ChildCareStrongNC Public Health Toolkit Updated

As the pandemic evolves, the North Carolina Department of Health and Human Services is committed to providing the most effective and appropriate public health guidance for the current phase of the pandemic. The best tools right now are getting vaccinated, getting boosted when eligible, wearing a well-fitting mask, testing after exposure, and staying home when sick. ​ 

An important tool for slowing the spread of COVID at earlier points in the pandemic has been formal contact tracing – identification, notification, and guidance by local public health authorities for individuals who have been exposed to COVID-19. While contact tracing remains important in certain high-risk settings, such as long-term care facilities and homeless shelters, formal contact tracing is a less effective tool in other settings, such as child care facilities because:

• New more contagious COVID-19 variants have emerged which have shorter incubation periods.
• People with infections are most contagious prior to the start of their symptoms and during the first few days of illness. 
• Many individuals who have COVID-19 do not have symptoms and have less severe illness.
• Many infections are never identified by local public health departments because individuals with asymptomatic or mild cases may not get tested, and more people are using over the counter at-home tests.

Together, these factors limit the effectiveness of contact tracing to reduce transmission. The impact of individual contact tracing on transmission may be particularly limited in settings where layered prevention measures are in place. Therefore, the February 21, 2022, update of the ChildCareStrongNC Public Health Toolkit now reflects that individual contact tracing and exclusion from child care after an identified exposure are no longer a statewide requirement or recommendation. DHHS and DCDEE are changing strategies to better balance prevention efforts with the goals of supporting and providing access to quality early care and learning, allowing parents and caregivers to get back to work.

Although exclusion from child care is no longer required following an exposure, child care programs should continue to notify potentially exposed children and staff. This is particularly important for settings that do not have other layered prevention strategies, such as universal masking, in place, and therefore have a higher risk of viral spread.  ​  

The February 2022 edition of the ChildCareStrongNC Public Health Toolkit includes the following updates:  

• Page 3: Public health guidance section revised as background information for the rest of the edits in the Toolkit.
• Page 5: Mask wearing exemptions provided. 
• Page 8: Promotion of the no-cost at-home testing option included.
• Page 10: Individual contact tracing and exclusion from child care programs of asymptomatic people after an identified exposure is no longer recommended statewide in child care settings. 
• Page 10: Guidance for identifying individuals exposed to COVID-19 has been updated.
• Page 10: Summary Table for Returning to Child Care revised to include revised guidance for exclusion and isolation. 
• Page 11: Scenarios related to individuals who are been exposed have been removed. 
• Glossary: 
• Terms “contact tracing” and “variant” were added.
• Isolation and quarantine definitions were updated to match current guidance.

The ChildCareStrongNC Public Health Toolkit will go into effect on February 21, 2022. If you have questions about these updates, please contact your child care health consultant.