact sheet nine times out of 10, we’ll share that fact sheet at the time that we know that that particular illness is circulating in the center so that parents know what to look out for. And then the exclusion period for hand foot and mouth is until all the blisters are dried. So they don’t have to be disappeared, but they have to be dry. They can’t be any gooey ones on there

Zoe (10:53):
Just on that point as well. Sometimes we are not a hundred percent sure about some of the illnesses. So we will sometimes especially like things like hand, foot and mouth because children get all kinds of rashes. Sometimes we

Tracy (11:05):
They present in many different ways. Yeah.

Zoe (11:07):
Yeah. So sometimes we will also suggest to families to reach out to their doctor just to get a check to see if it is or is not what we suspect it is. Hand foot and mouth is probably the one we get the most where we will say, look, we think, but, um, we are not doctors, so <laugh> please just go and get it checked.

Tracy (11:26):
Yeah. And if we’re unsure too, we may also ask that if you could go to your doctors and get a clearance with some illnesses to come back as well, and I really want to stress as much as reasonable that your child also has, even though they may have a, doctor’s a clearance they have, the child has to be happy and well within themselves as well. Childcare is not necessarily the place to come when you’re needing a lot of rest. Obviously we provide that opportunity, but it can be hard. And so if they are really needing to rest their bodies and recuperate, then home’s probably a better place for them.

Zoe (11:58):
Yeah. On that. It’s probably really important to point out as well to families that I guess the government does really recognize the amount of illness that children can possibly get while they’re in childcare. <laugh> and that’s why in a typical year you get 42 absences. And at the moment it’s 52 because of COVID. But typically it’s 42. And I really encourage parents to, if you get medical certificate while your child is off ill, then we will put that into their file. Because if you get to that 42 days of allowable absences, and you start going past that the government will consider giving you additional days off. If you have medical certificates to back up that your child’s been sick

Tracy (12:42):
And they have increased those days to 52, I think I read the other day until June, 2023 on the understanding that a lot of people are having to have at least seven days off with the current COVID situation. The other thing that you might have read in our policy regarding illness is that we have a timeframe. So say your child does start showing symptoms while they’re at care, which happens. And we understand that we will give you a call to let you know. And once again, we can say, look, we know that this is going around the center. The symptoms are consistent with that. Or we might say, look, we don’t know. Please take them to the doctor. As Zoe said, we are not doctors, we can’t diagnose, we will ask that you come and collect your child within an hour.

Tracy (13:30):
Obviously when we call you and you say, oh no, I’m two hours away. If we know, you know, we can work with that. But we ask that you get there or get someone to come and collect the child as soon as possible. Because once we’ve identified, your child is ill, for two reasons, we want to give them one on one care. So firstly, we want to take them away from the other children and staff members so that they are not spreading, whatever is going on for them. We’d like them to just keep those gems to themselves as much as possible. So we’ll try and if they’re, you know, sit them somewhere on their own with a staff member, not on their own, on their own, with a staff member in the room or they’ll make, come and sit in a director’s office with a staff member or a couple staff members, it’s different for each service.

Tracy (14:15):
And so there’s the other thing too, is obviously that child is unwell, they don’t wanna be in a room full of other noisy children. Generally they’ll fall asleep, those sorts of things, and home is just a much better place for them. The reason why we’ve put the hour time limit on it too, is that because we are giving them one-on-one care with an educator at that point, and the way that our services are set up is that we can’t do that for an extended period of time. So we can’t give one on one care for four hours until the end of the day or something like that. So after that hour time, we’re having to call someone else into the service and that fee covers their wages or covers the cost that’s incurred from having to provide one on one care.

Tracy (15:01):
So that’s the reason why we have it set up like that. And most parents do wanna get there as soon as possible and make all sorts of arrangements. And we do appreciate that. But we just wanted to explain why we ask within the hour and it’s just because we have a staff member that then comes off of ratio to be with your child and make sure they’re getting the care that they need. And as you can imagine, if we’ve had a gastro case in the center, it’s all hands on deck, someone’s cleaning up the mess, another person’s attending to your child, getting everything ready to go home. So it can be a little hectic as well. But also just for the wellbeing of your child, the best place for them is at home where they can rest and not have everything going on around them.

Zoe (15:42):
And that’s also a really important reason why you should keep your emergency contacts up to date with us as well. In case we can’t get in contact with you because you might be in a meeting or, you know, on a flight somewhere or anything

Tracy (15:54):
That’s right. Just didn’t hear your phone ring. It happens a lot. Yes. That is absolutely why we need those emergency contacts. Or even if you can’t get away for work, so you’re sending grandma, we need to have grandma’s details beforehand so that we can legally release that child to grandma or granddad. Zoe is there anything else about illness that I have yet to cover?

Zoe (16:13):
I guess the one thing to kind of point out is that these illnesses don’t magically manifest within the center, they do come from the community. So if you are hearing stories of gastro in the community or hand foot and mouth in the community, it’s kind of that time for you maybe to be a little bit more vigilant when you’re out and about in the space as well, because they do come from somewhere else, not from within the center. Obviously people catch it once it’s in the center, but you know, it doesn’t just magically appear in the center on its own.

Tracy (16:46):
And that’s why we do make requests and we have it in policies for parents to come in and wash their, and their children’s hands ondrop off. And I’d highly recommend washing your hands again on the way out the door <laugh> between you and me. Um, but also include siblings in that. Quite often we have children that are dropped off with older siblings that are at school who come in and they play with the toys and everything as their brother or sister is being dropped off. And a lot of these illnesses, we’ll hear about them being in the primary schools and then a few weeks later they’re here and so that’s the way it flows. With your gastros and things like that, not so much hand foot in mouth, because that is something that people generally get in early childhood. And then you sort of meant to be immune to it.

Tracy (17:27):
You’re meant to only be able to get it once I heard of cases. <laugh> um, and this is the thing we’re not doctors, there’s always exceptions to the rule, I guess. Um, and probably the only other thing that I just like to point out, and I know that everyone’s aware, but I think it’s a great time to sort of remind everyone too, is that, you know, while your child might be able to handle a cold and carry on, we have a number of vulnerable children and vulnerable staff working with us who have every right to be at the service and participating in care as well. And these things can be a lot more serious for them. And that’s why we have to be vigilant and have to be really on top of these things as well, to protect every member, you know, children who haven’t had the opportunity to be vaccinated yet, children who have other medical conditions that make them vulnerable, we’re caring for all of them in our services.

Tracy (18:18):
And so while for your child, it might be just a cold other children. It can be a lot more serious than that. Probably just going off on a tangent now, but probably also a good time just to sort of feed a little bit into our immunization policy as well. And we will probably do a podcast on immunization, especially as we move into this new world with COVID and what vaccinations will, and won’t be required for that. But also with that, if that illness that comes into the center and we do at, we do have a policy where all have our children have to be vaccinated or on a government vaccination plan, or they can have a medical exemption. So that is how we operate with that. If we do get a, an illness within the service, that is one that you can be vaccinated against, that’s fine because all of our children should be vaccinated, but it might be that if your child is not yet eligible. So I know chickenpox I think it’s 18 months.

Zoe (19:17):
Yeah, we just had that recently here. So we had an outbreak of chickenpox and the room that it was in the children were not that age yet. But we informed families and so then they made the choice to go and get that done a little bit earlier than they were due to.

Tracy (19:31):
Yeah, absolutely. And so we’ll always let families know so that if your child is extra susceptible or if you have someone that’s vulnerable at home, they may choose not to send their child for that period. Once again, that’s what you have the 42 day absences for, and you can always talk to the service if you have any concerns or questions about those sorts of scenarios as well. Once again, those sorts of situations are reportable to public health, we’re on the phone a lot to public health. And so they will also advise us as to what to do and what advice is out there because we won’t be the first people calling them. They’ll be aware that these diseases are out in the community and they’ll advise us as to what to do. I think that that’s everything. I hope that we’ve demystified some of our policies and procedures and, you know, acknowledge your frustration when it feels like you’re having to have every second week off work to be at home with your littlies.

Tracy (20:27):
You know, I remember when I started, there was a lot of rules about whether your snot was green or clear as to whether you come <laugh>. Um, I think we’ve all sort of landed in the last few years that snot is snot and you shouldn’t be here if you’ve got any, and things like that. But it is really just looking at your child and saying, are they well? And if not, then they probably need to be at home. So yeah. Thank you everyone for listening. I hope that this has been informative. And if you do have any questions about your center’s illness policy, please just ask your director. And if they can’t answer it, they’ll follow it up to me and we’ll get an answer for you. So thank you very much.

How Childcare Centres are Preventing the Spread of Illness